neurocritical care fellowship interview experiences

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ashtraveler

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Anybody want to share their interview experiences? I thought I'd start a thread here since there isn't a forum on the NCS site yet.

I've interviewed @ Duke, Hopkins, UTSW so far. If anyone is interested let me know.

Duke and Hopkins both only have one spot available for the match. I think they're different but great programs.

Has anyone interviewed @ UCSF, Penn, TJ, Columbia, Wash U, Baylor?

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Hi, I interviewed at Duke, Wash U, MCW and Cleveland. I have a visa and even though I rotated at Hopkins, I would not rank them as I would not be getting the visa I hold currently. Same for Columbia. I did not call/interview at MGH and California programs. How many places do you think average people would be interviewing at. This is first year of match and there is a lack of clarity so far. What do you think?
 
what did you think about UTSW?

i'll be the fellow starting in july.. :D:scared::confused::eek::

i didn't any programs in the northeast or midwest (fiancee didn't want go to new york.. i didn't want to be in boston).. unfortunately.. by the time i sent my application in.. a lot of places were full (e.g. ucla, ucsf,etc).. lot of internal candidates..
 
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There isn't a lot of uptodate info on the neurocritical care programs. If anyone feels like it, it would be great to hear your opinions of the various programs you visited.
 
TAKE WITH A GRAIN OF SALT

UTSW: It has great potential. It's new. Parkland is not quite up and running. Neurosurgery gives great support. Great camaraderie. I had a hard time understanding Dr. Yu. Dr. Hall has an MS and will be a great asset for publications, etc. I dont' know how many they will interview. I think they will have 2 spots.

JHU: They get their hand dirty. They're involved. They essentially work like residents. The fellows like that there. I don't think they have enough "required" exposure to the MICU, SICU, anesthesia. My attendings who went to Hopkins said they would have liked that when they trained. Not much trauma. PD (Carhuapoma) didn't seem too open and frank--seems like he's hiding something. Most other attendings I interviewed with were great except for (Stephens). Ziai, Nyquist, Naval, Mirski are all great folks. Only have one spot for the match. They take 3 fellows per year, but I don't think they count the military fellows?? I think they're interviewing about 10 applicants.

Duke: Great attendings and unit. Attendings are easy to talk to and collegial. PD (McDonagh) really nice guy. Big minus for me is the community hospital attending work for a few weeks. Would be good to keep up general neurology skills. Great research potential. Only one spot for the match. I think they're interviewing 7 applicants.

These are only my opinions and thoughts.

Anybody who's interviewed at UCSF or Columbia or Wash U or Baylor would like to give some feedback/thoughts?
 
My interview experiences (in the order of appearance) so far

Duke: good solid program. Prides itself on stability and solidity. Has faculty who are all Duke trained with diverse research experiences. Multiple clinical projects where a fellow could participate as an investigator. Patient population has diversity. Good hands on experience. Rotation through different ICUs required.

On the flipside, you work in an outreach hospital 6 weeks of the fellowship to finance your own fellowship. But seems like this is a settled plan and would not be changed much.

Cleveland Clinic: Provencio is a plus, ? other faculty, Manno coming from Mayo, but the program is yet to be stable enough from constant changes it has gone through. Neurosurgeons still like to take charge of their patients. Makes life in ICU a little challenging. But Provencio says 97% of orders written by ICU staff only. (Remaining 3% might make some vital difference). It promises to get bigger and better in future. But what holds true about future? Fellows had to decide their own training in the past and they have come out well trained.

Wash U, MO: Diringer is a big plus. He trains his fellows hard and well. There is a PET scanner in ICU and projects are being designed around that. Rest of the Neuro ICU faculty is young. A pulomonologist is also getting to run the ICU once a week. Still early to say whether it is a plus or a minus. Open ICU. (But by this time of the tour I am not really sure if that means much to me). Plan is afoot to get MICU, SICU selectives in the training curriculum.
Lot of research time.

MCW: Torbey and a bunch of trained neurointensivists + Interventional neurologists run the ICU. SAHs are coiled and NSG has nothing to do with them. Neurointensivists provide consultancy services to neurosurgical patients if required. Hands on training. MICU, SICU rotations. Lot of research time and good research coming out of Torbey's lab- mostly basic sciences.

I would be happy getting into any of the ICUs since the training experience of the fellows has been good so far. The stability of Cleveland Clinic program is a doubt, but it promises to get better.

