Neurosurgery

Neurocritical Care Fellowship

The Neurocritical Care Fellowship is directed by Paul M. Vespa, MD

Background

The ACGME-accredited UCLA Neurocritical Care Fellowship is a nationally recognized clinical training program in Neurocritical care. This fellowship is a 2-year program. This is one of a few recognized training programs in the United States and has been in existence since 1999. The Neurocritical Care Society and the American Academy of Neurology Section of Emergency and Critical Care Neurology have recognized UCLA as a premier example training program which encompasses and exceeds all fellowship requirements in neurocritical care. We have trained many fellows who have gone on to academic and clinical careers since our inception. 

How UCLA is Unique

  1. The program is formally housed within the Departments of Neurosurgery and Neurology and is under the directorship of the neurocritical care program director. Our program is separate from but intersects deeply with the UCLA stroke program. All patients with any type of neurological or neurosurgical critical illness from the entire UCLA Health Network come to the NeuroICU.
  2. A focused expertise on minimally invasive neurosurgical techniques is a unique goal of the fellowship. Fellows are trained on multiple invasive procedures and other brain diagnostic testing (EEG and TCD).
  3. The fellow is the main ICU doctor for all of the patients in the Neuro-ICU and has primary responsibility for the treatment of these patients.
  4. The program features several state of the art technologies including cerebral microdialysis, brain oximetry, and a comprehensive electronic ICU featuring EPIC, GCQ® and a In-touch Health Robotic Telepresence®. Telemedicine expertise for acute stroke and other neurological emergencies is featured in our program.
  5. The program features an advanced ICU based research environment.
  6. Critical Care education is integrated across disciplines and there is a large number of multidisciplinary faculty in critical care including medicine, anesthesia, surgery, pediatrics, and neuroscience who teach and mentor the fellows.

UCLA is the NeuroICU of the Future

The UCLA Neuro-ICU is a state of the art intensive care unit that is leading the world in patient care, technology, and research. Located in the dedicated 24 bed ICU in the Ronald Reagan UCLA Medical Center. We have a total of 106 ICU beds at UCLA and a team of 40 intensivists house wide. We average 2000 admissions/year. UCLA NeuroICU fellows are exposed to a large volume of clinical material and experience. All neurological emergencies and critical care cases are admitted to the ICU with an equal balance of stroke, trauma, neuromuscular disease, status epilepticus, subarachnoid hemorrhage, intracerebral hemorrhage, brain tumors, myasathenia gravis, Guillain-Barre syndrome, cardiac arrest, and spinal cord injury/surgery admitted each year. We triage and treat every cardiac arrest patient in any ICU at UCLA.

UCLA Neurocritical Care is a Leader in Research

Basic and clinical science research are strongly supported through NIH funded research programs in brain trauma, intracerebral hemorrhage, and stroke. Fellows are expected to conduct a closely mentored research project, publish abstracts and full-length manuscripts and participate in ongoing research efforts. The ICU environment is strongly oriented towards innovation and cutting edge approaches and research. We are funded by several sources including an NIH Program Project Grant, NIH SPROTRIAS grant, NIH K08 grant, NOH RO1 grants, Department of Defense, The State of California Neurotrauma Initiative Grant and several industry sponsored trials. Each fellow participates in the 2 year NIH K 30 Clinical Translational Research Program that is offered at UCLA in conjunction with the NIH. UCLA features the Clinical and Translational Science Institute which facilitates interdisciplinary research across much of the distributed UCLA campus.

Internationally Acclaimed

The UCLA Neurocritical Care program is well regarded among neurointensivists. We have trained over 35 graduates. These program graduates have matriculated to University Faculty Appointments in Neurocritical Care. Dr. Vespa is a Fellow of the American College of Critical Care Medicine, a founding member of the board of directors of the Neurocritical Care Society, and an Editorial Board Member of Critical Care Medicine, Neurocritical Care, Surgical Neurology, and The International Journal of Critical Care. Dr. Vespa is a member of the UCNS Board of Directors and was named Chair of the UCNS in August 2009. He is also a guest editor for several additional journals including Critical Care, Current Opinion in Critical Care, Journal of Cerebral Blood Flow and Metabolism, Neurology, Annals of Neurology. Dr. Vespa has served as a faculty educator for numerous national and international conferences.

Goals and Expectations for Fellows

Fellows are very cherished in our program and one of the fundamental reasons for the existence of our program. The expectations for fellows are that each fellow matriculate into a premier position as a clinician-scientist and be positioned to make a significant contribution to the field. The job market continues to increase for neurointensivists and our candidates are encouraged to seek outstanding career opportunities. We expect fellows to pass the UCNS Neurocritical Care Board Examination within 1 year of completion of the fellowship training and be certified in Neurocritical Care. Fellows average 56 hours/week of work, well below the 80 hour work limit.

12 months of protected time dedicated to research that is divided between the first and second year. Neuroscience-ICU based clinical investigation in SAH, TBI, ICH. Basic science laboratory research in Neurotrauma lab or Interventional neuroradiology basic laboratory. Fellow is expected to write at least one manuscript and one grant proposal during the 24 month fellowship. The fellow is expected to generate several abstracts and manuscripts during the fellowship, and is closely mentored by a PhD in statistics, as well as the other PhD and MD researchers in the neurocritical care program.

Central Mission & Team Structure

The fellow will be trained as neurointensivists/critical care neurologists under a pathway that will enable them to matriculate as academic neurointensivists with specialized training and expertise in critical care. The neurointensivist is the primary attending for on all ICU patients. The fellow serves as the main ICU physician for the patient and is responsible for treatment decisions as a "primary team" member. The nurse practitioners or neurology residents function as the unit resident. The fellowship is structured to not displace any resident from completing the ICU portion of their training, but to provide service for an unmet patient care need. The fellowship is balanced towards providing the fellow the opportunity to be hands-on and gain first-hand experience in treating critically ill patients, while providing time for education, reading and thoughtful contemplation. An integrated approach where the neurology and neurosurgery residents, fellows and attendings are on one team is our approach. Neurosurgery residents benefit from the interaction with the fellows in terms of learning classical neurology principles in the areas of stroke, seizures, coma etc. Fellows benefit from interaction with senior neurosurgery residents who provide surgical knowledge and expertise.

Application Process

Eligibility: Applicants must be ABMS board eligible or certified in Neurology, Neurosurgery, Internal Medicine, Anesthesiology or another critical care ABMS specialty, and independently licensed or fible for licensure through the state of California. Applicants must be eligible for a California Medical License by the fellowship start date. The Match application deadline is February 1st of the year prior to the fellowship start date.

Applications are submitted through the SF Match System SF Match system.

Fellowship Coordinator: Abigail McCann, MPA [email protected] 

Program Details 

  • Program Length: 2 years
  • Start of Program: July 1st
  • Number of Fellows per Year: 2
  • Salary/Benefits: Please see UCLA GME for details
  • Accreditation: Accreditation Council for Graduate Medical Education (ACGME)
  • Location/Campus: Ronald Reagan UCLA Medical Center (RRUMC)