typhoonegator

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Any info/thoughts on Peds Neuro ICU fellowship? Thanks in advance!
There are very few places where you can make that work -- unless you're also a PICU attending. As a peds neurologist with some NCC training, your scope of practice is actually pretty limited when it comes to a general PICU population, which means that it is hard to do much more than consult. Which is fine, but that's a lot of training to see a low volume of inpatient consults. For instance, a place like CHB has enough referral volume to carve out a few beds for dedicated neurocritical care. But it is a multidisciplinary unit, and the director (Tasker) has done two PICU fellowships and an peds neurocritical care fellowship. If you really want to fully manage a pediatric NCC population, that is probably the best way to go.
 

MemberX

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A friend in Neurosurg told me today there is a movement in his field to take NCC from neurology. Similar to how they are trying to protect endovascular, he said they want to control as much as possible to prevent an analogous situation to what happened to CT surgery from Interventional cards. How true is this? Given the advancing disease burden of elderly and w/ thrombectomy becoming standard of care, how can neurosurgery (w/ such limited number of docs) be able to prevent neurology from filling the gaps to meet the demand?
 

typhoonegator

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No. And why would they? So they can spend time in the ICU rather than the OR? Makes no business sense. They want good outcomes just like everyone else. How could they possibly benefit from rounding on stroke patients all day? GBS? CNS vasculitis? Doesn't seem like the right use of their skills.

A few places can justify dedicated neurosurgical ICUs separate from the neuroICU population, but that is because of high throughput post-operative care, and I know several neurointensivists who work in those types of units anyway. I don't think every unit needs to be a closed neuroICU where the surgeons only consult on their own patients, but overall NCC has benefited neurosurgery, not harmed it. And let's not forget that a lot of neurosurgery, particularly spine, never even passes through the ICU.
 
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TUGM

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Neurosurgery is not taking over NCC or even NIR for that matter. Surgeons should be (and will be) operating - that is what they are trained to do. It does not make practical sense for them to be out of the OR rounding on ICU patients. Also, in my humble opinion, the medical and intensive care management of most surgeons leaves much to be desired, anyway.

NIR is slowly becoming dominated by neurosurgery, but neurologists have their foot in the door and they aren't going anywhere. The surgeons have had the historical power of referral, since cases like AVMs, CCFs, tumors, and aneurysms usually go to them - that was their foot in the door. The volumes of those procedures have plateaued and will likely not go up significantly. Stroke intervention, on the other hand, is the domain of the vascular neurologist, and they hold the power of referral for these cases. As accessibility to stroke care evolves, I believe we will gradually see more LVOs come to the angiosuite, and volumes will increase. Neurology is in a good position to establish themselves as the primary providers for neurovascular patients. Most departments, however, seem to be multidisciplinary, and I don't see that really changing.
 
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MemberX

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Thanks for the replies. If the shift in stroke care, especially LVO, greatly increases the number of thrombectomies done, would neurosurgery (with its limited numbers) be able to keep up with demand in the future? Wouldn't the vascular neurologists be the most likely to fill the gap ?
 
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Hey all... thanks for the great discussion... congrats to all those who recently matched... looking at getting impressions/opinions of programs that are updated.

Always appreciate interview reviews based on your interview... but also would appreciated the following if anyone has time:
-comments of overall program structure (ie call schedule, elective time),
-% neuro trained faculty compared to IM, ED etc.,
-Blend/interest of unit- ie is training Vascular heavy, heavy focus on EEG etc.
- # fellows
- Anything else you care to provide.

Thanks in advance!
 

barzan

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Hope we keep this valuable thread going for years to come, Congrats in advance for those waiting for the match results.
 

barzan

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hows the Match results?
 

barzan

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For those that matched this year, any guidance for us applying this upcoming cycle?
 

radfish723

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For those that matched this year, any guidance for us applying this upcoming cycle?
It was a pretty similar, but simpler, experience compared to applying for residency. There wasn't a lot of advice about how many programs to apply to; I applied to 6, and I met people who applied to fewer and way more, but it seemed like 5 or so was the average. It's a smaller applicant pool, so you tend to get proportionately more interview offers. That being said, I felt pretty confident with my application, and if you have concerns about your stats, err on the side of applying to more. Away rotations are still a thing, and if there's a program that you have your sights set on and think it might be a reach, then it's something worth looking into, but I didn't do one. The application opened in October, and it's always good to get submitted early, but it doesn't seem quite as rigid as residency apps; I got mine in like a month late and my interviews were scheduled between January and April.