Share your experiences. How many programs is everyone planning to interview at? I will be Emory next week and then decide if I need to interview more. I am pissed with some programs coming out with the BS that they have committed 1 out of 2 seats (Duke, Wash U) to people from before. It raises a question about validity of the match- considering the time and money you spend in going to meet those people and get this information during the interviews.
 
I'm planning on interviewing at 10 to 12 programs. Does anyone have any idea how many applicants there are?

Anyone interviewing at CPMC?

I think that the match this year is careless and wasteful and selfish amongst the PDs and NCS committe members. Most of as residents have a difficult time to schedule and afford multiple interviews. Rather disappointing to go to an interview and learn that there is only one position available. Feels as if we've been mislead.
 
I'm planning on interviewing at 10 to 12 programs. Does anyone have any idea how many applicants there are?

Anyone interviewing at CPMC?

I think that the match this year is careless and wasteful and selfish amongst the PDs and NCS committe members. Most of as residents have a difficult time to schedule and afford multiple interviews. Rather disappointing to go to an interview and learn that there is only one position available. Feels as if we've been mislead.

i interviewed at CPMC last year.. still a young program... dr. jack rose and dr. david tong seem very committed to teaching and both seem approachable.. facilities are pretty nice.. program seems very stroke oriented.. dr. tong seems to emphasize research..
 
university of miami - jackson memorial hospital

i didn't techinically interview here.. but i'm currently a resident.. if you asked me about a year ago (before i started interviewing at other institutions) i would have stayed here for neurocritical care..

it's a relatively young program.. 1 fellow right now.. 2 fellows coming in next year... 24 bed neuro icu.. headed by dr. kristine o'phalen and dr. hal mangat.. dr. dileep yavagal is a neuro trained interventionalist.. all are very good at teaching with a strong knowledge base.. the neurology chairman is dr. ralph sacco (big name in stroke.. new AHA president), however his role is limited..

unfortunately it's going through a lot of growing pains.. neurosurgery pretty much runs the unit.. although neurology shares beds with neurosurgery.. it's a closed unit only for general neurology patients.. it's an open unit for neurosurgery patients..

there's piss poor communication between teams (neurosurgery, gen. neuro, stroke, neurocritical care).. it's not necessarily a neurology/neurosurgery problem, but rather a culture of jackson memorial hospital problem.. no one communicates with one another.. it's almost antagonistic

neurocritical care fellows take in house call with 2 other residents (currently once a week).. hence.. there's only on-call coverage Monday-Wednesday.. i expect this to change.. and will probably be a q3 call... since it's a 24 bed unit.. morning rounds tend to be quite long and often runs into the afternoon..

the role of the neurocritical care team needs to be better clarified.. neurology residents main complaint about the ICU is that they feel pretty much useless since the neurocritical care team is only the primary team on general neurology patients..

nevertheless.. despite all the shortcomings.. it can be a great program within 5-10 years.. man power problems can be overcome.. the culture of jackson memorial hospital will always remain...
 
university of miami - jackson memorial hospital

i didn't techinically interview here.. but i'm currently a resident.. if you asked me about a year ago (before i started interviewing at other institutions) i would have stayed here for neurocritical care..

it's a relatively young program.. 1 fellow right now.. 2 fellows coming in next year... 24 bed neuro icu.. headed by dr. kristine o'phalen and dr. hal mangat.. dr. dileep yavagal is a neuro trained interventionalist.. all are very good at teaching with a strong knowledge base.. the neurology chairman is dr. ralph sacco (big name in stroke.. new AHA president), however his role is limited..

unfortunately it's going through a lot of growing pains.. neurosurgery pretty much runs the unit.. although neurology shares beds with neurosurgery.. it's a closed unit only for general neurology patients.. it's an open unit for neurosurgery patients..

there's piss poor communication between teams (neurosurgery, gen. neuro, stroke, neurocritical care).. it's not necessarily a neurology/neurosurgery problem, but rather a culture of jackson memorial hospital problem.. no one communicates with one another.. it's almost antagonistic

neurocritical care fellows take in house call with 2 other residents (currently once a week).. hence.. there's only on-call coverage Monday-Wednesday.. i expect this to change.. and will probably be a q3 call... since it's a 24 bed unit.. morning rounds tend to be quite long and often runs into the afternoon..

the role of the neurocritical care team needs to be better clarified.. neurology residents main complaint about the ICU is that they feel pretty much useless since the neurocritical care team is only the primary team on general neurology patients..

nevertheless.. despite all the shortcomings.. it can be a great program within 5-10 years.. man power problems can be overcome.. the culture of jackson memorial hospital will always remain...


thanks for the info..as a UM med student and strong interest in doing a neuro residency at UM, i hope in 5-10 years the kinks of the program are worked out!
 
