Neurocritical Care Fellowships
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 ACGME and UCNS accredited 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
- 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
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.
The Stanford Neurocritical Care Fellowship program is a ACGME and UCNS accredited 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
|3.5 Neurocritical Care ICU,
1.5 Neurocritical Care ICU, KPRC
2 Medical-Surgical-Neuro ICU, SUH
1.5 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
Stanford Neurocritical Care program currently has nine faculty neurointensivists:
Karen Hirsch, MD, Division Chief, Neurocritical Care
Lucia Rivera Lara, MD, MPH, Neurocritical Care Fellowship Program Director
Anna Finley Caulfield, MD, Neurocritical Care Fellowship Associate Program Director
Marion Buckwalter, MD, PhD, Professor
Hannah Louise Kirsch, MD, Clinical Assistant Professor
Prashanth Krishnamohan, MBBS, MD, Clinical Assistant Professor
Zachary Threlkeld, MD, Clinical Associate Professor
Chitra Venkatasubramanian, MBBS, MD, Clinical Professor
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.
Throughout the two-year fellowship, fellows receive education through daily bedside teaching rounds and weekly didactic lectures. Lecture topics by faculty reflect the below core curriculum. Examples include: ventilator management, sepsis, post-cardiac arrest care, intracerebral hemorrhage, EEG in the ICU, acute ischemic stroke endovascular trials, and transcranial doppler, among many others. During the fellows first year of training, fellows receive bedside transthoracic ECHO teaching. Fellows are expected to present at conferences including journal club, difficult case conferences, morbidity & mortality (M&M) conferences, and ECHO conferences. Fellows also receive a copy of the UCNS core curriculum for self-study.
General Core Curriculum
- Obtain understanding of the following:
- Cerebrovascular anatomy
- Physiology of cerebral blood flow, metabolism and intracranial pressure
- Pathophysiology and treatment of increased intracranial pressure, altered cerebral blood flow states and coma
- Neurological examination techniques, including examination techniques for a comatose patient
- Neurosurgical and neurology imaging techniques
- TCD monitoring and interpretation
- EEG application in the ICU
- EVD management and sampling
- CSF diagnostics
- Various neuro-monitoring techniques and their use in guiding hemodynamic therapy
- Ventilator management for brain injured patients
- Hemodynamic management for patients with brain or spinal cord injuries including fluid resuscitation and vasopressor therapy
- Airway management with special focus on patients with reduced level of consciousness, cranial nerve impairment and patients with traumatic brain, facial and cervical spine injuries
- Sedation regimens, scores, weaning and special considerations in neurocritical care patients
- Special considerations of pain management in neurocritical care patients
- Management of fluid, acid-base, and electrolyte disturbances
- Management of nutrition including routes, indications and ability to create basic nutritional plan
- Basic infection control risks, strategies to prevent and treat ventilator associated pneumonia, urinary tract infections, central venous line infections and surgical wound infections; demonstrate basic knowledge of antibiotic therapy, groups of antibiotics, neuro-specific considerations e.g. CSF-penetration
- Specific considerations for patients with coexisting critical illness, e.g. ARDS, and intracranial pathologies
- Endocrine consequences of pituitary tumors
- Brain death
- Ethical considerations for end-of-life decisions
- Exhibit safe order writing and closed-loop communication
Apply the above knowledge for the diagnosis and treatment of patients with:
- Coma, including post cardiac arrest
- Herniation syndromes
- Acute hydrocephalus
- Moderate and severe traumatic brain injury (Subdural and epidural hematomas, hemorrhagic contusions)
- Ischemic and hemorrhagic strokes
- Administration and management of intravenous thrombolysis or intra-arterial therapies with Neurointerventional team
- Cardiogenic brain embolism
- Large vessel cerebral atherosclerosis
- Management of patients pre and post CEA or stenting
- Aortic arch cerebral and spinal embolism and spinal infarctions
- Small cerebral artery occlusive disease
- Hemodynamic brain ischemia
- Hereditary and acquired hypercoagulable states, including antiphospholipid antibody syndromes
- Disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, other hematological disorders
- Substance abuse and drug toxicities
- Hypertensive encephalopathy/Posterior Reversible Leukoencephalopathy Syndrome
- Cervical and intracranial artery dissection
- Vasculopathies including genetic (i.e. Moya-moya), inflammatory (i.e vasculitis), and infectious
- Cerebral venous thrombosis
- Genetic and metabolic disorders
