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Vascular Neurology Fellowship
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Education & Training

Vascular Neurology Training Curriculum

The Vascular Neurology Fellowship Program curriculum is designed to develop proficiency in the emergent and urgent treatment of vascular neurologic conditions, and comprehensive care throughout the continuum of care including preventive care. Throughout the year fellows will gain experience in administration, stroke quality metrics, and organization of stroke systems of care and participate in Stroke Quality Reviews and Stroke System meetings. These skills are needed to participate and lead stroke centers both in community hospitals and academic centers. All fellows participate in and become investigators in stroke clinical trials and StrokeNet Regional Coordinating Center activities. There is an opportunity to apply for a StrokeNet Training Award for those interested in additional research experience.

Fellowship Highlights

  • Acute Stroke Care including thrombolysis and thrombectomy
  • Stroke Prevention Clinic
  • Telestroke (Acute Care, In-patient consults, and outpatient appointments)
  • Stroke Quality Projects
  • Systems of stroke experience
  • Research Training
    • Active role in StrokeNet Regional Coordinating Center/Stroke Clinical Trials
    • Introduction to the Principles and Practice of Clincal Research (NIH course)
  • Individualized Mentoring
  • Schedule optimizes time for board preparation early in the year
  • Progressive responsibility including sharing call with attendings, running morning rounds
  • No in-house call
  • Teaching of residents, medical students and other healthcare providers

Rotations

  • Stroke inpatient service (20 weeks)
  • Neurocritical care (4 weeks)
  • Stroke prevention clinic (4 weeks)
  • Telestroke (4 weeks)
  • Elective (4 weeks)
  • Rehabilitation (4 weeks)
  • Research (4 weeks)
  • Neurology Board preparation time: (one week)
  • TCD course (Wake Forest): (1 week)
  • Introduction to the Principles and Practice of Clinical Research Course (NIH) (1 week)
  • International Stroke Conference (1 week)
  • Vacation (4 weeks)

Electives Chosen by Recent Fellows

  • Endovascular
  • Vascular Laboratory
  • Research
  • Community Neurology

Conferences and Meetings

Regional and national conferences, special seminars and lectures are offered to all vascular neurology fellows and are attended regularly. All fellows will attend the International Stroke Conference and participate in preconference activities. This past year fellows also attended the World Congress of Stroke (Abu Dhabi) and the Society of NeuroInterventional Surgery Meeting and Fellows course (Colorado Springs).

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Comprehensive Stroke Training

Fellows receive comprehensive training in the diagnosis and treatment of ischemic and hemorrhagic stroke, transient brain ischemia, occlusive and hemorrhagic diseases as relevant to mastery required of the American Board of Psychiatry and Neurology Vascular Neurology board examination, such as:

  • Air/fat embolism
  • Aneurysmal subarachnoid hemorrhage
  • Aortic arch cerebral and spinal embolism
  • Cardiogenic brain embolism
  • Cerebral venous thrombosis
  • Cervical artery dissection
  • Complications including raised intracranial pressure, infections, pneumonia, and deep venous thrombosis
  • Encephalopathy Syndrome
  • Genetic and metabolic disorders
  • Hemodynamic brain ischemia
  • Hereditary and acquired hypercoagulable states, including antiphospholipid antibody syndromes, disseminated intravascular coagulation, thrombotic thrombocytopenic purpura
  • Intracerebral hemorrhage
  • Lacunar strokes and microangiopathic white matter disease
  • Large vessel extra-cranial cerebral atherosclerosis
  • Large vessel intra-cranial cerebral atherosclerosis
  • Migraine and stroke mimics
  • Non-atherosclerotic vasculopathies including those that are genetic, inflammatory, or infectious
  • Radiation vasculopathy
  • Reversible Vasoconstriction Syndrome/ Posterior Reversible
  • Spasticity and neurorecovery after stroke
  • Spinal cord infarction
  • Stroke in malignancy, immunosuppression, and as a consequence of systemic illnesses/conditions
  • Subdural hematomas/epidural hematomas
  • Substance abuse and drug toxicities
  • Surgical management of brain ischemia and hemorrhage
  • Vascular malformations

Core Curriculum Blocks

  • CRISP Course (introductory course on epidemiology, outcomes and statistics; 3 weeks)
  • Acute Stroke Care Inpatient Service; includes telestroke (20 weeks)
  • Neurocritical Care (4 weeks)
  • Rehabilitation (Combination of inpatient Rehabilitation Hospital and Inpatient Physical Medicine and Rehabilitation Consult service; 4 weeks)
  • Stroke Prevention Clinic (longitudinal clinic and Ambulatory blocks including a Telestroke Virtual Clinic and a Spasticity Clinic with the opportunity to learn botox injections) (6 weeks)
  • Research 4 weeks
  • Elective 7 weeks
  • Vacation (4 weeks)

There is flexibility in the curriculum to provide some customization reflecting prior experience during neurology or other training and to ensure that fellows gain experiences that will be comprehensive and optimized to meet their future career goals.

Evaluation Policy

Evaluation of progression to competency in the areas of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice is based on the Vascular Neurology Milestones.

Fellows evaluate themselves on these milestones at entry into the fellowship - to determine where they are and identify gaps that would become areas of focused study; mid-way through their training to see how far they have progressed and reevaluate their goals; and near the end of training to ensure your preparation for graduation and the next phase of your career.  Faculty evaluate the fellows mid-way through and near the end of training. 

In addition, fellows will evaluate attending faculty and the Vascular Neurology Fellowship Program.  They are appointed members of the Vascular Neurology Program Evaluation Committee and participate in the formal review and performance improvement activities of the training program.

Administrative Tasks and Other Policies

In accordance with Accreditation Council for Graduate Medical Education (AGCME) policies, administrative duties are similar to those required during residency, such as timely submission of duty hours and evaluations and monitoring for fatigue as well as participation in quality activities as an appointed member of the Stroke Quality Committee and University Hospitals System Stroke Program Committee. Moonlighting is permitted during the fellowship and available within the Department of Medicine at UH Cleveland Medical Center, as consistent with ACGME policies on respecting duty-hours and avoid interfering with your primary training.