I interviewed at about 10 places and each place has its positives and negatives.

1. U Penn - good new program with plenty of support and collaboration from NSG. Multimodality tons. You see everything trauma, bleeds, myasthenia. Lots of procedures but drains and licox put in by NSG but will teach you if you like. Positives very academic, will make you present 1 lecture per month which equals 24 when you are done from fellowship. Negatives, new, call is 7 per month for all 2 years, databases and clinical research not as developed as Columbia but on the up

2. U Cincinnati - If you like stroke as well then you should seriously consider this program with exposure to the best stroke program in the country. Plenty of procedures and willingness to teach how to do EVDs but multimodality monitoring is limited. But very good training and ED presence is def a plus.

3. Duke - solid program, limited multimodality monitoring but one of the first programs with plenty of mentoring, research opportunties, and much more practical call schedule. Def top program. Neurosonolgy course. Basic science aswell is one of the top.

4. U Chicago - smartest neurointensitivist in all of chicago and possible the entire midwest. You do all procedures but multimodality not as developed. Rosengart left due to Frank sex scandal but still I would trust a Neurointensivist out of this program especially if they stay 2 years.

5. NorthWestern - Faculty are young but Northwest has plenty of money and probably going to be stable. no multimodality but clinical research and basic science opportunities are there.

6. Rush - up and coming with very friendly young faculty with push for multimodality and new hospital coming with Dr Bleck this program will probably be the best in Chicago shortly. Also lots of exposure to stroke.

7. Wash U - Diringer is solid mentor and will get you what ever experience you want. Research & clinical. No EVD or Multimodality cause not proven, similar to Hopkins view. Tons of neuroimaging research. Busy with good training.

8. Stanford - consultative service but 1st year is all MICU, SICU, Trauma so you will be confident to handle sick patients. No multimodality and no EVDs procedures during NICU month during 2nd year. Lots of exposure to stroke and would be a good program for someone who is considering stroke as well as interventional in the future. Nice schedule beautiful city

9. Columbia - do I have to say anything. Closed unit, multimodality, tons of clinical research, call only once a week, time for research, all graduates go on to do what ever they want. # 1 program in the country from my point of view unless you like putting in EVDs, Licox, etc. That is only thing lacking. Also Mayer may be going to Mount Sinai as Chair.

10. UCSF - solid critical care training especially first year, integrated in neurovacular service at Mofitt hospital. Great mentors and opportunities but they realize lack of time for research and academic career development has been a complaint in past. They have tried to change it with more electives. Still one of Top programs aswell.

11. Emory - 4/21

12. Cedar Sinai - 4/24

Please add more comments for all these programs if you have interviewed there as well. That is just my first impression of the programs would love other views on the programs.:)
Sincerely,
Brain on Brains
 
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I believe there are 20 total applicants. With many just interviewing at coasts while others are interviewing every where about 12 to 15 went every where. Most people should get one of their top 5 picks depending on how competitive you are. Most programs will have 1 to 2 spots x 10 schools = 15 spots available if you interviewed at 10. There are more spots then applicants considering there are over 20 schools. I believe in end, the top programs will benefit by having chance to interview everybody and the proactive 1st movers will get punished by waiting for everyone to get looked at. Don't know if this is the best system. Also very expensive.
Positives are no one can force you to make a decision prematurely but you might lose a spot you would have otherwise gotten. You do get to look at all the programs which are so different to see where you fit best.
So overall + and -.
 
I've interviewed at a total of 10 programs and would estimate that there are about 15 to 20 applicants.

See above for UTSW, JHU, and Duke.

UCSF: I ditto what others have said. Great first year. Great trauma at SFGH. Lots of autonomy at SFGH. Great potential for research. This year will start biostats/grant writing course. It's 2 months of protected class time. It's something they're trying. All staff are nice and friendly. Work like resident at times at Moffit while in the MICU. Home call.

