Stroke/Vascular Neurology Fellowship
The Vascular Neurology fellowship at the University of South Florida Morsani College Of Medicine is an ACGME accredited fellowship and involves both clinical training in the management of all cerebrovascular diseases and stroke, and the opportunity to participate in clinically related research for graduates of an accredited neurology residency program. There are two positions available each year, and the training is for a total of 12 months.
Our fellowship training provides complete exposure to the problems of clinical stroke and other complicated cerebrovascular disorders, and clinical stroke research; familiarity with clinical trials and methodology; and experience with the most recent advances in stroke technology. Training includes clinical experiences in the outpatient stroke clinics, acute and inpatient stroke service, Neurological and Medical Intensive Care Units, didactic lectures, stroke case conferences, and journal clubs. Training also includes exposure to neuroradiology, endovascular neurology, neurorehabilitation, and neurosurgery.
We have strong collaborative services in Neuroradiology, Endovascular Neurology, and Neurosurgery. There are more than 800 stroke patients each year. Our patient population provides excellent clinical and research base. The stroke service is involved in many research projects including clinical trials for treatment of stroke and stroke prevention and experimental trials of stroke recovery.
Fellowship Duties and Curriculum
Each fellow spends a minimum of 6 months on the acute and inpatient stroke service. The two fellows will alternate being on service, two weeks at a time. While on service, the fellow will participate in the daily rounds on the Neurology patients in the Neuro ICU and the inpatient stroke service. He/she is required to be familiar with all aspects of the individual patient's care, but may delegate case presentations to the Neurology residents. Our stroke service sees patients in the Neuro ICU in conjunction with the Department of USF Pulmonary Critical Care. The fellow will be required to supervise and teach the Neurology residents. In all cases, the fellow will serve as an adjunct to the attending with responsibilities delegated as the attending sees fit.
The fellow will supervise the Neurology residents during Code Stroke calls during weekdays and nights and weekends, when on service. The fellow will be required to write an addendum to the Neurology resident note on all patients seen as a "Code Stroke".
Each fellow (whether on or off service) will attend two half-day clinic sessions per week under the supervision of a stroke service attending. The clinic will consist primarily of stroke patients (new and follow up from inpatient hospitalization).
Each fellow will also spend a cumulative total of one month each in Neuroradiology, Endovascular Neurology, Neurorehabilitation, and Neurosurgery. Two months will be spent in the Intensive Care Unit. These rotations will take place during off service periods, two weeks at a time.
Goals and Objectives
During the one-year training, fellows will be expected to progressively gain the knowledge and skills necessary for the diagnosis and management of a wide range of cerebrovascular diseases and others that result in vascular injury to the nervous system. The primary goal is for the trainee to be capable of independently managing any type of clinical situation related to stroke.
The overall objective for our Vascular Neurology fellowship training program is to provide the trainees with the skills and knowledge necessary to:
- Provide high quality clinical care and assessment of patients with various cerebrovascular disorders in different settings (emergency, inpatient, and outpatient), including diagnostic evaluation, treatment, management, counseling and prevention.
- Management of critically-ill neurological patients, such as those with cerebral hemorrhage, brain aneurysms or vascular malformations, head trauma, brain tumors, and status epilepticus.
- Work effectively with multidisciplinary teams oriented to the care of these patients.
- Ordering and interpretation of laboratory and imaging tests in patients with cerebrovascular diseases and stroke.
- Develop the capacity to pursue an academic career in the field of stroke and cerebrovascular disorders.
Clearly the goals during any given rotation will depend on the rotation. During neuroradiology other imaging techniques will be emphasized. In the clinic, consultative rotations clinical details and evaluation will be prominent, and in the emergency room rotation, rapid evaluation and treatment will take precedence. The specific goals and objectives of the cerebrovascular fellowship training are:
- to become familiar with the clinical syndromes in patients with brain ischemia and hemorrhage;
- to know the basic anatomy, pathology, and pathophysiology of the cerebrovascular system and the relevant cardiac and hematological systems;
- to become very familiar with the important cerebrovascular disease literature;
- to learn in depth the important therapeutic options, their indications, potential benefits and risks;
- to become skilled in weighing benefits vs risks in making therapeutic decisions;
- to become capable in interpreting the various cerebrovascular investigations- CT scanning, MRI, MRA, CTA, standard dye angiography, cervical ultrasound of the carotid and vertebral arteries, and transcranial Doppler;
- to become skilled at rapid evaluation of patients with acute stroke syndromes;
- to be able to tell patients their problems in a sensitive and clear fashion and to improve all interpersonal skills;
- to understand basic research techniques;
- to understand the major issues in cerebrovascular disease that already have been answered successfully and the conundrums and uncertainties that remain;
- to learn how to design, plan, and carry-out research projects; and
- to become familiar with biostatistical analyses of randomized trials
The trainee's mandatory duties and responsibilities include:
- Evaluation of acute stroke patients in the Emergency Department
- Supervise acute care of stroke patients (on the inpatient stroke service) and critically ill neurological patients (in the Neuro ICU) in the inpatient setting
- Have two ½ days of outpatient clinic session per week
- Learn and interpret neuroradiology studies
- Attend all weekly stroke conferences
- Alternate night call between two fellows to provide coverage for the acute and inpatient stroke service (fellows will strictly adhere to < 80 hour work week averaged over 4 weeks)
- Participate in the ongoing clinical trials involving stroke patients
- Completion of NIHSS and mRS training and certification during the first 2 weeks of training
- Completion of the CITI Human Subject Training Curriculum and HIPPA tutorials and exams offered during the first 2 weeks of training
- Teaching medical students and residents during daily rounds
The trainee is encouraged to maintain a log of patients evaluated throughout his/her training with regard to clinical diagnosis to assure that the diversity of cerebrovascular disorders cases has been seen and that an understanding of the condition has been achieved.
