Neurocritical Care Fellowship

Founded in 2012, the Neurocritical Care Fellowship is a one- or two-year program accredited by both the ACGME-and the United Council of Neurological Subspecialties (UCNS). Most fellows undertake two years of training; however, the one-year training pathway is available to trainees who have successfully completed another critical care fellowship or those with neurosurgical training prior to applying to our program.

Trainees will be part of our pioneering unique Multidisciplinary Critical Care Training Program, in which physicians from the specialties of Internal Medicine, Emergency Medicine, Anesthesiology, Surgery, Neurology and Neurosurgery receive advanced clinical training in an integrated environment. This innovative approach enables an expansive clinical experience supported by a collaborative learning environment. Our multidisciplinary training program employs a mix of hands-on clinical experience, interactive workshops, medical simulation, asynchronous and didactic education. In addition, our novel approach allows for significant academic productivity and advanced professional development that allows our fellows to become future leaders in Neurocritical Care.

Fellows will gain in-depth medical knowledge and technical skills necessary to care for critically ill patients with neurological conditions. Areas of focus include cerebrovascular diseases; neurotrauma; refractory seizures; post-cardiac arrest care; alterations in consciousness; central nervous system infections; neuro-oncology; and perioperative neurosurgical care; as well as general care of patients with sepsis, acute respiratory failure, and other forms of critical illness.

Mission Statement

The Neurologic Critical Care (aka Neurocritical Care) fellowship at UPMC is committed to providing superior clinical and academic training that delivers the highest quality care to critically ill and injured patients across the UPMC Health System, and that develops tomorrow’s leaders in Neurocritical Care. Our multidisciplinary and collaborative approach to research, education, patient safety, and quality is integral to this training and enhances the program’s ability to improve and innovate in each of these areas. We seek to select and retain a diverse group of highly qualified candidates and foster their academic career advancement through broad clinical experience, scholarship, leadership opportunities, structured professional development, and robust mentorship.

Application, Interviews, and Match

APPLICATION

Our program participates in the Neurocritical Care Society Fellowship Match via SF Match. Please visit SF Match Common Application Service for application requirements, deadlines, and submissions.

INTERVIEWS

Virtual interviews typically occur from February through June. Highly qualified applicants will be contacted by our Office of Education to schedule an interview date.

AFTER ACCEPTANCE

All trainees must obtain a graduate medical training license. We will contact successful candidates shortly after the match to begin this process.

Clinical Experience / Rotation Schedule

CLINICAL EXPERIENCE

UPMC has multiple subspecialty ICUs, including three Neuro-ICU settings totaling over 40 beds that provide care to a high volume and broad diversity of patients with neurological conditions. We work collaboratively with Neurosurgery, Neurology - including our renowned Neurovascular program, and Rehabilitation Medicine to provide advanced neuromonitoring and optimal management of patients to maximize recovery potential. What makes this program unique is its focus on both general critical care and advanced neurocritical care training, as well as the experience of training with a multidisciplinary group of fellows to facilitate cross-specialty education.

Trainees obtain hands-on clinical experience and advanced instruction in:

  • Management of patients with acute neurological conditions, shock, sepsis, acute respiratory failure, acute kidney injury, multisystem organ failure, traumatic injury, post-surgical critical illness, and other critical illness syndromes.
  • Pathophysiology of critical illness, including advanced neurological monitoring, cardiopulmonary physiology, hemodynamic monitoring, and cardiopulmonary resuscitation.
  • Communication and team leadership skills, including patient and family interactions, end-of-life care, and collaborative team management.
  • Mechanical ventilation, extra-corporeal life support, intracranial neurological monitoring, and point-of-care ultrasound.
  • ICU procedures including endotracheal intubation, bronchoscopy, central venous catheterization, and chest-tube placement. Fellows have primary airway management responsibility for their patients requiring intubation.

CLINICAL ROTATIONS

YEAR 1

The year is divided into 13, four-week blocks. Trainees in the 2-year training program receive eight blocks of critical care training with a neurological focus and five blocks of rotations in other specialty ICUs or general critical care training. Fellows qualifying for a 1-year fellowship program have their rotations individualized to meet specific training requirements and preferences.