CPMC: modeled after UCSF with less MICU. You do trama at SFGH. Take a great deal of stroke call. I think it's stroke heavy. Otherwise consultative service. Home call.

Penn: I didn't feel welcomed, especially by Levine. Park is great. Kofke seemed arrogant. Great place to train. All the toys available. Research potential great. Trauma. New NICU this year. 3 fellows per year?? 7 or so overnight calls per month, neurology is coming on board, but don't take overnight call. You do get some moonlight money for call.

TJU: Kumar will be the strength of that program. Very busy! Not enough of attendings nor fellows. This program has a ways to go. Doesn't sound like the greatest relationship with neurosurgery. Less trauma than Penn. They're adding more NICU beds, as if they don't have enough. 30+ step down. No overnight call.

Wash U: Diringer is tough but great thinker. No one stays. Not sure why. Great NICU. Growing as well. Little trauma. Not much research potential with Licox, etc. More of an imaging center. Call will start to be staggered, but currently is home call. Only 2 neurointensivist. 3rd is a pulmonary CC. Very nice. Is currently learning the neuro aspects of it. Trauma fellow rotates often. Neurology resident rotates. You encouraged to rotate in TICU. Like Hopkins don't rotate much through other units.

Columbia: I think the best program in the US. No trauma. Combined with Cornell. Will have about 8 or so fellows so call will be one overnight per week. Well equipped. Attendings are all great guys. No one is stuck up. All welcoming. Humble. Take care of sick patients. At times take care of non neuro patients if they overflow. Real intensivists. Neurology only rotates.

Baylor: Suarez is a great person and trainer. Lopez is not well liked. (they keep him hidden) Trauma at Ben Taub. Do lots consultations at St. Lukes 5 to 6 per day. Done by neurology resident and staffed by you. Stroke call. Home call, but would have to come in for stroke. Seems really busy. They want to take over at Ben Taub, but they don't have enough staff yet. Claudia Robertson get lots of research grants and has every toy. Relatively new program, but has great potential.

Good luck to everyone!
 
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Here is my opinion of how a few programs rank. Anybody care to share their opinions on programs ranking?
This is my opinion more based training quality, research potential and exposure to trauma.

Columbia/Cornell
UCSF
MGH
Duke
Penn
UCLA
JHU
U Chicago
MCW
Baylor
Wash U
Henry Ford
UTSW
Cincinnati
Wayne State
Cedars-Sinai
Cleveland Clinic
Rush
Miami
Northwestern
Oregon HSC
TJU
MUSC
Standford
Mayo
CPMC
SLU
 
9. Columbia - do I have to say anything. Closed unit, multimodality, tons of clinical research, call only once a week, time for research, all graduates go on to do what ever they want. # 1 program in the country from my point of view unless you like putting in EVDs, Licox, etc. That is only thing lacking. Also Mayer may be going to Mount Sinai as Chair.

Anybody care to comment how this might affect the program?
 
If Mayer leaves that would be bad for Columbia from the surface or from a fellowship training point of view. I think the attendings there are all strong and hard-working. For some reason, we think that name alone carries a program. At some places it does, but I think Columbia is strong for having Lee, Badjatia, and Classen. All young but great potential. Of course there is something to say about experience. But I wouldn't be surprised then to see some other big name recruited to Columbia.

I hadn't heard this. Not sure how much of it is a rumor? Anybody else heard this?
 
In my opinion, Columbia offers superb training but they do not see brain trauma. This is a serious drawback. I would worry about training at a program that does not allow me exposure to a major component of the neurocritical care curriculum.
MGH has great people but they are not participating in the match - seems a bit unfair.
Penn seems to offer superb training - they have a young group of attendings who already seem like they are leaders. The call requirements are heavy, but they get to place monitors, especially at night, and their fellows feel that the call is educationally beneficial.
UCSF and JHU seem like solid training programs as well.
 
If Mayer leaves that would be bad for Columbia from the surface or from a fellowship training point of view. I think the attendings there are all strong and hard-working. For some reason, we think that name alone carries a program. At some places it does, but I think Columbia is strong for having Lee, Badjatia, and Classen. All young but great potential. Of course there is something to say about experience. But I wouldn't be surprised then to see some other big name recruited to Columbia.

I hadn't heard this. Not sure how much of it is a rumor? Anybody else heard this?

