Neurocritical Care Fellowships

The Neurocritical Care Fellowship is a 2-year ACGME-accredited training program within the Division of Neurocritical Care at UT Southwestern. Neurocritical Care is jointly supported by both the Departments of Neurology and Neurological Surgery.

We have a diverse group of faculty members with training backgrounds in neurology, neuroanesthesia, pulmonary critical care, interventional neuroradiology, and a large Advanced Practice Provider Program.

Fellows gain valuable experience in managing acute neurological and neurosurgical conditions such as acute ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, refractory status epilepticus, neuromuscular respiratory failure, neuroinfectious and autoimmune processes, traumatic brain and spinal cord injury, and more.

A 1-year fellowship training pathway is available for eligible candidates who have completed an accredited neurosurgical residency program or critical care fellowship program (anesthesia, surgical, internal medicine, or pediatric critical care).

We have significant experience with candidates from various educational backgrounds and welcome applicants from neurology, internal medicine, neurosurgery, emergency medicine, and anesthesia residency programs. While our strength is the breadth of our clinical experience, our primary goal is to provide high-quality, comprehensive, culturally relevant, and individualized mentorship and training to foster the development of fellows into well-rounded clinicians, scholars, and educators.

Curriculum & Training
Fellows will rotate primarily through two different clinical sites during their training:
1. The NSICU at William P. Clements Jr. University Hospital (CUH) is a 24-bed ICU and is a tertiary referral center for complicated vascular neurosurgical cases that include aneurysmal subarachnoid hemorrhage, arteriovenous malformations, Moyamoya disease, and dural arteriovenous fistulas. UT Southwestern is also an Advanced Comprehensive Stroke Center which serves a large geographical area expanding throughout North/Central/West Texas and into neighboring states. The NSICU is hardwired for continuous video EEG monitoring (24/7 availability and interpretation) in each room and has dedicated advanced neuroimaging (64-slice dual-energy CT, 3T MRI, neuroangiography) capabilities adjacent to the unit.
2. Parkland Memorial Hospital is a safety net hospital supported by Dallas County and is a Level I Trauma Center and Comprehensive Stroke Center. The new Parkland building has 862 single-patient rooms with a dedicated 12-bed neuroscience/neurotrauma ICU that is adjacent to our Trauma/Surgical and Cardiovascular ICUs.
Timeline

This represents a typical training pathway in our fellowship, but adjustments can be made to better serve a candidate's career goals.
- 52 - 62 weeks – Neuro ICU
- 12 - 16 weeks – Medical, Surgical, and Cardiothoracic ICU
- 4 - 6 weeks – Anesthesia (airway proficiency at beginning of fellowship)
- 2 - 4 weeks – Neurosonology
- 22 - 28 weeks – Electives/Selectives/Research
Available electives

Neurosurgery, ICU EEG monitoring, Stroke, Critical Care Nephrology, Procedure Team, Infectious Diseases, Palliative Care, Emergency Critical Care Ultrasound, Neuroanesthesia, Neuro-Interventional Radiology, Burn ICU, Research, etc.

Mentorship

Fellows are paired with 1-on-1 mentors as an all-encompassing resource throughout their fellowship to assist with career and professional development and well-being.

Education and Didactics

We have weekly didactic conferences attended by faculty, fellows, residents, and NPs/PAs. These include:
- Article exchange and literature review
- Lectures (neurocritical care, critical care, pharmacy, etc.)
- Debates
- Case-based presentations
- Morbidity & Mortality conference
- Journal Club
- Board Review
Simulation Education

Simulation education is a large component of the fellowship curriculum to develop procedural proficiency (central venous cannulation, arterial cannulation, endotracheal intubation, bedside critical care ultrasound, bronchoscopy, chest tubes, advanced airway, etc.), as well as teamwork and communication skills (Code Blue & high-fidelity training). The UTSW Simulation Center is one of the largest and state-of-the-art facilities in the nation and includes virtual reality technology, task-trainers, high-fidelity environments, and a team of educators to assist with curriculum and content development. Training in external ventricular drain (EVD) and intracranial monitor placement is supported by the Neurosurgery department. Fellows also have the opportunity to become certified in Simulation Education or participate in other educational endeavors (e.g., curricula development, medical student education, etc.) if they are seeking a career in education.

Research and Collaborations

We are involved in numerous clinical trials and expect fellows to participate in scholarly activities (research, QI, etc.) under the guidance of a faculty mentor. We have monthly Neurocritical Care/Neurotrauma meetings to propose new research ideas, discuss ongoing progress of current research, and collaborate with researchers from other departments. We work closely with the Neuroscience Nursing Research Center, which operates under the direction of DaiWai Olson, Ph.D., R.N.

We participate in several clinical research networks with the Texas Institute for Brain Injury & Repair, Lonestar Stroke Consortium, and the SIREN network for trauma and emergency neurological trials. We were the lead site for the BOOST-2 study and are currently enrolling in BOOST-3 and several other acute trials in TBI. We also have the largest database of automated pupillometry in the world (ENDPANIC).

Fellows are expected to take part in monthly ICU quality and safety meetings and potentially develop quality-assurance focused projects if they have interest in systems-based practice or administration.

Equipment and Technology

The ICUs are equipped with the latest Philips© Intellivue monitors, continuous video-EEG monitoring, bronchoscopy procedure carts, Sonosite© portable ultrasounds, noninvasive cardiac output monitoring, surface and intravascular cooling techniques, video laryngoscopy with Glidescope© and McGrath©, NeurOptics NPi®-300 pupillometers, and intracranial monitors with the ability to record parenchymal temperature, brain tissue oxygenation levels, and intracranial pressure.
Prerequisites

Potential fellows must have completed an ACGME accredited residency training program in neurology, child neurology, anesthesiology, internal medicine, or emergency medicine. Potential fellows seeking a 1-year training position must have completed a fellowship in critical care (anesthesiology critical care medicine, internal medicine critical care medicine, surgical critical care medicine, or pediatric critical care), or have completed or be matriculated in a neurosurgical residency program.
Application

We participate in the Neurocritical Care Fellowship Match Program via the SF Match and receive applications via the Central Application System (CAS). Applications typically open in January with interviews occurring throughout the Spring. Rank lists are usually finalized and submitted in August. For inquiries about the application process, fellowship positions listed outside the match, or any questions about our program.
Fellowship Education Team
Ranier Reyes, M.D.

Program Director
Neurocritical Care Fellowship

Team Members
- Venkatesh Aiyagari, M.D.
- Joshua Battley, M.D.
- Christiana Hall, M.D.
- Bethany Lussier, M.D.
  (Pulmonology & Critical Care)
- David McDonagh, M.D.
  (Neuroanesthesia)
- Robin Novakovic, M.D.
  (Neurointerventional)
- DaiWai Olson, Ph.D., R.N.
  (Clinical Research)
- Bappaditya Ray, M.D.
- Ranier Reyes, M.D.
- Jia Romito, M.D.
  (Neuroanesthesia)
- Michael Rubin, M.D.
- Kartavya Sharma, M.D.