Otherwise, the interviews feel pretty similar to what you've already done, just fewer free dinners...
 
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TickTakeTack

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Anybody have any info about the Boston NCC fellowships other than mass general? Tufts or Boston medical center?
 

oopsy

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For those that matched this year, any guidance for us applying this upcoming cycle?
I recently applied and matched. I was very surprised how different programs were across the country. Program philosophy and program cultures vary dramatically from hospital to hospital. There are places where you are treated as an (soon to be) intensivist who happens to have a neurology background, and other places where you're a neurologist who happens to be in the intensive care unit. I think it's helpful to see both ends of the spectrum, and from there, listen to your gut as you react to the program you're visiting. I personally was very surprised to find myself looking for certain features in a program that I had not anticipated early in the process. This only came from looking at exactly opposite programs. Similarly, the cultures of the program are also dramatically different. Points of emphasis would be the relationship with neurosurgery, as well as the way fellows are treated and mentored by the program. Some programs pride themselves on a grind it out mentality, and others are much more explicitly mentorship oriented. You have to decide for yourself what's best for you.

In terms of where to apply, this is really hard. Most of this is very personal, but I would try talking with any faculty that are available to you to get a sense of what other programs are like. You may already know that MGH and Pittsburgh are at the opposite end of the spectrum, but did you know about how different the experiences are at shock trauma, UT-Houston, and UCSF (all excellent)? It's not feasible to really interview 10 places as a resident. I went to five interviews, and that was relatively reasonable although still quite an effort. Given that, the premium is on leg work on the front-end. It may be even helpful to reach out to a program director and just ask about their program if it's one that you don't have any contact or information on.

Finally, when you're there at a program of interest, be sure to talk with both the fellows and if at all possible, the residents. The fellows may or may not give you an unfiltered view. The residents on the other hand have courtside seats to the experience and will not have skin in the game.
 
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Ramified

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I recently applied and matched. I was very surprised how different programs were across the country. Program philosophy and program cultures vary dramatically from hospital to hospital. There are places where you are treated as an (soon to be) intensivist who happens to have a neurology background, and other places where you're a neurologist who happens to be in the intensive care unit. I think it's helpful to see both ends of the spectrum, and from there, listen to your gut as you react to the program you're visiting. I personally was very surprised to find myself looking for certain features in a program that I had not anticipated early in the process. This only came from looking at exactly opposite programs. Similarly, the cultures of the program are also dramatically different. Points of emphasis would be the relationship with neurosurgery, as well as the way fellows are treated and mentored by the program. Some programs pride themselves on a grind it out mentality, and others are much more explicitly mentorship oriented. You have to decide for yourself what's best for you.

In terms of where to apply, this is really hard. Most of this is very personal, but I would try talking with any faculty that are available to you to get a sense of what other programs are like. You may already know that MGH and Pittsburgh are at the opposite end of the spectrum, but did you know about how different the experiences are at shock trauma, UT-Houston, and UCSF (all excellent)? It's not feasible to really interview 10 places as a resident. I went to five interviews, and that was relatively reasonable although still quite an effort. Given that, the premium is on leg work on the front-end. It may be even helpful to reach out to a program director and just ask about their program if it's one that you don't have any contact or information on.

Finally, when you're there at a program of interest, be sure to talk with both the fellows and if at all possible, the residents. The fellows may or may not give you an unfiltered view. The residents on the other hand have courtside seats to the experience and will not have skin in the game.
Thanks for this post. I am starting to think about NCC fellowship and am hoping to get some sense of the current lay of the land.