YEAR 2

The goal of this year is to achieve mastery of critical care skills and knowledge as well as academic development and expansion of leadership skills. Clinical requirements are less, and fellows are permitted to schedule their ICU clinical time in 1 – 2 weeks blocks instead of by 4-week blocks. This gives greater flexibility to pursue academic interests and provides a schedule that is more like an attending intensivist. Fellows are matched with a mentor who shares their scholarly interests and are also encouraged to schedule their clinical time with their mentor(s). Second-year fellows also work with their academic mentor to complete a scholarly project in quality improvement, education, or research. Opportunities for more advanced research training are available through one of our NIH T32 awards.  Rotations during this year include:

  • Research/Scholarly projects/Professional Development - 8 blocks
  • Neuro-interventional OR Post-Cardiac Arrest Service - 1 block
  • Cardiothoracic ICU - 1 block 
  • Neurotrauma ICU - 1 block
  • Neurovascular ICU - 1 block
  • NICU Leadership (i.e., work as a junior attending physician) - 4 weeks
Research, Scholarly Activities, & Educational Highlights

RESEARCH and OTHER SCHOLARLY ACTIVITY

The Department of Critical Care at UPMC is one of the most academically productive research programs in the nation, and the faculty is made up of leaders that are advancing the specialty. Opportunities for fellows to participate in research activities, scholarly projects, or advanced training in clinical leadership or education are extensive and reflect the breadth and diversity of critical care medicine. These opportunities lay the foundation for future academic career development. The program assists fellows in identifying appropriate mentorship teams from CCM faculty, other University of Pittsburgh departments, or external institutions as needed in order to achieve their goals. Examples of the opportunities available include:

SPECIAL ACTIVITIES

Unique educational activities include:

  • Hands-on simulation workshops including difficult airway management, central venous catheterization, chest tube placement, neurological device management, mechanical circulatory support,  point-of-care ultrasound, and more.
  • A three-day Critical Care Communication Course providing state-of-the-art training in end-of-life discussions with family members
  • Weekly interactive lectures in which trainees learn from our own renowned faculty, complemented by an online learning management system to help with asynchronous learning.
  • Weekly department-wide educational conferences including Grand Rounds featuring national and international experts in Critical Care, as well as fellow led Journal Club presentations and Morbidity & Mortality conferences.
  • Critical Care Leadership and Professionalism Course – Essential faculty development for fellows to facilitate the transition from fellowship to attending. The course features job search and negotiation skills, research and teaching skills, understanding business and leadership in healthcare, and additional topics in professional advancement and personal well-being.
  • Annual Mitchell P. Fink Scholar Day for fellows to present their QI, education, and research projects.
Professional Development and Mentorship

The MCCTP program is proud of our professional development and mentorship program that features professional tracks, structured mentorship and mentor selection, and opportunities for advanced education.  Such professional development is vital to success in medicine. Since its inception in 2011, our program has helped our graduates assume leadership positions in Critical Care, many right out of fellowship. Activities within this program include:

  • Professional track system– These tracks represent an important mechanism by which fellows, with the help of their mentors, guide their own advanced learning to become leaders in the field of Critical Care Medicine. The Research, Medical Education, and Clinical Leadership tracks approximate the professional pathways that intensivists can pursue as attending physicians. The program also has several specialty tracks that leverage the expertise in our department. These specialty tracks offer advanced training and experience with Global Health, Point of Care Ultrasound (POCUS), Critical Illness Recovery, Post-Cardiac Arrest management, and the CTICU/Mechanical Circulatory Support population.
  • Structured mentorship and mentor selection – Fellows reflect on their professional goals and then meet with several potential faculty mentors before mutually entering a mentor-mentee relationship with their primary faculty mentor. Fellows further develop their mentorship team with the help of their primary mentor.
  • Advanced education opportunities and funding – Fellows can take advanced coursework towards a certificate or Masters degree. Many of our fellows have taken such coursework and many have graduated with a certificate or Masters degree in clinical research or medical education. Others have taken coursework to prepare for an MBA program or other degree which they subsequently completed after graduation. Funding is available from the fellowship to help our fellows invest further in themselves.
Contact

For inquiries about the Neurocritical Care Fellowship program, please contact Susan Fancsali, GME Senior Department Manager.

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