Neurocritical Care

Neurocritical care is an evolving subspecialty, integrating clinical expertise in neurology, neurosurgery, and intensive care medicine to diagnose and treat critically ill patients with neurological disease. University Hospitals Cleveland Medical Center (UHCMC) offers a comprehensive Neurocritical Care Fellowship that provides physicians with a unique combination of cognitive, diagnostic and therapeutic skills necessary for the neurocritical care.

The purpose of the training program is to prepare the physician for the independent practice of neurological intensive care. Our approach is based on supervised clinical work, with increasing patient care responsibility over the course of the training program. The UHCMC fellowship program, affiliated with Case Western Reserve University School of Medicine, has a strong foundation of organized instruction in basic elements of both neurological and medical aspects of critical care.

Curriculum

Like all intensivists, the neurointensivist assumes the primary care role for patients in the ICU, coordinating both the neurological and medical management of the patient.

Therefore, the Core Curriculum for the UHCMC Neurocritical Care Fellowship Training is evenly split between neurological diseases and conditions and medical diseases and conditions that commonly complicate acute neurological illnesses.

Clinical Rotations

Our UHCMC program is a two-year fellowship that includes 12 months of ICU time in which the fellow functions as a primary provider of critical care. This includes eight months in the Neurological Intensive Care Unit and four months rotating in the other medical and surgical intensive care units. The remaining 12 months are dedicated to Neurosurgery and Stroke Service, Electives, and protected Research time.

Didactic Components

All fellows regularly attend seminars and conferences in neurology, neurosurgery, critical care, and neuroradiology. This includes a two-year multi-disciplinary critical care course that cover all aspects of intensive care medicine. Additional didactic exposure is available in neuropathology, neuromuscular disease, cerebrovascular disease, epilepsy and neurophysiology, pain management, and rehabilitation. All fellows attend periodic seminars, journal clubs, lectures in basic science, didactic courses, and meetings of local and national neurological societies.

Research

All fellows conduct clinical or basic research during the course of the training. There is tremendous support available at UHCMC and CWRU for developing research projects. Some of the Center's research projects are listed on the research page.

Annual Cleveland Neurocritical Care & Stroke Conference

Each year, we have gathered a distinguished group of world leaders to review advances in the diagnosis and management of acute stroke and neurocritical care in a two-day course. This conference has an innovative, informal, Rock and Roll-themed format so as to create an experience that is both educational and enjoyable. We also host the Annual CWRU Critical Care Bioinformatics Workshop designed to focus on advances in Health Information Technology and informatics. Third, we host our Annual CWRU TCD Ultrasound Workshop designed to provide a complete review of ultrasound principles, techniques, and interpretation. In 2010, we hosted the the 1st Annual Cleveland Music and Medicine Symposium designed to explore the fascinating intersection of music and the brain and music and health.

Trainee Duty Hours and Working Environment

Fellow duty hours are consistent with the ACGME requirements. Neurocritical care fellows do not take in-house calls.

Evaluation and Certification

Clearly defined procedures for regular evaluation of fellows knowledge, skills and overall performance, including the development of professional attitudes consistent with being a physician, are part of the fellowship. Fellows are evaluated on following areas: Patient, Medical Knowledge, Practice-based learning and improvement, Interpersonal and communication skills, Professionalism, Systems-based practice. Upon completion of the program, fellows will be eligible for certification in Neurocritical Care through the United Councils of Neurologic Subspecialties.

Trainee Qualifications

Neurological intensive care fellowship training must be preceded by the completion of residency training in neurology, neurological surgery, internal medicine, anesthesiology, surgery, or emergency medicine, in a program accredited by Accreditation Council for Graduate Medical Education (ACGME) or the Royal College of Physicians (Canada). An Ohio medical license is required.

Contact

For more information, please contact:

Michael A. De Georgia, MD, FCCM, FNCS
Director, Center for Neurocritical Care
Email: Michael.DeGeorgia@UHhospitals.org

Tarrika Allen
Academic Education Coordinator
University Hospitals Neurological Institute
216.844.3100
Email: Tarrika.Allen@UHhospitals.org