Regarding some of the claims in the above post, would someone (incl. fellows and residents who have recently interviewed) be able to elaborate a little? By that I mean: In what sense are MGH and Pitt at opposite ends of the spectrum (what spectrum)? What are some of the important parameters used in selecting programs, apart from the neurology-trained intensivist vs neurologist-in-the-ICU philosophy, which I admit I only vaguely understand? I imagine there's a decent amount of variation in fellow participation in typically 'resident-like' things like admissions, placing orders, etc.; the number and variety of procedures performed; the distribution of peri-op NSG patients vs. 'true' neurology/NCC patients; patient volume; and overall workload. Finally, would someone be able to comment on what are maybe the 5-10 programs thought to be highest caliber overall? For instance, I recently heard from fellows at my program that Columbia was one of if not the premier NCC training program, but after losing several of its faculty, this may no longer be the case.

I realize the questions are subjective and quite broad, but I would appreciate any and all input. Thanks in advance!
 
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barzan

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Application submitted still now invites how is it going for you guys?
 

radfish723

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Application submitted still now invites how is it going for you guys?
I know last year I didn't get my app in until mid-November, all the invites started rolling in from end of November well into the spring. I got an invite at every place I applied without having to email anybody so I wouldn't sweat it quite yet.
 
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Drfeel

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Hi.
I've applied for NCC this year for 2019 match. Wanted to know about a few programs in west coast, CPMC, Cedar Sinai, UCSD and UC Irvine. How are these programs, if you guys interviewed there what was your impression like? Thanks in advance.
 

champ02155

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Hi All,

I have also applied to NCC for 2019 and wanted to know some info about some of the programs. How is UT Houston after Dr. Lee left. Also what are your thoughts on Duke, UVA, Mount Sinai and also Wash U.
 

TUGM

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I'll post my experiences regarding some programs. Possibly more to follow, depending on when I find some time.

Washington University - St. Louis
EDUCATION - excellent training, getting your hands dirty; do all procedures except for EVDs, and have opportunities to learn from some of the best departments in the country - CTICU, NSGY, Interventional Pulm, NIR, etc.; take care of sick patients, including spillover from other ICUs; currently 20 beds, but by late 2018, will be 44 beds; fellows from 2/year to now 4/year; moving from 6 NPs to 12 NPs to help with additional demand; only con is that no exposure to acute stroke (that's a good thing some people), but I suppose you could always do an elective with the stroke service if you're dying to push some t-PA.

RESEARCH - it's WashU, so unlimited potential, i'll have a PET scanner, almost to myself essentially, to continue my research. great mentorship from the young faculty w/ some impressive research backgrounds; also great career/research mentorship from Dr. Diringer - the big daddy of NCC, himself (unfortunately, he does not do any more clinical time - but he will make you work hard and teach you tons).

LIFESTYLE - call schedule is reasonable (I mean it's an ICU fellowship, not neuromuscular, ya know?); Typically 1 week of nights, 1 week of days, 1 week as "expediter" (you help out during the day with simple post-ops, procedures, run codes, etc.), 1 week elective; occasional 24 hour calls over the weekends.

Overall, one of the top programs in the country, and definitely the best in the midwest. Some will argue about Mayo, but Mayo runs like a consult service.

Columbia/Cornell
EDUCATION - another awesome program; you get your hands dirty; and great exposure to neuromonitoring; 18 beds at Columbia, 11 at Cornell; pretty much see everything, EXCEPT NO TRAUMA EXPOSURE!!. 3 fellows/year. Neurology department (not the ICU department) is a bit old-school snobby, but they probably have a right to be, given the sheer amount of data and Nobel laureates from the place. Beautiful, beautiful units (Cornell is like a 5 star resort for comatose patients and their families). Also have great NP, resident support while in the unit, so minimal amounts of scut. Cons - once again, no trauma; minimal acute stroke stuff, maybe a bit more at Cornell.

RESEARCH - wide open to do whatever you want; seriously one of the most drool-induced SAH databases in the country with every datapoint you can imagine, ripe for retrospective inquiries; and obviously tons and tons of prospective opportunities as well, with plenty of time to do time. Great mentorship under some big names, who are extremely down to earth and approachable.

LIFESTYLE - Honestly, don't remember if night float or 24 hour calls... I kind of stopped paying attention to call schedules. NYC is obviously expensive, although the area around Columbia is slightly more affordable. Cornell is smack dab in the middle of Upper East Side, and probably a more fun place to live at a premium price.

I mean these guys are always in the Top 5 of everything, and the premier place to go to in NYC.