I talked to Erroll Gordon (NICU attending at Mt Sinai) at AAN who said that they did interview him but job was offered to someone else. So Mayer is still at columbia. I also agree that columbia has such a set up and so much research that they would not miss a beat or hinder training if Mayer did leave.
 
Today is the match day. Has anyone heard anything yet? Please share.
 
Hey Guys, I know this is a relatively old thread but I was just wondering if anyone had anything else to add. I know UCSF and Columbia are amongst the top of the line programs, anything new ?
Dose MGH participate in the match now? I heard that at some point they were not. What do people think about their system? Heard is a consultant service.
Some one mentioned that Johns Hopkins work their fellows like residents. Is that true?
Your inputs would be apppreciated.
[GVIDEO][/GVIDEO]
 
MGH did not take part in Match first year due to having promised the spots to people before match talk was finalized. I believe they are now taking part in the match.
Hopkins will have you work a lot but it's one week on, one week of so I don't expect

Other solid programs besides Columbia or UCSF are DUKE, MGH, Hopkins, UCLA (if u get along with Vespa), Wash U

But there are several underrated programs U Chicago, Emory, Rush,
Stanford & U Cincinatti (due to their strong stroke interaction).
 
Hey there, I'm interviewing this season for a fellowship in 2013. So far I've interviewed with U of Chicago, and felt it was a good hands on program. Would like to hear from other people.

Would greatly appreciate any input from newly graduated fellows about job opportunities and lifestyle.

I've interviews lined up with MGH, JHU, CUMC and Wash U. Any suggestions/comments? One thing I'm having trouble with is choosing whether I should go for the "name" or actual training experience because I've had a very good experience with U of Chicago and unfortunately they do not participate in the match and will be asking the question about joining their program too early! One thing about the program is that they allow us to put in EVD, bolts and from what I hear there are not too many programs that allow this.

I'M SURE THE NUMBER OF PEOPLE INTERVIEWING FOR NCC FELLOWSHIPS HAS INCREASED OVER THE YEARS, AND IT WOULD BE HELPFUL TO HEAR FROM OTHER FELLOW APPLICANTS.
 
Hi arrythmic
I am applying to NCC 2013 too.
Can I know when heard from MGH and JHU?. MGH told me that they will be reveiwing applications in Mid Jan.:(
Thanx.

Hey there, I'm interviewing this season for a fellowship in 2013. So far I've interviewed with U of Chicago, and felt it was a good hands on program. Would like to hear from other people.

Would greatly appreciate any input from newly graduated fellows about job opportunities and lifestyle.

I've interviews lined up with MGH, JHU, CUMC and Wash U. Any suggestions/comments? One thing I'm having trouble with is choosing whether I should go for the "name" or actual training experience because I've had a very good experience with U of Chicago and unfortunately they do not participate in the match and will be asking the question about joining their program too early! One thing about the program is that they allow us to put in EVD, bolts and from what I hear there are not too many programs that allow this.

I'M SURE THE NUMBER OF PEOPLE INTERVIEWING FOR NCC FELLOWSHIPS HAS INCREASED OVER THE YEARS, AND IT WOULD BE HELPFUL TO HEAR FROM OTHER FELLOW APPLICANTS.
 
Hi arrythmic
I am applying to NCC 2013 too.
Can I know when heard from MGH and JHU?. MGH told me that they will be reveiwing applications in Mid Jan.:(
Thanx.

Hi there. I have also applied for NCC. MGH told me the same thing. As per SF match, MGH has 6 spots. That sounds like too many! Can anyone verify that?

Arrythmic, it's interesting that you brought the issue of UChicago. I was told that it's a really good program but the PD of UChicago told me that they plan to fill their spot out of match so did not even bother to apply there. My logic was that if it's not among my top 3 choices, I would take chance and go for the match. I know it's difficult to judge a program before even visiting there. By the way your interviews list is very impressive. I wouldn't mind going to any of those places. I wonder what you bribed them with to get those interviews because my application hasn't been opened by any of those yet. ;)
Good luck to both of you. Hope to run onto you at one of the interviews.
Let's keep this thread alive.
 
MGH does have 6 spots.
Thanks TN for the info.
WashU PD sent me an email last week saying they are not accepting applications this year. Other programs that are not accepting applications are Northwestern and Stanford.
Awaiting responses from JHU, Columbia, UCLA, UCSF, Duke, Emory, and Mayo (not in SF match). Anyone else awaiting this places too?
 
