Neurocritical Care Fellowship Curriculum

Clinical rotation are structured in one week block to allow balance between continuity of care and academic work.

During two years of training, 52 weeks in 20 bed Neuro intensive care unit (NICU) at Baylor St Luke’s medical center forms foundation of clinical training. This core rotation in NICU provides comprehensive training in management of diverse acute neurological pathology including acute ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, status epilepticus, neuromuscular emergencies, brain tumor and infectious diseases. Fellows take home call during nighttime with in-house support of senior neuro resident and advance practice providers.

Mandatory electives include four weeks in neurotrauma ICU at Ben Taub Hospital, which is tertiary care level I trauma center and 4 weeks in cardiovascular anesthesia at Baylor St Luke’s medical center for airway management.

Fellowship provides ample time (44 weeks) for independent electives. Elective rotation includes subspeciality intensive care unit (MICU, SICU. CCU), research elective with faculty mentorship, EEG and neurophysiology and Interventional neurology.

Structured didactics with focus on evidence based medicine is integral part of training at BCM.

“Introduction to ICU”,  a weekly lecture series in month of July & August (Friday 1-3 p.m.) is conducted multidisciplinary critical care medicine core faculty and includes topics of intubation & airway management, introduction to mechanical ventilation, advanced mechanical ventilation, management of shock, hemodynamic monitoring, ARDS and Sedation & Analgesia in ICU.

NICU conference,  two hour structured lectures  (1st and 3rd Wednesday, 1 p.m.)  from core faculty and internationally recognized invited experts in the field.

Multidisciplinary Critical Care conference, two hour monthly lecture series (September- June, 3, Tuesday, 4-6 p.m) focuses on more broader multidisciplinary (MICU, NICU, CCU, SICU) critical care topics .

Journal Club,  fellows driven monthly journal club (2nd Wednesday, 1 p.m.) to discuss most recent clinical trials in neuro and general critical care topics.

Board Review,  a monthly NICU board review (4th Wednesday, 1 p.m.) and general critical care board review in collaboration with MICU (2nd and 4th Tuesday, 2 p.m.) helps fellows in preparation for their eventual board certification.

Other didactics include monthly Neurovascular conference (1st Tuesday, 7 a.m.), monthly multidisciplinary critical care grand round (1st Wednesday, noon).

*currently all educational activities are offered via teleconferencing due to pandemic.

Training of procedure competency will be conducted through simulation center workshop (July-September) with focus on common critical care interventions. Fellows will practice direct and video laryngoscopy with endotracheal intubation, LMA placement, insertions of central venous and arterial catheters, fiberoptic intubation with bronchoscope, bronchoscopy, chest tube insertion, thoracentesis, paracentesis  and percutaneous tracheostomy.

Other workshops includes Point-of-Care UltraSound (PoCUS) which provides unique hands-on experience of bedside applications of portable ultrasound in critical care setting. Finally fellows will be provided structured exposure to certify in Emergency Neurological Life Support (ENLS) and Advanced Cardiovascular Life Support (ACLS).

Fellows are required to perform research during their fellowship. During first year of the training under guidance and mentorship of faculty, fellows are encouraged to present research ideas and interest. Based on presentation and discussion with core faculty, fellows submit formal research project for IRB approval.

All fellows are required to attend quarterly research meeting to provide  update and report on research progress.

Neurocritical care section at BCM is home to multiple multicenter clinical trials and space medicine research projects in collaboration with NASA. All core faculty have authored multiple papers, book chapters and provide editorial review to high impact journals. Fellows are encouraged to collaborate on this projects. Opportunities are provided for fellows to present their research at national and international conference. Fellows are expected to publish journal articles during their training.