Acute neurologic disease that is seen in the inpatient setting has become increasingly complex and intertwined with systemic medical illness. The skillset needed to manage patients with acute brain injury and concurrent critical systemic illness is highly specialized and in demand. Neurocritical Care has been at the forefront of delivering treatments to improve care and physiologic understanding of acute brain injury. The NY Presbyterian Neurocritical Care Program is one of the longest-running and most-respected in the country. The 2-year fellowship is based on the curriculum defined by the United Council of Neurologic Subspecialties (UCNS). Training occurs in the 18-bed NeuroICU at the Columbia University Medical Center and the 14-bed NeuroICU at the Weill Cornell Medical Center under the supervision of 10 faculty neurointensivists. Upon completion, fellows are proficient in the complex management of a wide range of acute brain injury in critically ill patients. Development of independent research projects is strongly encouraged and are supported with training in database management and biostatistics. A substantial time commitment is required, including five-day rotations of 12-hour-shift in-house call and weekend call once a month. Four weeks of vacation time are allotted per year. Salary is commensurate with PGY level. Fellows will gain proficiency in the medical management of the critically ill patient. Procedural skills include: ultrasound-guided central venous line placement, arterial line placement, endotracheal intubation, fiberoptic bronchoscopy, point-of-care ultrasound performance and interpretation, lumbar puncture and drains, continuous EEG monitoring, ventriculostomy management, and cerebral multi-modality monitoring (including brain oxygen monitoring, cerebral microdialysis, cerebral autoregulation). In addition to time spent in the NeuroICU, fellows will complete required rotations in the medical, surgical, cardiothoracic intensive care units, as well as the acute stroke service. Fellows will participate in the Columbia Critical Care Medicine Curriculum, which is an organized collection of lectures, teaching conferences, Journal Clubs, and Grand Rounds. The primary goal for our NCC Fellows is to develop proficiency in providing critical care for adults with a variety of neurological and non-neurological critical illnesses, as well as performing diagnostic and therapeutic procedures, acute postoperative (neurosurgical) management, and advanced life support. All required rotations are at the New York Presbyterian Hospital's Weill Cornell Medical Center (WCMC) or Columbia University Medical Center (CUMC) campus. Elective rotations may be taken at either campus, unless otherwise specified.
There are 16 months of core ICU Rotations (16 months): Neurological Intensive Care Unit (NICU) (13 months inclusive of CUMC Night Float 3.5 months), Trauma/Surgical Intensive Care Unit (SICU) (1 month), Medical Intensive Care Unit (1 month), Cardiothoracic Intensive Care Unit (CTICU) (1 month). There are 2 months of mandatory non-ICU rotations: Vascular Neurology/Stroke service (2 weeks), Interventional Neuroradiology (2 weeks), Anesthesiology/Operating Room (1 month). There are four total months of elective rotations, which may include: clinical research, clinical teaching, critical care ultrasound, neurosonology, neuromonitoring, critical care radiology, neuroradiology, neurocritical care informatics, as well as rotations in nephrology, infectious disease, cardiology, and pulmonology.