The vascular neurology fellowship alternates inpatient rotations with outpatient care and electives.
Inpatient Stroke Service
The core rotation is the inpatient stroke service. The fellow attends the service an average of 4-5 months a year. During that time, the stroke fellow serves as a link between the stroke attending and the senior and Junior neurology residents. Patients are admitted to the dedicated stroke unit in 6JC, as well as in the surgical and neuroscience intensive care unit (SNICU). Rather than a hands-on patient experience, the fellow’s role is to supervise the work of the neurology residents. The stroke attending gives gradual autonomy to the fellow, which includes leading stroke round and code stroke activations. The goal is to prepare the fellow for successfully managing an academic or private practice stroke service.
Dr. Boyle (left) and Dr. Adams demonstrate the new remote-presence stroke care robot.
Dedicated Critical Care Experience
The stroke fellow attends the SNICU average of 1-2 months a year. The cerebrovascular patients admitted to the SNICU are dually managed by anesthesiologists with neurocritical care training, and by the Vascular Neurology attending. During the months of critical care experience, the fellow stays exclusively in the SNICU under the supervision of the anesthesia/neurocritical care team where she/he acquires additional experience in the management of ventilators, central line placements and arterial lines.
Outpatient Cerebrovascular Clinics
Stroke fellows will acquire ample experience in the outpatient management of complex cerebrovascular cases and determining best strategies for stroke prevention through clinics that are supervised and staffed by a vascular neurologist. There are dedicated stroke clinic months, as well as ½ day clinic during the inpatient months.
Stroke fellows get exposure to code strokes and telemedicine stroke consultations throughout the whole fellowship. The stroke call frequency is higher during the inpatient stroke months. There is gradual autonomy with constant stroke attending support. The goal is to be comfortable taking stroke call in a busy academic or private institution.
Dr. Boyle and Dr. Adams using the telemedicine stroke robot.
The fellows are exposed to a month of the dedicated neuroimaging interpretation in the neuroradiology service. There is also elective time available for pursuing transcranial Doppler training as well as interventional new radiology exposure.