As an advice, you should pay attention to the Cleveland Clinic fellowship:
They have now 24/7 inhouse attending coverage and probably the largest number of attendings (9), among those some stars like Jennifer Frontera (moving from Mount Sinai), Edward Manno, Javier Provencio and Joao Gomes. Also, it is one of the few programs that has neurotrauma rotations. Plans to expand even more the unit (currently has 24 beds)

Good luck with the process to all!!
 
Hi arrythmic
I am applying to NCC 2013 too.
Can I know when heard from MGH and JHU?. MGH told me that they will be reveiwing applications in Mid Jan.:(
Thanx.

Hello,

Was stuck with night float and a busy stroke rotation. I've my interview with JHU on the 25th (yes its fantastic that they schedule interviews on weekend). Wash U later replied back saying that they are hiring 2 internal candidates and do not have funds for the third candidate and hence gently declined the interview. I still have to schedule dates with MGH and Columbia. Any inputs on the program at U Penn and Case Western?
 
Anyone read the NCS email by Wade Smith about the match. He basically railed on programs who sign outside of the match.
 
Just thought I'd jump start this thread again.
Anything anybody wants to add? Duke JHU CCF ? Anybody interviewing at Mount Sinai?
Tons of changes to the Columbia program....not sure how it will affect it. Good :luck: y'all
 
I heard Mt Sinai may not have a position this year. No word from Duke and JHU yet! Did anyone from the forum interview at JHU yet?
 
what makes an applicant competitive for neuro crit care? do board scores matter? research? LOR? I'm not quite sure what people mean when they say "competitive" for NCC

thanks
 
what makes an applicant competitive for neuro crit care? do board scores matter? research? LOR? I'm not quite sure what people mean when they say "competitive" for NCC

thanks

Once you're a resident, pretty much no one cares about your board scores anymore, unless you failed multiple times or something. Research and letters go a long way, but there are plenty of people with crap research who get into NCC fellowships. Who you know and where you train counts for a lot.

None of us want to hand the keys to some of the hospital's sickest patients over to some yahoo who will wilt under adversity.
 
what makes an applicant competitive for neuro crit care? do board scores matter? research? LOR? I'm not quite sure what people mean when they say "competitive" for NCC

thanks


No resident will have taken their neuro boards prior to applying for the fellowship. Most programs will want letter of interest, CV and LOR. If you want to go to the big name NCC programs, some form of research is going to be essential. Also your LOR are very important. Other than that, it comes down to the interview and how much they like you and you hit it off.
 
So now another interview season is drawing to a close any updates from applicants over programs on the interview trail? Any contenders to Hopkins/Columbia/UCSF/MGH/UCLA (in no particular order lol).
 
Hey all,

I will post a review of my personal interview experience and thoughts soon. I am finishing residency at a program without Neurocritical Care, and did not have a ton of guidance during the applications process, so it may help those with a similar background.
 
Everyone,
Wanted to post this before the match results come back as to not bias anything. Below are my opinions on the programs that I visited. They’ll come in chunks as I have time. Please keep in mind that everything that follows is one applicant’s subjective impression of these training programs. Another applicant with different career goals could have very different things to say. A few general things about applying/interviewing to NCC fellowship:

- This is an awesome time to train as a fellow. Many programs are starting/maturing, so whatever you are looking to do with your career there is a program for you.
- Every program I visited was “the right program” for some applicant. . . all had specific strengths that make them very desirable depending on what you desire
- Everyone you meet on the interview trail is laid-back, welcoming, and smart, so enjoy the trail
- I’ll use the terms “get your hands dirty” and “keep their hands clean” a lot, because I think this is the major distinction between programs that exist. In my opinion, a Neurointensivist should master all things critical care, then become a great Neurointensivist along with / after that, while also pursuing projects in basic/translational/clinical research. To be honest, two years is not really enough time to do that. Pulm/CCM people get 3 years, and the field in general is not as “academic” as NCC. There were programs I visited where you can really “get your hands dirty” and become a phenomenal clinical critical care physician: you are the one intubating every patient, placing patients on ECMO and managing them, placing every central access and A-line, placing EVDs, doing your own trachs/pegs, running a CT-Surgical ICU, MICU, or Trauma/SICU. You are the primary on every patient and his or her survival is on you. There were other programs where the fellows/attendings seem to “keep their hands clean”, performing the more stereotypical role of a Neurointensivist as a critical care – minded stroke Neurologist, doing tons of clinical/translational research, usually being a consultant or co-managing patients, and building fellows that will have very strong academic careers. There are very few programs in the country where you can do all of the above in two years. Personally, I am still trying to plan how to become a stand-alone, do everything intensivist while still making time for basic/translational research.

