About the Program
The Vascular Neurology Fellowship Program is a one- to two-year program that includes course work and extensive hands-on experience in clinical research as well as unique training in the evaluation and treatment of patients with acute stroke.
Our fellowship program has been training neurologists and emergency physicians for the past several years with the goal of producing academic leaders and clinical researchers in the area of cerebrovascular disease. Individuals trained have been productive as measured by publications and subsequent grant awards.
The hallmarks of our training program are extensive hands-on experience in the hyper-acute treatment and subsequent management of acute stroke patients, substantial protected time for course work in clinical research methodology and clinical research projects, interdisciplinary collaboration and interactions and careful mentoring.
Program fellows are expected to pursue an academic career in clinical stroke research.
The stroke fellow is provided with substantial protected time to attend course work for clinical research methodology, biostatistics and epidemiology and is expected to spend much of their time in clinical research projects including acute treatment research protocols, epidemiologic studies and chart reviews as well as grant writing and manuscript production. The fellow sees patients in the outpatient setting one-two half-days per week.
After two months of shadowing acute stroke calls with the senior members of the stroke team, fellows are allowed to evaluate and treat acute stroke patients with telephone and in-person backup by stroke attendings, as well as independently enroll into numerous hyperacute clinical trials.
Our fellows have the most extensive experience of acute ischemic stroke and ICH in the emergency department setting of nearly any program in the country, as our team receives over 4,000 calls about acute stroke patients, with over 400 acute reperfusion treatments per year.
Within a year, the stroke fellows evaluate and treat more patients within three hours of acute stroke than many of the established acute stroke physicians in the United States.
The stroke fellows also have extensive opportunities for inpatient management of stroke patients, both with tPA-treated patients and thorough evaluation of stroke patients admitted to the inpatient service at UC Medical Center.
Neurocritical care experience is also required within the fellowship program with a one month rotation in our 20-bed Multidisciplinary Neurointensive Care Unit.
Our program, one to two years long, consists of the following components:
Course work in clinical research methodology, biostatistics and grant-writing will be completed during the first year. The stroke fellow will have substantial experience in clinical research, including epidemiology, ischemic stroke treatment trials and hemorrhagic stroke trials, and it is expected that the fellow will submit abstracts and manuscripts, as well as grant submissions, during their fellowship.
A series of lectures regarding all facets of cerebrovascular disease will be presented to the stroke fellow and neurology residents, by stroke team members, including stroke neurologists, neurosurgeons, neuroradiologists, epidemiologists, and physical therapists. The stroke fellow will also present lectures to the residents and students. Furthermore, fellows will attend relevant critical care lectures.
Basic Science Research
This fellowship does not require a specified rotation for benchwork research. Each fellow is required to visit all of the laboratories of cerebrovascular researchers during the first three months to meet with the faculty and observe laboratory techniques. However, especially during the second year, a multitude of opportunities exist for the fellow to enter the lab for research projects, depending on the wishes of the fellow.
Hyper-acute treatment of stroke: The fellow takes stroke call independently, with phone backup, after a two- to three-month training period. Average call is one weekend per month and one weekday per week, but is flexible to accommodate the needs of the fellow. Call will involve coverage of the 17 hospitals in the Cincinnati area, evaluating patients for thrombolytic or other acute treatments and enrolling patients in clinical trials. Despite covering a large number of hospitals, physicians on call are rarely called out overnight.
There is also extensive experience with telemedicine, as we now provide primarily telemedicine coverage for 10-15 hospitals. Fellows are trained in utilization of the software used for the telemedicine consultations, as well as facets of the implementation needed to create a telemedicine network in their own future institutions.
The fellow will always follow critically ill patients treated with acute therapy for the first 24 hours at all hospitals in the city. At UC Medical Center, it is expected that the stroke fellow will continue to follow their acutely treated patients for the duration of the hospitalization. In addition, it is expected that the stroke fellow will spend at least one to two months during the year(s) on the inpatient service (which is staffed only by the stroke neurologists), rounding daily on all stroke patients on the service and teaching students and residents as well. One month of critical care and one month of neuro-interventional radiology are also required. Additional clinical electives are also available.
The stroke fellow will see patients for a total of one-two half-days per week. In their clinic, the primary patients to be seen will be those with cerebrovascular disease, at either of three possible clinic locations, which will be supervised by a stroke attending.
The fellow will receive substantial experience in performing transcranial Dopplers (TCD), and in interpreting carotid ultrasounds. If desired, the fellow will be eligible to sit for the neurosonology board examination at the end of their training.