- Aneurysmal subarachnoid hemorrhage and vasospasm
- Vascular malformations (AVM, cavernous malformations, fistulas,etc)
- Indications for surgical management of brain ischemia and hemorrhage
- Encephalitis/meningitis/brain abscess
- Acute neuromuscular illness
- Peri-operative care after neurosurgical or interventional neuroradiology procedures
- Concurrent critical medical or surgical illness
- Complications of vascular disease, including raised intracranial pressure, sepsis and venous thrombosis
- Management of extra-ventricular drains and multimodal monitoring
- Seizures and status epilepticus
- Neurological complications of pre and post organ transplant patients
Our NCC Fellows
Lia C. Franco, MD
Dr. Lia Franco is a neurologist originally from Ecuador. She completed her medical degree at Universidad San Francisco de Quito and pursued her residency in Neurology at Tulane University in New Orleans, LA. During her residency, Dr. Franco received several honors, including the "Golden Plunger Award" for fastest tPA administration during her PGY2 year. She was also recognized with the “Outstanding Humanitarian and Patient Advocate Award” on two occasions and received the Leon Weisberg Award for Excellence in Clinical Teaching. Dr. Franco served as chief resident and actively contributed to the wellness committee. Driven by a passion for advancing healthcare in Latin America, Dr. Franco seeks to create a career in Global Neurocritical care.
Sung (Dave) Jeon, MD
Sung Dave Jeon is one of the neurocritical care fellows at Stanford. He studied English and Neuroscience at Amherst College, where he graduated Magna Cum Laude. He subsequently acquired his medical degree at the University of Rochester School of Medicine and Dentistry, and completed his residency in neurology at the University of Colorado School of Medicine. He has a background in liberal arts with experiences in palliative care and clinical research, which ranges from deep-brain electrophysiology, behavioral psychiatry, as well as management of status epilepticus and low NIHSS large vessel occlusion strokes. Some of his favorite hobbies include hiking, reading, wine tasting, and going to the dog park with his roommate Kaia, who is one judgmental Shiba Inu. He fell in love with neurocritical care in medical school and residency for its high acuity environment, complexity of cases, and interaction with patients and families.
Aaron Kaplan, MD
Aaron is a neurocritical care fellow at Stanford. He received his undergraduate degree at Washington University in St. Louis, where he studied English Literature, Psychology, and Creative Writing. He discovered his love of medicine after graduation, and attended the pre-medical postbaccalaureate program at Columbia University, where he stayed on for medical school at the Vagelos College of Physicians & Surgeons. He completed his neurology residency at Weill Cornell, where he was accepted into the education track and received the Resident Teaching Award for Excellence in Education. He intends to use his humanitarian and educational interests to emphasize shared decisionmaking and palliation in the intensive care unit. When not practicing neurology, Aaron illustrates for education and theater, studies Narrative Medicine, and expands his practice as a home chef.
Hena Waseem, MD
Diversity & Inclusion
Stanford Neurocritical Care strongly values diversity in our faculty, staff, and training programs, and we are focused on recruiting and supporting individuals from all backgrounds. We encourage unique and diverse perspectives which enhance our clinical, research, and education missions. Faculty from the division serve on the Department of Neurology Diversity and Inclusion Committee, and trainee membership is welcomed.
Candidates who are exploring Stanford for fellowship are encouraged to attend the Diversity Reception and Socials that are hosted by the School of Medicine's Office of Diversity in Medical Education (ODME).
Other helpful links include:
NCC Fellowship Alumni
"I chose the Stanford Neurocritical Care Fellowship for its excellent clinical training, ample research opportunities (and flexibility to conduct research even during busy fellowship time), and the truly supportive environment to grow as a neuro-intensivist. The unique fellowship structure—consisting of primarily medical ICU blocks (as a MICU fellow) in the first year, followed by dedicated time and experience in the neuro-ICU in the second year-- exposed me to a breadth of illnesses and diseases, and created a phenomenal learning environment. The support, friendship and learning from both neurology and critical care colleagues of various backgrounds and disciplines further enhanced my learning experience during fellowship. I feel extremely well-trained and prepared as a neuro-intensivist. Through fellowship and now as faculty, I continue to draw on the knowledge and training I acquired during fellowship and apply them consistently in current clinical practice and teaching."
