NCC Questions

[TUGM]

I figured this might be a good place to post some questions about life in NCC. Also posted this in the fellowship review thread, too... didn't get any bites.



What are some good books for residents to read to get prepped for those NCC rotations? How much non-neuro critical care should I aim to learn to be in good shape to be a competent resident? Any must-know articles/guidelines/studies that I should start getting comfortable with?

What are some common practice models at some of these places? What's the schedule like (for fellows and/or attendings)? And is there a difference in the way practicing NCC works in academia vs private practice? Do you feel like 2 years of CC experience is enough to be proficient at managing some of the IM/surgical CC components involved in holistic training? As always, thanks.

---

Members don't see this ad.

 

[typhoonegator]

The Practice of Emergency and Critical Care Neurology by Wijdicks.

Amount of non-neurologic CCM varies by program. Basic vent management, ARDS, pressors, sepsis, trauma resuscitation, tachyarrythmias, DIC, sedation and analgesia are a must. Ability to at least talk your way through a central line would be nice.

Academic vs. private are very different. Private NCC are often paid by neurosurgery to manage post-ops. Different feel, different goal.

Schedule depends completely on the size of the group. Often one or two weeks on at a time. 24/7 when on. I work 10 weeks a year, but in many smaller groups you have to work considerably more than that.

You aren't necessarily getting much less CCM exposure than pulm or anes/surg people do in their fellowships, depending on how hard-core your residency is and how you structure your elective time. Two years is pretty reasonable. You probably won't see enough ECMO or manage enough necrotizing pancreatitis to take care of those without help, but you'll be able to lead a team and coordinate consultants for things outside your area of expertise. And your focus will always be on neuro patients anyway. It's not like your standard Pulm/CC fellowship cranks out people who could manage a burn/trauma ICU without help, so why should NCC fellowships be different?

 

[interventional]

Alot of residents/fellows also like the NeuroICU book by Kiwon Lee

 

[TUGM]

Thanks for the response. Sounds like you spend quite a bit of time in the lab or have admin duties, TN? Or do you do some general neurology time?

 

[typhoonegator]

80% research. 15% clinical. 5% admin/teaching. All clinical time is critical care and acute stroke call.