Johns Hopkins
EDUCATION - busy, hands on training; learn from neurology trained and anesthesiology trained mentors; i think 3-4 fellows/year. "I mean, it's JOHNS HOPKINS" - something I heard a lot during my interview day. 22 beds at Hopkins, 14 beds at Bayview. Have all the toys you can imagine. Great didactics as well. Cons - not a lot of stroke or trauma, which seems to go to University and Shock Trauma. Have opportunity to do rotations in trauma across the street, though, but probably not the same experience.

RESEARCH - "I mean, it's JOHNS HOPKINS." 2 weeks of clinical time, followed by 2 weeks of protected research time - pretty awesome. Mentors are involved in all types of ICU related research.

LIFESTYLE - Probably the best lifestyle amongst the programs that I saw with the 2 weeks of research time every block (fellows said you aren't supervised during this time, and can do whatever you want, as long as you remain academically productive). Baltimore is... meh, but at least it's an affordable east coast city.

Overall, one of the top programs, well rounded training. Can't go wrong.

University of Pennsylvania
EDUCATION - top notch training, extremely busy and rigorous; the ICU is 24 beds if I remember correctly, but you also see consults, and so patient load can be > 30-40 at times; fellows also have to write notes, so take that as you will; beautiful, beautiful hospital w/ all the toys you can imagine. 4 fellows/year. you see absolutely everything; attendings are all pretty awesome, and were extremely welcoming - was a great interview experience.

RESEARCH - currently involved in a lot of TBI research, and are setting up a huge database of TBI patients; received a large grant and funding to build a giant research network. great research mentorship, and you can take on whatever project you want to.

LIFESTYLE - probably the busiest fellowship program, w/ exception of maybe MGH/BWH.

Overall, phenomenal training, but extremely rigorous. You won't be afraid of anything coming out of training there.

University of Miami
EDUCATION - hands-on, busy, busy, busy 24 bed unit at Jackson; 8 beds at University of Miami (which is a joke compared to Jackson). you see everything here, including loads of trauma and stroke; attendings are amazing mentors, and you can get involved in great stroke or TBI-based research here. 2 fellows/year at this time. Attendings write the notes, and at most, you may have to write an H&P (although rare). Jackson brings in some very interesting patients with all sorts of weird encephalitides and tropical diseases + lots of vascular patients. Good relationship with neurosurgery.

RESEARCH - fellows have the opportunity to pursue whatever research they want, but it's never forced upon you. can collaborate easily w/ stroke, neurosurgery, or NIR departments, as all are readily available and always publishing.

LIFESTYLE - Miami is expensive, but an awesome place to live. Great weather for your post-call days. No night float at this time at Jackson - call shared w/ residents and typically 1-2x/week, and you split nights with NPs at UM.

Overall, excellent clinical training with great exposure to trauma.
 

oopsy

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UT Houston:

Very large program with a high volume, clinical focus. The fellows are interdisciplinary, including neurologists, ED physicians, etc. Attendings are also multi-disciplinary. Kiwon Lee was the director when I interviewed, someone farther up in the thread said he has since left, I have no primary information about this. Regardless, this is a great clinical training program. They have an insane referral network and patient base (they have 5 air ambulances that land on top of the hospital to get trauma/acute patients in quickly), tons of trauma and vascular cases (I think they quoted something ~300 SAH/yr), and a ridiculous volume on service. The ICU has ~40 beds on one contained unit, split into 2 teams. I don’t remember the details of the call schedule, but it did not seem absurd. I think they have 3 fellows, an army of NP/PA, and neurosurgery residents that they work closely with. The training model is intensivist first, then neurology. They train straight-up intensivists. It is a closed unit, and you are doing all of your own procedures. The unit itself does not seem to be particularly academically inclined. Graduates often go into private practice.


They have a very impressive stroke program (Jim Grotta leads it) and are at the forefront of clinical stroke research. The deal-breaker for me was that they have a stroke team rounding in the unit and leaving recs regarding stroke management. That was a problem for me, but for others who would not mind that, then this is a great place to train. Houston is a great town, very affordable, and cosmopolitan. While you will live in Texas, the culture within the city is very different from when you get beyond.


