The Neurocritical Care Fellowship at Mayo Clinic's campus in Jacksonville, Florida, provides the necessary skills for efficient delivery of high-quality care to critically ill patients, particularly those with neurological and neurosurgical illness in the intensive care unit (ICU).

Fellows become competent in critical care management and procedures for these patients in the ICU. In addition, fellows have the opportunity to learn about the business and administrative aspects of ICU-based care necessary for successful implementation of quality care and quality-improvement initiatives.

The curriculum also covers the processes and accrediting bodies for delivery of acute stroke patient care.

Formal procedural training includes:

• Bedside point of care ultrasound
• Endotracheal intubation
• Advanced airway management
• Bedside percutaneous tracheostomy
• Bronchoscopy
• TCD ultrasound
• Critical care echo
• Critical care and quantitative EEG
• Central venous and arterial catheters
• Thoracentesis and chest tube placement
• Swan Ganz catheter
• Paracentesis
• Bedside lumbar puncture and lumbar drains
• External ventricular drain (EVD) placement
• IRRAFLOW management
• Advanced trauma life support (ATLS)

Rotation schedule

The 24-month curriculum includes these core rotations:

Each month, fellows have primary responsibility to the assigned clinical or elective rotation. Each rotation has specific goals and learning objectives that are reviewed at the beginning and end of each rotation.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, didactic courses and one-on-one instruction are integral parts of the Neurocritical Care Fellowship.

Conferences

Throughout your fellowship, you participate in and periodically present at weekly conferences, including:

• Neurocritical Care Grand Rounds
• Neurocritical care core curriculum (board review, journal club, case presentation, attending lecture)
• Neurocritical care mortality and morbidity conferences
• Critical Care Grand Rounds
• Critical care core curriculum

Additional conferences available to fellows include:

• Neurosurgery Grand Rounds
• Neurovascular conferences
• Medical Grand Rounds
• Neurology Grand Rounds

During research elective rotations, you are encouraged to attend Center for Clinical and Translational Science (CCaTS) webcasts, which include topics on statistical design and research methodology.

Technology

The Mayo Clinic Neurological Intensive Care Unit (Neuro ICU) has state-of-the-art ultrasound machines for critical care echocardiography, lung ultrasonography, optic nerve sheath ultrasound, and transcranial Doppler. The Neuro ICU practice has used 24/7 Telepresence robotic technology to strengthen ICU practice since 2010.

Evaluation

To ensure that you acquire adequate knowledge and develop your cognitive and procedural skills, your performance is monitored carefully during the course of the Neurocritical Care Fellowship. You are evaluated formally by your supervising faculty member after each clinical rotation and meet with the program director to review these evaluations. In addition, you have opportunities to regularly evaluate the faculty.