Neurocritical Care Fellowship

Program Overview

The ACGME-accredited and UCNS-accredited UC San Diego Neurocritical Care program is a 1-2 year clinical fellowship specialized in neurocritical care. Currently we offer 1-2 fellowship positions per year.

Fellowship Mission

The mission of UCSD's Neurocritical Care Fellowship is to produce neurointensivists that are well trained in all areas of neurocritical care and critical care medicine including clinical management, administration, education, quality improvement and research. Through our innovative and individualized curriculum, our NCC fellows acquire all the skills needed to be leaders in the field. They are trained at a level expected for an academic intentsivist position and are also fully capable of serving well in the community (non-academic) setting.

Clinical Training

The fellowship is housed at the University of California San Diego (UCSD), San Diego's only academic health system. UCSD Health encompasses multiple hospitals, including Jacobs Medical Center (JMC), UC San Diego Medical Center-Hillcrest (HC), Moores Cancer Center, Sulpizio Cardiovascular Center, as well as multiple affiliated community hospitals in the greater San Diego area. UC San Diego is the only medical center in San Diego County with a dedicated NCCU and primary Neurocritical Care Service (NCCS). JMC and HC are both Joint Commission accredited Comprehensive Stroke Centers . Additionally, JMC is a Joint Commission accredited Spine Center and Hillcrest is a Level 1 Trauma Center.

UCSD’s Neurocritical Care Program is a joint effort of the departments of Neurosciences, Neurological Surgery, and Anesthesiology. Our program is interdisciplinary, staffed by neurointensivists with training in both neurology and anesthesiology, that are also board-certified in neurocritical care. UCSD has 2 primary NCCUs, located at JMC 3F (12 beds) and Hillcrest SICU (20 beds). The JMC NCCU is staffed by an in-house neurointensivist attending, NCC fellow, NCC nurse practitioner (NP), and 2-3 dedicated neurology, neurosurgery, and anesthesia residents, who participate on daily interdisciplinary rounds with our NCC pharmacists, RT/PT/OT/ST, and NCC nurses. The Hillcrest NCCS is staffed by an attending neurointensivist, a NCC NP, a senior fellow, and NCC nurses. The NCC team maintains a close relationship with our neurosurgery and stroke teams, rounding with these teams daily. At night, the NCCU is staffed by in-house dedicated residents, NCC NPs, or fellows. An NCC nurse educator, social worker, case manager, and nutritionists round out the NCCU’s interdisciplinary team.

NCC patients include all ICU-level patients with a primary neurological or neurosurgical injury as well as postoperative neurosurgical and spine patients. Our primary service cares for a large number of subarachnoid and intracerebral hemorrhage, complex ischemic stroke, status epilepticus, and complex post-neurosurgical patients. Neurological patients are admitted under the NCCS, while neurosurgical patients are admitted to neurosurgical/NCCS co-management. The NCCS also consults on post-cardiac arrest patients undergoing targeted temperature management, fulminant liver failure with cerebral edema, CAR-T and other ICU-level patients with life-threatening neurological complications, and patients with traumatic neurological injury. UCSD’s NCC team performs their own procedures for their primary patients, including endotracheal intubation, bedside echocardiography, invasive and noninvasive hemodynamic monitoring, continuous EEG and TCD analysis, bronchoscopy, percutaneous tracheostomy, lumbar drain, EVD, and line placement, among others.

Curriculum

The Neurocritical Care fellowship includes a total of 12 months or 24 months depending on specialty according to ACGME NCC program requirements. For the 24-month track:

52 weeks will be spent on the NCC service or equivalent rotations such as Neurointerventional radiology or Neurosurgery.
52 weeks will be spent performing research and education, or elective clinical blocks such as stroke, neurosurgery, EEG, trauma, neurointerventional radiology, PCCM, or ACCM.
Clinical service time will be performed in 1-2 week blocks and alternated with research time to encourage trainee well-being.
Summary of block rotations:

Didactics

The NCC attending currently provides 30 minutes-1 hour of protected educational didactic time every weekday to residents and fellows that are on the NCC service. NCC fellows are provided with a weekly didactic curriculum that covers all required UCNS and ACGME required educational topics for NCC fellowship. NCC fellows will be expected to attend one or all of the following monthly conferences: neurovascular conference, anesthesiology journal club, and stroke journal club. The fellow will be given support to attend at least one significant national meeting in neurocritical care (Neurocritical Care Society, International Stroke Conference, Society of Critical Care Medicine, etc) during the course of the fellowship.

Weekly Conference Schedule

Tuesday—NCC Conference /M&M/Journal Club/ICUEEG (w/epilepsy division)
Wednesday—NCC fellow didactics/ PCCM didactics
Friday—Neurosurgery/Neurology grand rounds & didactics

Mentorship and Research

Throughout their fellowship, NCC fellows will meet frequently with the program director, medical director and attendings from NCC and our affiliated departments to provide comprehensive mentorship, career development guidance, and support. Each fellow’s experience will be tailored to support the achievement of their career and personal goals. Participation in a research project is required and research mentorship is available from the NCC division as well as UCSD’s campus at large, which includes our world-class neurosciences and bioengineering departments.

Training Faculty and Staff

Cynthia Gonzalez Gonzalez, MD (Neurocritical Care Fellowship Program Director)

Navaz Karanjia, MD (Medical Director, UCSD Neurocritical Care Program and NeuroICU’s)

Jamie Labuzetta, MD

Brain Lemkuil, MD

Anushirvan Minokadeh, MD

Arthur Lam, MD

Martin Krause, MD

Thomas Hemmen, MD, PhD

Alexander A. Khalessi, MD, MBA

Danise Adrianzen-Talavera (Program coordinator, datalavera@health.ucsd.edu)

Maria Miller (Program administrator, m7miller@health.ucsd.edu)

How to Apply

We appreciate your interest in the UC San Diego Neurocritical Fellowship Program. We participate in the SFMatch; all applications must be submitted through their website.

Applicant information

For detailed Fellow eligibility please refer to https://www.acgme.org/globalassets/pfassets/programrequirements/550_neurocriticalcare_2023.pdf
International Medical Graduates/Foreign Medical Graduates (IMG/FMGs) are welcome to apply.
For IMG/FMG's, we are only able to accept applications with a J-1 VISA status.
Apply Here