Duke:

The program leadership is extremely nice and supportive, the work atmosphere seems collegial, and the training seemed superb. The staff is interdisciplinary, including a few anesthesia and mostly neurologists. The program itself is in an amazing clinical research environment, the Duke Clinical Research Institute is a major player. Duke is obviously the premier institution in its locale, but there are certainly centers throughout the Carolinas trying to take in some volume. The unit is 22-24 beds and has a model of an attending run service with the fellow and then a separate service largely run by the senior fellow (I think I’m remembering this right). I don’t remember the SAH volume numbers, but it seemed comparable with other major centers. They have an army of NPs/PAs who are very experienced. The fellowship schedule is essentially tailored to the fellow, so they really do build your training around you. In general, you spend a fair amount of time getting intensivist training in other ICUs, but most of your time in the neuroICU. They do most of their own procedures, they get trained on transcranial dopplers, and they carve out time for you to do research. You also run all of the codes on the neurology floors (across the hall and downstairs; you are their code team). One peculiarity of the program is that you spend a couple weeks as a consultant at a nearby satellite hospital, which I think is to pay for your salary (not sure, don’t remember). If doing minimal neurohospitalist coverage is a deal-breaker, FYI.


The fellows seemed to be genuinely happy with their training experience—I did not get a sense of burnout at all. Graduates go into academia versus private practice, probably more of the latter. That said, the culture of the program seems to be shifting more academic. Finally, the triangle (Chapel Hill, Raleigh, Durham) is a wonderful place to live. It’s very affordable, beautiful, and walkable in those particular college towns. The hospital opens up onto the Duke quad, and you have access to great stuff in Durham and the surrounding areas. You’re 2 hours from the coast, 2 hours from the mountains, and 3-4 hours from Shenandoah up in VA. Amazing place to live. I didn’t end up going here purely for family proximity reasons, but I would’ve been extremely happy to train here.


Emory:

Great program with a focus on intensivist training. The program is spent between Emory University Hospital (EUH, main campus, on the university campus) and Grady Hospital (<20% of the time, public hospital, downtown ATL, major stroke center). Emory also has or is opening up an ICU at a privademic like hospital called Emory Midtown--I don’t think fellows are going there but I can’t remember. All in all, it’s something like 70!! ICU beds. The city is divided between ischemic and hemorrhagic stroke. Ischemic (LVO) mostly goes to Grady, hemorrhagic (aneurysm) mostly goes to EUH. This is an extremely high volume center. 300-350 SAH/year, 300+ thrombectomies a year. There’s a major population base in Atlanta and really bleeding out into neighboring states, and not a lot of other players to compete with. The program leadership is nice and firmly grounded in a hardcore intensivist model of practice. The relationship with neurosurgery is excellent, built on the relationship between the neuroICU director and the head surgeons. NeuroICU is a division of neurosurgery at Emory, not neurology, and your training reflects that. Fellows told me that they were comfortable doing all the routine ICU procedures, as well EVDs, lumbar drains, etc, and the neurosurgeons were happy to be left to operate and let you run the show in the unit. The program is vascular heavy for sure. The vascular neurosurgeons are very prominent (Barrow is the chair), and they have a very high profile endovascular program for both SAH (Jacques Dion, first ever coil) and ischemic stroke (Raul Nogueira, DAWN trial, etc). The director is Owen Samuels who is a well-known leader in ICU, and I got along with everyone I met there and found everyone to be personable and interested in whether this was a mutually good fit.

The training model is intensivist heavy—the first year you spend mostly not in the neuroICU (renal, ID, SICU, etc) and the second year you run as a junior attending with your own service that you then discuss with the attending. Emory itself has a huge critical care presence, the president of the critical care society is an intensivist at Emory. They’re apparently a major liver transplant center (#2 in country), so you work with a lot of liver complications, ie hyperammonia with edema, coagulopathy complications, etc. Grady is the major trauma center for the region so the trauma volume comes through there. There’s a huge patient population to work with in terms of research, and an opportunity to get really into clinical trials. The stroke and neurosurgery groups are very active in research. The ICU culture is less academic in comparison but you won’t be on an island. Clinical research infrastructure at Emory includes a major public health school and the CDC literally next door.

