Vascular Neurology Fellowship

Rotations:

• Inpatient stroke service, NMH
  • Approximately 6 months (Home call)
• Telestroke service
  • Occurs throughout fellowship
• Neurosciences Intensive Care Unit, NMH
  • 1 month (no call)
• Vascular Neurology Clinic, NMH
  • 1 or 2 half-days per week (none during NSICU)
• Neurosonology, NMH
  • 2 weeks
• Neuro-rehabilitation, Shirley Ryan Ability Lab & NMH
  • 2 weeks
• Neurointerventional Radiology, NMH
  • 2 weeks
• Elective
  • Approximately 3 months

Conferences:

• Weekly Vascular Neurology Noon Conference (each held once a month - journal club, research meeting, check-in with PD, didactic lecture)
• Weekly Vascular and Critical Care Neurology Case Conference 
• Weekly Vascular Neurosurgery conference
• Weekly/monthly Quality Improvement/Patient Safety meetings

Our Fellows may also further develop their skills in medical education through membership in the Feinberg Academy of Medical Educators (FAME). Members and non-members are invited to attend FAME events, which include lectures on innovations in medical education, workshops on advancing their own scholarship and educational practices, and networking socials.

Fellows are encouraged to participate in ongoing clinical and translational research or to initiate new projects. The goal will be to gain research experience and ideally to present at one or more national meetings and publish in a peer-reviewed journal.

There are opportunities available to pursue an additional research fellowship year.

The interests of our faculty include:

Clinical and Translational Research

• Community engaged health equity research to reduce the incidence and burden of stroke. Health services research with a particular focus on equitable access to stroke services using large databases including Health and Retirement study and National Health and Aging Trends Study linked to Medicare
• Stroke recovery and rehabilitation
• Stroke clinical trials
• Analysis of neuroanatomical properties in the brain using multi-modal MRI techniques. Identification of novel MRI biomarkers for post-stroke outcomes of cognitive and motor function
• Stroke in the young and arterial dissections
• Pioneering work on risks, especially vascular contributions, and mechanisms for cognitive impairment in underserved communities, global brain health and its definition, stroke risk reduction in underserved communities with an emphasis on hypertension, and community engagement. Research collaborations within the US and internationally, serving as senior research mentor to vascular neurology Fellows and faculty
• Transcranial doppler (TCD) in stroke and neurocritical care
• Clinical and translational studies in hemorrhagic strokes including subarachnoid hemorrhage and intracerebral hemorrhage, with particular focus on the brain-body crosstalk, immune and inflammatory responses to injury, and patient-centered outcomes.  We have built multi-center biorepository to enable blood and CSF translational biomarker studies in SAH and ICH
• Coagulopathy in intracranial hemorrhage. Minimally invasive evacuation of ICH and IVH. Mycotic aneurysms / septic emboli
• Pathophysiology and treatment of chronic subdural hematomas, emergency stroke thrombectomy process improvement, and quality and outcomes for aneurysm treatment
• Advanced MRI techniques to optimize patient selection for acute ischemic stroke and intracranial atherosclerotic disease interventions
• Translational research studying the effects of acute neurologic and systemic illness of sleep and circadian rhythms, and the effects of sleep and circadian rhythm disruption on cognitive and physical recovery
• The role of sleep and circadian rhythm as a potentially modifiable determinant of cognitive and everyday function; and testing electronic health records-enabled health system interventions to promote early detection and management of sleep and circadian disturbances
• The management of and identification of mechanisms underlying encephalopathy and delirium. Focus on hepatic encephalopathy, noninvasive detection of cerebral edema, assessment of cerebral autoregulation and hemodynamics using transcranial doppler, and mechanisms of neurologic complications from septic encephalopathy (including COVID-19). Neurologic outcomes and quality of life after intracranial hemorrhage
• Interdisciplinary pharmacoepidemiology research, particularly focused on oral anticoagulants.
• My research bridges immunology, vascular biology, and neuroscience with a focus on understanding mechanisms of neurovascular inflammation in acute neurologic injury. Specifically, my translational and clinical interests are in developing novel approaches to treat acute cerebrovascular diseases through cellular therapies and bionanotechnology
• Detection of atrial fibrillation after stroke using advanced diagnostic techniques; development of novel anticoagulants for stroke prevention; relationship of low burden atrial fibrillation and stroke of known and unknown cause

Quality Improvement Research

• Stroke Systems of Care and leveraging a multi-hospital healthcare system and Telestroke to optimize acute stroke patient triaging and treatment interventions
• Quality assurance regarding acute stroke care provided via Telestroke: Quality improvement projects in acute stroke care

Medical Education Research

• Innovation in medical education and assessment methods. Using medical simulation as an assessment tool to evaluate and track trainee performance and acquisition of skills. APP education and factors that affect retention in the critical care setting
• Medical education and direct student support. Trainee education in the care of LGBTQ+ patients. 

NMH is a Joint Commission certified Comprehensive Stroke Center and is the highest ranked hospital in Illinois and the Chicago metropolitan area. The Departments of Neurology and Neurological Surgery rank in the top 10 hospitals nationwide according to USWNR.

The breadth of cases presenting to Northwestern span a wide spectrum of cerebrovascular disease from acute ischemic stroke, transient ischemic attack, subarachnoid hemorrhage, intracerebral hemorrhage, intracranial aneurysms, arteriovenous malformations, carotid and intracranial stenosis and intersect with complex conditions such as atrial fibrillation, cardiovascular surgery, malignancy, hematologic disorders and inherited or genetic rare disorders. Our Telestroke Program provides acute consultative services across the region with a spoke-and-hub model. There are over 800 stroke and related conditions treated per year at NMH and over 1,500 outpatient visits for stroke in the Northwestern Medical Group stroke clinic. These clinical opportunities provide ample exposure to vascular neurology over a one-year training program. Our Fellows form part of the Stroke Quality Improvement Committee and may participate in QI and Patient Safety projects under faculty supervision. 

Applicants must be board-certified or board-eligible in neurology, neurosurgery or endovascular surgery related to cerebrovascular disease and must demonstrate interest in pursuing a career in vascular neurology.

Residents are selected for the fellowship from eligible applicants based upon their preparedness, ability, aptitude, academic credentials, communication skills and personal qualities. No discrimination is made based upon sex, race, age, religion, color, national origin, disability or veteran status. Approximately half of the eligible applicants are invited for personal interviews.

The program participates in the AAMC’s Electronic Residency Application Service (ERAS).

Required documents include:

• CV
• Personal statement
• Three letters of recommendation
• A copy of current temporary medical license
• Copies of USMLE scores

Interviews will consist of meeting with our faculty and key stroke team members. Specific requests may be made for select candidates interested in pursuing specific research careers. Interviewers rate each applicant independently.

A stroke faculty meeting is held after interviews, at which time applicant ratings are reviewed. Decisions regarding appointments to the fellowship are then made by consensus.

Housestaff training through McGaw Medical Center of Northwestern University provides diverse and challenging clinical experiences and world-class education located in the heart of the beautiful city of Chicago.

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