"My Neuro ICU fellowship training was not just a training program, but rather an educational experience enriched with opportunity to prepare us to provide compassionate, high-quality patient care with a focus on a multidisciplinary approach. I was given a well-rounded experience to manage the most complex and highest acuity patients in both the medical and neuro intensive care units. During my time at Stanford, I felt confident in building relationships with my mentors who then supported me as I began my practice. My fellowship exceeded my expectations and the educational experience was unparalleled. Working with the most forward thinking, distinguished physicians, encouraged me to not only challenge myself to take an active role in evaluating literature, but to also find ways to contribute to a successful research program. I really could not imagine any other type of program that has the same caliber mentorship and education as the one at Stanford and which also fosters such an incredible atmosphere for learning and growth."
|Spencer Craven, MD
|Neurocritical Care Medical Director and Neurointensivist at Saint Alphonsus (Boise, ID)
|Varun Shah, MD
|Neurointensivist, Kaiser Permanente (Redwood City, CA)
|Nick Murray, MD
|Neurointensivist, Intermountain Health (Salt Lake City, UT)
|Sandeep Walia, MD
|Neurointensivist, John Muir Health (Walnut Creek, CA)
Kassi Kronfeld, MD, MS
|Clinical Assistant Professor, Harbor UCLA Medical Center; Director of Inpatient Neurology; Associate Stroke Director (Torrance, CA)
Jack Wang, MD, PhD
|Instructor, Stanford University School of Medicine (Stanford, CA)
Basit Rahim, MD
|Neurointensivist, Mission Viejo Hospital (Mission Viejo, CA)
Adam Rizvi, MD
|Neurointensivist, Sound Critical Care (Tucson, AZ)
Prashanth Krishnamohan, MD
Clinical Assistant Professor, Stanford University School of Medicine (Stanford, CA)
Gracie Mui, MD
Clinical Assistant Professor, Neurology and Critical Care, UConn Health; Co-director, UConn Health Stroke Center (Farmington, CT)
Kyle Hobbs, MD
|Neurointensivist, Intermountain Medical Group (Salt Lake City, Utah)
Pablo Bravo-Valenzuela, MD
Assistant Professor of Clinical Neurology, Yale School of Medicine (New Haven, CT)
Reza Pirsaheli, MD
|Neurointensivist, Mercy Medical Group (Sacramento, CA)
Mohamed Talib, MD
|Endovascular Neurologist, Banner Health (Phoenix, AZ)
Charlene Chen, MD
|Neurointensivist, California Pacific Medical Center (San Francisco, CA)
Duane Campbell, MD
Vascular Neurologist, Lakeland Regional Medical Center (Lakeland, FL)
Edgar Samaniego, MD
Clinical Assistant Professor, University of Iowa Hospitals and Clinics (Iowa City, Iowa)
|Chitra Venkatasubramanian, MBBS, MD
Clinical Professor, Stanford University School of Medicine (Stanford, CA)
|Anna Finley Caulfield, MD
Clinical Associate Professor, Stanford University School of Medicine; Program Director, Neurocritical Care Fellowship (Stanford, CA)
How to Apply
The Neurocritical Care Fellowship Program participates in SF Match’s Candidate Application System (CAS). Applications can be submitted through CAS beginning January 3, 2023.
Documents to Include:
- SF Match application
- Curriculum vitae
- Personal Statement
- Three letters of recommendation, including one from your residency program director
- Medical school transcript
- USMLE transcripts
- Recent photograph
- If applicable, ECFMG Certificate (transmitted by NBME) *
* At this time, the Neurocritical Care Fellowship Program can only sponsor fellows on a J-1 clinical visa.
January 3, 2023
Applications submitted via SF Match
February – March, 2023
Candidates invited for interview days (virtual only for 2023 cycle)
March 3, 2023
April – June, 2023
Candidate interview days
August 3, 2023
Rank lists due
August 10, 2023
July 1, 2024
First day of fellowship
Program leadership conducts a holistic review of candidate applications. We encourage applications from candidates who identify as underrepresented in medicine based on factors such as race, ethnicity, socioeconomic status, abilities, and sexual orientation/gender identity. We seek highly qualified candidates who would be inquisitive, dedicated fellows.