Fellows go into both private practice and academia and seemed like normal people (this is not a given at all places) who enjoyed their experience there. I enjoyed hanging out with them at the dinner. Atlanta is a great place to live, big city in the South, affordable, pretty good weather most of the time, and you get all the perks of living in a major city. You can live a suburban lifestyle, or in-town living in walkable neighborhoods, whatever suits you, on the cheap. And while you will live in Georgia, the culture within the city is very different from when you get beyond.
 
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TickTakeTack

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Hello everyone. Curious what everyone's thoughts are. I know its a cliche to say this year seems more competitive than the past. But it really does seem to be different this year. Where is everyone with their interviews, and how many did everyone go on? I applied for the 20 places, received only 11 interview invites and ultimately interviewed at 7 places. Starting to worry maybe I didn't interview enough...
 

Hamhock

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Everyone,
There were programs I visited where you can really “get your hands dirty” and become a phenomenal clinical critical care physician: you are the one intubating every patient, placing patients on ECMO and managing them, placing every central access and A-line, placing EVDs, doing your own trachs/pegs, running a CT-Surgical ICU, MICU, or Trauma/SICU. You are the primary on every patient and his or her survival is on you.
This is ridiculous.
I trained at one of the very few CCM programs where NeruoCCM fellows get a taste of 'full CCM training'. None was even close to "placing patients on ECMO and managing them" or "running a CT-Surgical, MICU...".
Please.
NeuroCCM is a developing field with tremendous research opportunities that could really make patient-centered outcome differences (unlike a lot of general CCM, to be honest)...but do not fool yourself and think you will be trained to run a "CT-Surgical ICU", competently place patients on ECMO, manage a MICU, or...well, you get the point, I hope.

HH
 
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TUGM

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This is ridiculous.
I trained at one of the very few CCM programs where NeruoCCM fellows get a taste of 'full CCM training'. None was even close to "placing patients on ECMO and managing them" or "running a CT-Surgical, MICU...".
Please.
NeuroCCM is a developing field with tremendous research opportunities that could really make patient-centered outcome differences (unlike a lot of general CCM, to be honest)...but do not fool yourself and think you will be trained to run a "CT-Surgical ICU", competently place patients on ECMO, manage a MICU, or...well, you get the point, I hope.

HH
Yeah, agree regarding the research and CTSICU. I don't know of a single NCC attending that is comfortable doing their own ECMO. A lot of neuroICU have constant spillover from MICU, so I would say it's more realistic that NCC trained physicians would feel relatively comfortable managing most MICU issues.
 
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Cone774411

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Has anyone done a NICU fellowship without having spent time in a dedicated neuro ICU during residency? My residency is smallish and does not have a neuro ICU but I am in love with the critical care aspect of neurology/medicine and would love to do a fellowship in NICU. I am just a little scared that I have not had much exposure going into fellowship (I'm not worried I won't enjoy the fellowship, just that I may be underprepared entering).
 

TUGM

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Has anyone done a NICU fellowship without having spent time in a dedicated neuro ICU during residency? My residency is smallish and does not have a neuro ICU but I am in love with the critical care aspect of neurology/medicine and would love to do a fellowship in NICU. I am just a little scared that I have not had much exposure going into fellowship (I'm not worried I won't enjoy the fellowship, just that I may be underprepared entering).
Not sure if I know anyone in particular, but it shouldn't be back breaking to get a fellowship in neurocritical care outside of the usual top programs where you need to have some experience, research, and letters of recommendation from well known faculty. In my opinion, it is just hard to gauge what you really want until you have a lived a few weeks of it at the very least.

Your best bet is to spend some elective time at a program with an established ICU - many of them have observer ship opportunities.
 

typhoonegator

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Has anyone done a NICU fellowship without having spent time in a dedicated neuro ICU during residency? My residency is smallish and does not have a neuro ICU but I am in love with the critical care aspect of neurology/medicine and would love to do a fellowship in NICU. I am just a little scared that I have not had much exposure going into fellowship (I'm not worried I won't enjoy the fellowship, just that I may be underprepared entering).
The issue will be whether the application reviewers will feel like you know what you're getting into. For many faculty at the big programs, it is hard to imagine training somewhere where you don't have NCC exposure, even if that is the experience at many smaller programs. Fellowships are risk averse. If you want to go to one of the competitive programs, some experience in a known program will be very complimentary to your application. If you don't, then you'll probably still do OK rolling the dice.
 

