Neurocritical Care Fellowship

Stanford Stroke Center Neurocritical Care Fellowship


Since its inception in the year 2001, the Stanford neurocritical care program has provided unparalleled care for patients with critical neurologic illness. The neurocritical care team provides 24 hour clinical coverage of the neurocritical care unit, the emergency room, and the other inpatient units at Stanford, caring for patients with primary neurologic illness, neurological complications of systemic illness, and neurological emergencies. The diseases treated by a neurocritical care physician are broad, and include stroke, intracerebral hemorrhage, traumatic brain injury, brain injury after cardiac arrest, seizures, spinal cord injury, neuromuscular disorders, and many others.

In addition to the breadth and depth of the clinical activities, the Stanford neurocritical group has a long history of experience and success in performing clinical trials and basic science research. As one of the leading neurocritical care research groups in the country, there are numerous ongoing clinical trials in neurocritical care and robust basic science and translational research programs. Recognizing that the treatments of tomorrow are rooted in the research of today, all of the neurocritical care faculty members participate extensively in this research mission

The Stanford neurocritical care group is committed to rigorously training future generations of neurointensive care and vascular neurology physicians. The faculty work closely to focus on neurocritical care training for the neurocritical care fellows, vascular neurology fellows, surgical and medical critical care fellows, and Stanford neurology and neurosurgery residents and medical students as well. Graduates from our two year UCNS certified neurocritical care fellowship have gone on to work in a variety of practice settings and make significant contributions to the field.

Goals and Objectives of the Neurocritical Care Fellowship

Goals

  • Understand how to treat acute neurological emergencies and manage all patients in the intensive care unit who are neurologically critically ill or have a neurological complication
  • Learn the principles of general critical care medicine
  • Gain proficiency in procedural skills related to critical care medicine
  • Learn to prioritize and triage competing care needs
  • Develop expertise in the diagnosis, management, and prevention of vascular neurological disorders
  • Learn from the diverse neurological disorders seen in various patient populations
  • Gain an understanding of the process of clinical research and the critical evaluation of the literature
  • Acquire skills to teach neurology to medical students, interns, neurology residents, and physicians of other disciplines
  • Develop a sense of purpose with regard to ethical and humanistic aspects of care, with an emphasis on compassion and respect for patient-centered values

 

Anna Finley Caulfield, MD
Program Director, NCC Fellowship Program

Zachary Threlkeld, MD
Associate Program Director, NCC Fellowship Program

Objectives

Fellows learning objectives follow the ACGME core competencies of patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills, and system-based practice.

 

Rotations

The Stanford Neurocritical Care Fellowship program is a UCNS certified two-year education curriculum. While fellows care for neurologically critically ill patients throughout their two years of training, the first year of education is focused on general critical care medicine principles and in the second year neurocritical care principles are emphasized. The majority of clinical rotations occur at Stanford University Hospital; however, fellows also spend time at Santa Clara County Medical Center and Kaiser Permanente Redwood City Hospital. Fellows have in-house call during their Medical-Surgical-Neuro ICU blocks that is shared with the critical care medicine fellows (Anesthesia, Pulmonary, Emergency Medicine, and Critical Care Medicine). During their Neurocritical Care ICU rotations, fellows share home call with the vascular neurology fellows, but are expected to come in to the hospital to assist the residents and for potential endovascular acute ischemic stroke cases. Duty hours are tracked in MedHub and strictly follow UCNS and ACGME policies.

Year 1 Blocks*, Location

Year 2 Blocks, Location

5 Medical-Surgical-Neuro ICU blocks SUH
3 Neurocritical Care ICU blocks SUH
1 Surgical trauma block, SUH
1 Anesthesia block, SUH
3 Elective/research blocks

3.5 Neurocritical Care ICU, SUH
1 Neurocritical Care ICU, KPRC
2 Medical-Surgical-Neuro ICU, SUH
2 Neurosurgery, SCVMC
0.5 Clinic/ Teleneurology, SUH
1 Vascular Neurology, SUH
3 Elective/research blocks

* Total of thirteen 4-week block rotations per year

SUH = Stanford University Hospital
KPRC = Kaiser Permanente Medical Center, Redwood City
SCVMC = Santa Clara Valley Medical Center

 

Faculty

Stanford Neurocritical Care program currently has eight faculty neurointensivists:

Karen Hirsch, MD, Division Chief, Neurocritical Care

Anna Finley Caulfield, MD, Neurocritical Care Fellowship Director

Marion Buckwalter, MD, PhD, Professor

Chitra Venkatasubramanian, MBBS, MD, Clinical Professor

Prashanth Krishnamohan, MBBS, MD, Clinical Assistant Professor

Zachary Threlkeld, MD, Clinical Assistant Professor

Hannah Louise Kirsch, MD, Clinical Instructor

Jack Tzu-Chieh Wang, MD, PhD, Instructor

Fellows receive training and education in a multi-disciplinary method not only from neurointensivists, but also anesthesia and pulmonary intensivists, vascular neurologists, neurosurgeons, epilepsy neurologists, trauma-surgical intensivists, neurointerventionalists, and neuroradiologists.