Hours of Work and Call Schedule
Generally, daytime business hours with night call (night call only when on acute and inpatient stroke service). Each fellow will be on call for a total of 6 months. Night call is from home with a neurology resident in-house. A stroke service attending is always available for back up consultation, and to discuss each patient with the fellow and to review the examination and neuroimages. The two fellows will alternate being on-call but will strictly adhere to < 80 hour work week averaged over 4 weeks. Fellows will also have at least one day free of duty every week, averaged over four weeks. We expect the fellows to be flexible and in general, available to switch when something 'suddenly comes up'.
Research and Publications
We encourage supervised, independent or joint, stroke-related research during the fellowship. The fellow will be offered the opportunity to assist in the preparation and submission of articles in peer-reviewed journals. Authorship will be commensurate to the proportion of involvement in the intellectual planning of the paper and the work done in gathering and entering the data. Our goal is to have each fellow as a first author on at least one publication by the end of the fellowship, and to present at least one abstract at a scientific meeting during or shortly after fellowship.
Scientific Meetings and Travel
Fellows are encouraged to attend at least one educational conference during their one year of training. Attendance at the AHA/ASA Stroke Conference and the AAN annual meeting, where the fellows get an opportunity to interact with renowned Cerebrovascular experts, is advised. We expect the two fellows to alternate attendance at these meetings or not to attend the same meeting to avoid interruption of our 24/7 stroke coverage. Limited stipends, within the allowable institutional maximums, to attend scientific conferences may be available through the OGME on a competitive basis.
The fellows will be directly supervised by one of the stroke attendings at all times during their inpatient, outpatient, or elective rotations. Feedback will be provided directly and immediately to the fellow by the attendings. In addition, our division meets weekly to review programmatic issues and fellows' activities and performance. Our division maintains an "open door policy". Fellows are encouraged to discuss their concerns, stresses, challenges and plans with any of the stroke attendings at any time.
Vacation and Benefits
Fellows usually receive 15 days of paid personal vacation per year. We prefer taking one week off at a time, but longer vacation periods can be arranged if necessary. Schedules may be adjusted around the holidays or long weekends, if needed.
Fellowship stipend varies depending on the PGY level. This is usually adjusted by the hospital on a yearly basis to adjust for changes in cost of living.
Important Dates & Deadlines
Next available Vascular Neurology fellowship position (PGY-5) is: July 1, 2017
All candidates interested Vascular Neurology fellowship positions (PGY-5) must apply through Electronic Residency Application Service (ERAS). We will review all applications and invite the most promising applicants to interview. Interviews will be conducted in February 2016 to April 2016. Please visit the ERAS website for complete information about application, schedules, and regulations & the NRMP website for NRMP deadlines. We will only interview candidates registered in both ERAS AND NRMP.
To be eligible for a Vascular Neurology fellowship program, applicants must have successfully completed or be on track to successfully complete an ACGME accredited adult Neurology Residency. (Adult Neurology program must be completed prior to starting the Vascular Neurology fellowship.)
Technical Standards for Residency
Candidates for Neurology Residency must have abilities and skills in the areas of observation, communication, motor, intellectual, and behavioral and social attitudes, as outlined in the technical requirements for residency.
For more information contact
Residency Program Coordinator
Department of Neurology
2 Tampa General Circle, 6th Floor
Tampa, Florida 33606
Email: firstname.lastname@example.org or call 813-259-8577
Dr. Waldo Guerrero
Vascular Neurology Fellowship Program
Department of Neurology
2 Tampa General Circle, 6th Floor
Tampa, Florida 33606
Email: email@example.com or call (813) 259-0658