NeurologyHopeful2018

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The issue will be whether the application reviewers will feel like you know what you're getting into. For many faculty at the big programs, it is hard to imagine training somewhere where you don't have NCC exposure, even if that is the experience at many smaller programs. Fellowships are risk averse. If you want to go to one of the competitive programs, some experience in a known program will be very complimentary to your application. If you don't, then you'll probably still do OK rolling the dice.
I read somewhere less than 80% of NICU fellowships fill - so if he applies to all the low-mid tier programs why wouldnt he *guarantee* a match?
 

typhoonegator

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I read somewhere less than 80% of NICU fellowships fill - so if he applies to all the low-mid tier programs why wouldnt he *guarantee* a match?
Sure, he probably would match somewhere. But in my humble opinion there are programs where you'd be better off not matching than ending up at. With a little leg work in arranging an elective away block you can limit your chances of such an outcome.
 

NeurologyHopeful2018

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Sure, he probably would match somewhere. But in my humble opinion there are programs where you'd be better off not matching than ending up at. With a little leg work in arranging an elective away block you can limit your chances of such an outcome.
How could a program be so bad that you would rather not match than accomplish your dream of being a neurointensivist? Its just 2 years and you are a fellow...

Are there any Neurology programs that you would rather not match than being there?
 

Cone774411

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Jan 3, 2017
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Sure, he probably would match somewhere. But in my humble opinion there are programs where you'd be better off not matching than ending up at. With a little leg work in arranging an elective away block you can limit your chances of such an outcome.
I'm a little confused regarding the competitiveness of neurocritical care. I've been following the SF Match websites neuro critical care "Immediate Vacancies" for a while now and there have regularly been very top tier programs with openings. For example, listed for immediate vacancies in 2018 is UChicago, UAB, UMich, Mt Sinai and UCLA among many others. Last year UCSF, MGH/BGH, and Yale among many others.
 

NeurologyHopeful2018

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Jun 6, 2017
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I'm a little confused regarding the competitiveness of neurocritical care. I've been following the SF Match websites neuro critical care "Immediate Vacancies" for a while now and there have regularly been very top tier programs with openings. For example, listed for immediate vacancies in 2018 is UChicago, UAB, UMich, Mt Sinai and UCLA among many others. Last year UCSF, MGH/BGH, and Yale among many others.
UAB is a well known malignant program for NICU, also Loyola. I dont think Loyola NICU program has filled for many years..
 

barbarossa12

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UAB is a well known malignant program for NICU, also Loyola. I dont think Loyola NICU program has filled for many years..
How do you know that UAB is a malignant program? I am not even sure they have had any fellows.

Also typhoonegator, how do we know which programs to stay away from? What questions to ask during interview?
 

typhoonegator

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Also typhoonegator, how do we know which programs to stay away from? What questions to ask during interview?
Can't really answer without being in your shoes. Workload, call burden, lack of mentorship, malignant attitudes, poor actual critical care exposure, lack of oversight, poor post-fellowship placement, GME probation/sanctions, case mix, etc. All these things, or a combination thereof, could be cause for concern. The idea that anyone would settle for a horrible workload with poor oversight and a weak training environment just because it is "only for two years" is really sad to me. Those programs are out there, I'm not going to name them but it should be readily apparent on interview day. I don't think anyone should shy away from programs that have a heavy clinical load, because that is how you learn, but if that heavy load is coupled with poor oversight, lack of training, and a poor case mix, then you're working hard for a very low yield. So ask about case mix, attending contact, mentorship, and above all, where the fellows go after they graduate. If you're of the mentality that anything can be tolerated for two years, then at least make sure it will get you somewhere you want to go.
 
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champ02155

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Dec 20, 2016
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Hi Guys,

This thread just went dead, lets revive it again. The match is coming up so lets discuss the interview experiences from this year's trail.
 

barzan

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May 22, 2014
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Hi Guys,

This thread just went dead, lets revive it again. The match is coming up so lets discuss the interview experiences from this year's trail.
I think its too early to talk about the upcoming cycle, true it opens in October but most interviews take place between feb and april, I guess my advice to you apply where you TRULY wanna go to! I made the mistake of applying to 20 plus programs ended up interviewing at only 8.
 

champ02155

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Hi guys,

Wanted to know how is UT Houston as a training program? I looking in to programs in Texas and confused between UT houston vs Baylor Vs UTSW?