Applicants invited to interview with the program will be notified via email by Program Coordinator Haihong Nguyen. After reviewing information about our program, if you wish to speak with a specific faculty member on your interview day, please inform Ms. Berland and she will make arrangements for you and the faculty member to speak either on your interview day or at another mutually convenient time.
All interviews for the 2023 recruitment season will be conducted virtually using the Zoom video platform.
Thank you, once again, for your interest in our program.
We look forward to reviewing your application!
"I chose the Stanford Neurocritical Care Fellowship for its robust clinical volume, broad pathology exposure, and strong culture of community amongst residents, fellows, and faculty. The clinical experience provides learning from the best in the field: we rotate as independent fellows under the MICU, SICU, and NeuroICU attendings. The Stanford ICU has a good balance of bread and butter as well as cryptic cases. In addition, as fellows, we help run clinical trials, currently we are sub-investigators on over 15 national trials. This involvement in clinical trials, combined with ample support for fellow-led research, enables us to make significant investigative contributions. Finally, there is excellent support for training and implementing high-performance quality improvement projects, which many of us have taken part in. Overall, I feel both prepared and excited to take my learning from fellowship as I transition to a future academic neurointensivist position. I deeply value the community and relationships at Stanford and I would strongly recommend the fellowship."
Employment and Health Benefits
We offer extensive benefits and bonuses to program fellows.
Additional Benefits and Bonuses**
Moving bonus for incoming fellows ($3,000)
Housing stipend in addition to annual salary ($7,200 per year paid out monthly)
Annual cell phone allowance ($1,000)
Annual educational bonus ($2,000 with timely completion of administrative training modules)
Attendance at one national meeting second fellowship year (paid by Division)
1% annual bonus based on completion of a Quality Improvement project
Cost of initial California medical license and renewals
Cost of initial DEA license and renewals
On call food allowance for clinical shifts of >12 hours
Uber for fatigued trainees
Physician coats and laundry services
Caltrain Go Pass (free rides on commuter train that runs the length of the SF Peninsula)
Access to Stanford University athletic facilities (gyms, pools, climbing rock, golf)
Back up child/elder care program (80 hours per year)
Medical, dental, vision, life, and disability insurance plans are available to fellows. Retirement savings plans are also now available.
* Effective as of September, 2022
** Note: Amounts subject to change
- 15 days vacation/PTO per year
- Up to 5 days conference attendance
- 20 days sick leave
- 6 weeks maternity leave
- 1 week paternity leave
Committee on Advanced Subspecialty Training (CAST) Neurosurgical Neurocritical Care Fellowship
Conceived in 2021 and enrolling its first fellow in 2022, the CAST Neurosurgical Neurocritical Care fellowship offers a year of dedicated training in neurocritical care enfolded into the Stanford Neurosurgery Residency. The fellowship is certified by the Society of Neurological Surgeons (SNS). The fellowship focuses on developing expertise at the interface of neurology, neurosurgery, and critical care. Fellows work closely with faculty and other fellows within Critical Care Medicine, Surgical Critical Care, Neurocritical Care, and Stroke Neurology.
The Neurocritical Care service at Stanford was conceived in 2001 and provides 24-hour clinical coverage of the Neuro-ICU, the emergency room, and the other intensive care 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 clinical activities, Stanford Neurocritical Care and Neurosurgery each have long histories of experience and success in performing clinical trials and basic science research. As one of the leading neuroscience 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 neurocritical care and neurosurgical faculty members participate extensively in this research mission.
Graduates from the one-year enfolded CAST Neurosurgical Neurocritical Care Fellowship are ready to practice at the unique interface of neurosurgery and neurocritical care. Fellows are ideally positioned for future leadership in multidisciplinary academic neuroscience units.
The CAST Neurosurgical Neurocritical Care Fellowship is a one-year SNS-certified fellowship enfolded into Neurosurgery Residency. Education is focused broadly on general critical care, surgical critical care, neurocritical care, stroke neurology, anesthesia/airway management, procedural competency, and palliative care and medical ethics. In addition to didactic and clinical components, fellows are encouraged to pursue clinical or translational research and quality improvement, and fellows have protected time to complete this work.