Disclaimer: My residency training was at a program without formal Neurocritical Care, so I was more or less amazed by every unit/program I saw. My overwhelming opinion on all of these programs is positive, and I am not experienced in the logistics that make Neuro ICUs and training programs good/bad to a more discriminative applicant.
 
Case-Western:

Cleveland certainly has its charm. The medical center is integrated into the Case undergrad campus, so there are ample opportunities to collaborate on research projects. The faculty are all super-nice, with an academic and clinical focus on stroke and data processing in the Neuro ICU. Case is a regional referral center for stroke, so it seemed like you will see a ton as a fellow. The NCC fellowship has great formal stroke teaching built-it. Tons of opportunities to get-in on clinical research. Chairman and program director were great. It seems like you can get your hands as dirty as you want as a fellow there, but will also have ample elective time to pursure basic/clinical/translational research projects to build an academic career. The current fellow seemed very happy, not worn-down, and had already secured an academic NCC attending position at a major Midwestern university.

Case is for the applicant that wants to work with laid-back people, become a very good clinical intensivist while still having time to build an academic career in clinical/translational stroke research, and enjoys Midwest charm.
 
Case-Western:

Cleveland certainly has its charm. The medical center is integrated into the Case undergrad campus, so there are ample opportunities to collaborate on research projects. The faculty are all super-nice, with an academic and clinical focus on stroke and data processing in the Neuro ICU. Case is a regional referral center for stroke, so it seemed like you will see a ton as a fellow. The NCC fellowship has great formal stroke teaching built-it. Tons of opportunities to get-in on clinical research. Chairman and program director were great. It seems like you can get your hands as dirty as you want as a fellow there, but will also have ample elective time to pursure basic/clinical/translational research projects to build an academic career. The current fellow seemed very happy, not worn-down, and had already secured an academic NCC attending position at a major Midwestern university.

Case is for the applicant that wants to work with laid-back people, become a very good clinical intensivist while still having time to build an academic career in clinical/translational stroke research, and enjoys Midwest charm.

It's more of a place in between the "get your hands dirty" and "keep you hands clean" place. As a NCC fellow, you will not get the opportunity to do EVD, intubate, trach, peg or bronch (I'm not sure about the last one). A-lines are done with a kit rather than with an all in one. Procedure wise, you do get to do a fair amount of A-lines, central lines and laser doppler.

I concur, the people there are as awesome as you can get.
 
University of Maryland Medical Center / Shock Trauma Center:

Dr. Badjatia is the new-ish director of the Neurocritical Care department at the University of Maryland, and the fellowship actually falls under the direction of Shock Trauma. He has big plans to make this the best training program and he is on his way. If you haven’t heard of Shock Trauma, it is unquestionably the best training center for trauma in the U.S., likely the world. The class of 2014 will be the first fellows at UMMC and I think they are in for a treat. In my opinion, this program will likely be the best all-around clinical training program in the country within the next three years. Neuro-trauma cases and training are scarce in most Neurocritical Care fellowships and non-existent in many. At UMMC/Shock, there are two separate Neuro-ICUs: one “Neuro-trauma ICU” physically located in Shock Trauma Center, and one “Non-trauma” traditional Neuro ICU. If you want exposure to trauma, which you should as a NCC fellow, this is the promised-land. Where else are you going to see decompressive laparotomies being done for refractory elevated ICP? With respect to the role of the fellow, at UMMC your hands will get filthy. You rotate through the Neuro-trauma ICU, CT Surgical ICU, MICU and SICU, where you are the primary fellow, not observing, but being the man/woman running the show when the patient crashes. It sounded like you would do everything here from ECMO to PEGs. With respect to academics, you still get a lot of elective time at UMMC, which can be used for clinical/basic/translational projects. There are many strong basic neuroscience labs at the UMMC campus despite being geographically removed from the undergraduate campus. There is a ton of clinical research going on at Shock. UMMC is a regional stroke referral center, so the stroke volume is high enough and the stroke attending are very chill. Everyone I interviewed with was nice, laid-back, and extremely enthusiastic about the program, which has plans to grow into one of the best quickly. Numerous faculty are coming in with very diverse training backgrounds, which makes for great clinical teaching.