Thanks
 

Cyclist4Ever

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Sep 27, 2010
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Hi guys again, looking for some some insights on Texas programs. Thanks
I actually interviewed at those three programmes during the last application cycle

What are you interested in? Research, more clinical, Multimodality, TBI?
Do you want to be an "intensivist who knows about brain" or “neurologist who works in ICU”?


UT Houston:
Heavy and comprehensive clinical loads. They have 1500 TBI and ~300 SAH each year. Good clinical training, part of BOOST-3 and TRACK-TBI. 2 weeks on and off schedule. 40 beds split between 2 teams. They told me 75% of Stroke/SAH/ICH patients in Houston go to UT and 25% go to Baylor. Fellow can do/learn EVD and Bolt.

Baylor:
More neurovascular heavy. You see TBI patient at BenTaub for ~2 months? Part of TRACK-TBI, not sure about BOOST-3. Can do more as an elective. ~20 beds at St Luke and another 20 at Woodlands, which is ~40 miles north of TMC. One week on and off schedule, no night float, just home call. Less general critical care patient. Good research opportunities.

UTSW:
Comprehensive training, 20 beds each at Zale and Parkland, they see MICU-like patients at Zale because they dont have MICU in their Neuroscience hospital. Less emphasises on research but it is there if you are interested. Almost no Multimodality stuffs if I remember correctly. The weather in Dallas is a lot more tolerable than Houston ( I am from NE)


I don’t have any insight other than my one day interview experience so please take it for a grain of salts… PM if you have more question. If I made any mistakes, feel free to jump in.
 

M4NOBMW

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Any interview movement for peeps doing NCC this year? Or from peeps from past years when does the ball start rolling ?
 
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Longtime reader, first time poster and current neurocritical care applicant. This thread provides a wealth of information, thank you everybody.

For previous applicants who have matched (and those who have completed NCC fellowship), how many programs do you recall listing total and "how high up" did you match in order of your preference? I am sure it is different for everybody, but there is a paucity of match data other than a single table on the SF Match website.

Thank you!
 

loverofcoffee

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Apr 11, 2012
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Hi everyone,
Long time lurker, and finally applying this cycle.
When can we expect to hear back about interviews if we applied in October?
 

goodbadveryugly

2+ Year Member
Nov 1, 2015
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Same here. When do we usually submit the applications? Do the programs review incomplete applications? Sometimes it takes a while for an attending to write a recommendation letter.
 
Last edited:

calibrate

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Apr 14, 2012
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I am applying this cycle as well.

I believe your application is complete once your LOR writers uploads the letters. Once all are uploaded, the SF match will send your application out.

I have heard that we can expect invites from mid November and on-wards. I have received a few interviews so far.
 
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goodbadveryugly

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Nov 1, 2015
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I am applying this cycle as well.

I believe your application is complete once your LOR writers uploads the letters. Once all are uploaded, the SF match will send your application out.

I have heard that we can expect invites from mid November and on-wards. I have received a few interviews so far.
Thank you very much for your reply. I received a few interviews last month and haven't got anything this month.
 
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skyalien7

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Oct 20, 2017
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Hi everyone,
I wanted to revive this thread for neurocritical care training starting in 2021. How is the interview season going for you folks?
 

UTTARA KOUL

2+ Year Member
Sep 15, 2015
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Hi everyone,
I am applying for Neurocritical care fellowship to start in 2021, how is your IV season going so far, I have received a few and my first one is next week!
#nervous
 

goodbadveryugly

2+ Year Member
Nov 1, 2015
8
4
Interviews received so far: USC, UC Irvine, UCSD, U Maryland, RUSH, U Chicago, UT Houston, UT Southwestern, Baylor, U Penn, Duke, Cedars.
Application acknowlegement received, pending review: Yale and MGH
No response: Northwestern, Johnhopkins, UPMC, Stanford, UCSF, UCLA and Columbia.
 
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