The Advanced Practice Provider (APP) Fellowship in Neurology and Neurocritical Care is driven by hands-on, experiential learning. Core rotations include experience in ambulatory, inpatient, emergency, and critical care settings. A research and quality improvement project is a key component of graduation.
The curriculum integrates didactic training within clinical rotations that feature a mix of practice-based patient care, case-based learning, one-on-one mentoring and supervision, and approximately 8 hours weekly of didactic sessions. Content is aligned with education and practice guidelines supported by the American Academy of Neurology and the Neurocritical Care Society for the education of post-graduate residents and fellows.
Areas of study
Fellows are taught to master the following major areas in neurological science:
- Signs and symptoms in clinical neurology
- The neurological exam
- Localization in neurology
- Diagnostic methodology
- Treatment of neurological diseases
- Neurodiagnostic studies
- Lumbar puncture
- Neuroradiology (CT, MRI, interventional radiology)
- Headache disorders
- Cerebrovascular disease
- Infections of the nervous system
- MS and related disorders
- Systemic and metabolic disease
- Movement disorders
- Epilepsy
- Nerve and muscle disease
- Ataxias
- Neurological pain syndromes
- Dementias and disorders of behavior
- Neurocritical care:
- Management of acute neurologic emergencies
- Intracerebral hemorrhage
- Subarachnoid hemorrhage
- Status epilepticus
- Neuromuscular respiratory failure
- CNS infections
- Autoimmune encephalopathies
- Brain death
- Hypoxic-anoxic brain Injury following cardiac arrest
- Traumatic brain injury
Opportunities in sub-specialty care may include:
- Neurophysiological studies (EMG, NCV, EEG, evoked potentials)
- Ultrasonography
- Neuroophthalmology
- Psychiatry and neuropsychology
- Hospice and palliative medicine
- Neurooncology
- Medical and surgical critical care
- Traumatic brain injury
- Sleep disorders
- Physiatry and neuro-rehabilitation
- Pediatric neurology
- Neurological trauma
- Clinical research
- Neurosurgery
Sample rotations and electives
Cerebrovascular disease
During this rotation, fellows will:
- Work with members of the cerebrovascular team seeing patients in clinic
- Work with members of the cerebrovascular team in the hospital, assisting with daily inpatient management, responding to stroke alerts, evaluating eligibility for and facilitating acute stroke treatments, providing patient education, and preparing patients for discharge
- Gain experience treating a wide variety of hemorrhagic and ischemic cerebrovascular disorders
- Learn the procedures and applications of cerebrovascular diagnostic tools, including MRI, MRA, MRV, carotid ultrasound, transcranial doppler (TCD) and cerebral angiography
- Participate in clinical and epidemiological research.
Clinical epilepsy
During this rotation, fellows will:
- Provide subspecialty consultations.
- Evaluate and manage Epilepsy Monitoring Unit patients
- Evaluate patients before and after epilepsy surgery
- Gain initial experience with evoked potentials and surgical monitoring
- See patients referred to the supervising epileptologist
- Assist with epilepsy drug investigational studies
- Participate in the epilepsy subspecialty conference
Headache
During this rotation, fellows will:
- Work with members of the headache subspecialty group seeing patients in the headache clinic
- Learn the approaches to the evaluation and management of headache disorders
- Learn local anesthetic procedures and Botulinum toxin injection techniques used in treating head and neck pain
- See inpatient HA consults
Neuromuscular disease and clinical neurophysiology
During this rotation, fellows will:
- Evaluate patients with a wide range of neuromuscular disorders
- Learn basic nerve conduction and electromyographic techniques
Neuro-oncology
During this rotation, fellows will:
- Care for patients with common and unusual neuro-oncology disorders, learning clinical evaluation and treatment approaches
- Learn to evaluate and manage patients with primary and secondary brain and spinal tumors and paraneoplastic disorders
- Attend Neuropathology conferences, and review cases with staff
Neuro-ophthalmology
During this rotation, fellows will:
- Gain experience in ophthalmology as it relates to general medical and neurological problems
- Evaluate patients who are referred from the medical and neurological sections of the clinic
- Do inpatient consults
Neuroradiology
During this rotation, fellows will:
- Gain experience in interpretation of neuroimaging techniques, including MRI, MRA, MRV, cerebral angiography, and myelography
- Attend appropriate neuroradiology conferences
Pain medicine
During this rotation, fellows will:
- Assess and treat intractable pain problems
- Become familiar with both medical and invasive approaches to pain
Pediatric neurology
During this rotation, fellows will:
- Assess and treat children and adolescents with neurologic disease in both inpatient and outpatient settings
- Attend pediatric neurology conferences as well as appropriate rounds and conferences in the Pediatric department
Sleep disorders
During this rotation, fellows will:
- Work in the sleep disorders center
- Learn to read and interpret polysomnograms and multiple sleep latency recordings
- Consult on a wide variety of sleep disorders
Research and quality improvement
Fellows are expected to devote a portion of their time to research and quality improvement. Goals include gaining experience in research methodology, learning the use of investigative tools, and eventual writing and submission of at least one abstract covering work done in this elective. Proposed projects must be approved by faculty.
Supervision
During rotations, participants will practice autonomously with close supervision and mentorship of attending physicians, residents, physician assistants, and nurse practitioners.
You will meet individually with the faculty throughout the program with formalized feedback at three, six and nine months into the program.