The fellowship curriculum is flexible, and any of the critical care neurology areas may be emphasized, depending on your individual interests and needs.
The Neurocritical care fellowship at Mayo Clinic is particularly strong in teaching fellows the main neurologic manifestations of acute neurologic disease. Teaching includes recognition of acute neuromuscular respiratory failure, diagnosis of different stages of coma and its consequences and postneurosurgical complications. Fellows are involved in multifaceted care, coordinating surgical and neurointerventional procedures and discussions with family members about prognosis. Fellows are closely involved with brain death (DBD) and cardiac death (DCD) protocols.
Most of the first year is spent in the specialized Neuroscience ICU and 3 months in the general ICU (medical or surgical). The second year will be largely in the medical and surgical ICUs and focused on procedures and management of major medical problems causing critical illness. Rotations in the neurointerventional program in neuroradiology are also available.
The fellows start a major research project within the first two months and will be closely mentored throughout. Research entails primarily clinical research of prior admitted patients to the neuroscience ICU and patients seen in consultations. Research efforts are greatly facilitated by Mayo Clinic's extensive medical record system, the Biomedical Informatics and Statistics department, and a specialized Media Support department. The fellows publish multiple manuscripts and present them at meetings.
Clinical conferences, seminars, small discussion groups, journal clubs, didactic courses and one-on-one instruction are an integral part of the Critical Care Neurology Fellowship.
Formal didactic courses are available during the fellowship. Understanding statistical principles as applied to biomedical investigation is an important component of the fellowship. Mayo Clinic offers a number of courses in epidemiology, biostatistics, and design and conduct of clinical trials.
Neurocritical Care Course
A dedicated Neurocritical Care course is given by expert Neurointensivists every summer to prepare trainees for rotations in the Neuroscience ICU. Major topics covered include acute ischemic stroke, subarachnoid hemorrhage, status epilepticus, bacterial meningitis, acute neuromuscular respiratory failure, traumatic brain injury and brain death.
Throughout your fellowship you will participate, and periodically present, at weekly conferences:
- Neurology Grand Rounds
At Grand Rounds, research presentations are given by Mayo Clinic faculty, visiting faculty or neurology residents. Clinical pathological and vascular conferences are held several times a year.
- Cerebrovascular Case Conference
Cerebrovascular cases are presented and discussed. This is held jointly with the neurosurgical department every other Monday.
Clinical Case Conferences
Critical care conferences are held at Mayo Clinic Hospital, Saint Marys Campus, and alternate between the adult inpatient neurology, the child and adolescent neurology, neurosurgery and neuro-ophthalmology divisions.
These conferences focus on the pathophysiology, diagnosis, and management of neurological disorders. Subspecialty conferences are presented on a rotating basis by all subspecialty divisions of the Department of Neurology.
In addition to the regularly scheduled departmental conferences, you have the opportunity to attend resident conferences on Tuesdays. Residents and fellows also participate in an evidence-based medicine journal club.
Visiting professors have small group discussions with neurology residents and fellows. Topics covered include child and adult neurology vignettes and neuroethics.
A major goal of Mayo Clinic's critical care specialists is to continue a long tradition of clinical research in critical care neurology Clinical epidemiological research is emphasized in division research activities, including clinical treatment trials and medical records research. These types of research are a natural extension of Mayo's extensive experience with patient care, a unique records system and a unique local population base.
Development of independent research projects is encouraged, and will be supported with training in database management and biostatistics.
When you complete your research, you will be expected to present it at a scientific meeting or prepare it for publication in a scientific journal. Past fellows have been very successful, with some completing up to 15 manuscripts per year.