In addition, Baltimore is not just the low-rises you’ve seen on The Wire. There are many extremely safe, prospering neighborhoods (Federal Hill, Canton, Fells) that surround the harbor. It is a fun city with lots to do and void of the pretention of some of the surrounding east coast cities.

UMMC/Shock is for the applicant that wants to be an exceptional, all-around intensivist that could run any ICU, with unique exposure to trauma and who also wants to be a renowned expert in Neuro-trauma research. Must love Old Bay.
 
Northwestern:

Overall, the group seemed to be the happiest NCC faulty/fellows I met along the interview trail. They really seem to have fun while they are at work. The aim of the training program is on producing "Academic" Neurointensivists. They really focus on having their fellows publish frequently and early-on in their training in top journals. Additionally, there are tons of basic/translational opportunities at NW, but everyone is able to contribute to the large volume of clinical research. They are ahead of the game on having a research and outcomes database, and if I left with the correct impression, the patients in their stoke/NCC database have almost all of their inpatient data directly fed into their database software, so that they are just formulating research questions and never have to retrospectively review charts.
NW is an amazing medical center, getting a ton of tertiary referrals (minus a ton of trauma), as there are not that many tertiary referral centers in Chicago despite the size of the city.
It was difficult for me to tell exactly how dirty the fellows and attendings hands' get on the unit there, as there are shared attending responsibilities with anesthesia. I think that there is abundant elective time though, and the fellows can use this to brush up on their airways, lines, and other procedures. The fellows certainly were not bogged down with clinical responsibilities and had time to pursue their academic interests.

Chicago is an awesome city, and if you do not agree then I really can't help you there.

Northwestern is for the applicant that wants to develop a strong academic resume in clinical research while having the elective time to personalize his or her fellowship to focus on specific areas to strengthen. Seems like a lot of future chairs will come from this program. Again, the group is very productive while truly having fun on the job.

Have breakfast at "Yolk" while you are there.
 
Hey guys,

I am new to this thread. I read a lot of useful comments. I couldn't understand one thing. Do all the programs accept applications starting around the same time and do they all wait for the match or does it differ ? How does the match process work ?
 
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Wanted to post, this thread is great, I'm just starting neuro residency and want to do NCC. It's all very very exciting, it's a great time for an amazing field.
Because it's such a small field it's hard to hear about direct experiences and evolutions in the field, so I would really like to follow threads like this over the next few years just to keep up with what is happening all around the country. Again, all very exciting. Thanks for all the thoughts and info, please keep them coming!
 
hey guys, just wanted to share a few my experiences from the first round of my interviews for NCC fellowship for 2015-17 academic years
My first round of interviews ( Dec - Feb, the second round ofcourse will be March to June) so far have been SUNY Upstate and Loyola, Chicago. I will reveal more as I go through them.
SUNY Upstate in Syracuse is a good program overall, no big name, the PD Dr latorre is great, MGH graduate, basically runs their fellowship with two other staff attendings who are not yet boarded or I believe in the process of getting boarded. 10-12 bed NSICU, semi-open. They mainly see Status, AMS, neuro trauma. All SAH, IVH, ICH goes to neurosurgery and they rule this world. Varied patient population (caucasians mainly). Always a white christmas. Take 2 fellows, a big plus is fellows act as staff (ICU work + administration when needed) and not as fellows. Home calls only q 2 weekly with atleast 2 weekends every month. Currently, fellow belonged to medicine background though.

Loyola, Chicago IL - strength is Jose Biller, though he belongs to vascular neurology program, but in terms of being well published if you end up there he is the key. PD Dr Schneck is a genuine and very kind person. Will give you strengths and weakness of his own and other programs if not on service. Down to earth, good guy and very informal. Their ICU is a 13 bed. Havent had any fellows in the last 3 years or so (maybe some sort of stuff going on internally - possible red flag), semi-closed unit, see everything except trauma. Neurosurgery again has their reign over SAH/AVMs etc. residents are strong in the program and do the scut work, fellows home call only, 2nd year fellowship - fellows act as staff. Total 3 NSICU trained folks. All neurocritical care boarded. No step down units. PD controls the flow of what patients he wants to admit.
 
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