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Curriculum

Our goals and objectives

  1. Provide high quality clinical care and assessment of patients with various cerebrovascular disorders in different settings (emergency, inpatient and outpatient), including diagnostic evaluation, treatment, management, counseling and prevention.
  2. Manage critically-ill neurological patients, such as those with cerebral hemorrhage, brain aneurysms or vascular malformations.
  3. Work effectively with multidisciplinary teams oriented to the care of these patients.
  4. Ordering and interpretation of laboratory and imaging tests in patients with cerebrovascular diseases and stroke.
  5. Develop the capacity to a pursue great career in the field of stroke and cerebrovascular disorders.

Our fellowship prepares graduates for American Board of Psychiatry and Neurology (ABPN) vascular neurology board certification and a successful career as either an academic vascular neurologist or neurohospitalist. The clinical year provides the necessary rotations in vascular neurology required for vascular neurology board eligibility. Fellows obtain extensive experience in the management of acute ischemic stroke with intravenous thrombolytics and endovascular methods, including intra-arterial thrombolysis and thrombectomy. Additionally, fellows obtain extensive experience in interpreting neuroimaging including MRI, CT angiography and conventional angiography.

Clinical training

Acute inpatient stroke: Fellows refine their knowledge of state-of-the-art acute stroke management on our inpatient service. Fellows develop leadership and educational skills on service by working closely with board-certified vascular neurology attendings to lead a team of stroke advanced practitioners.

While on service, fellows will participate in the daily rounds on the stroke patients including the ICU. Our stroke service sees patients in the Neuro ICU in conjunction with the Department of Pulmonary Critical Care. In all cases, fellows will serve as an adjunct to the attending with responsibilities delegated as the attending sees fit.

Endovascular neurosurgery/ICU: Fellows participate in the robust clinical cases of the Geisinger Wyoming Valley Medical Center Endovascular Neurosurgery Department led by three endovascular neurosurgeons, residents, advanced registered nurse practitioners (ARNPs) and an endovascular fellow. Cases include mechanical thrombectomy for acute ischemic stroke, repair of cerebral aneurysm and vascular malformations, and carotid endarterectomy and stenting.

There is opportunity to spend additional time on the endovascular neurosurgery inpatient clinical rotation, as interest dictates.

Teleneurology: Geisinger has a robust telestroke service. Fellows have an opportunity to participate in the telestroke service.

Neurovascular continuity clinic: Fellows refine their longitudinal management of stroke patients by following select patients after inpatient discharge in a dedicated fellow continuity clinic or new stroke referrals. (1/2 day per week except when rotating on inpatient stroke)

Research: We have various opportunities available as per the interest of the fellow. For more details please visit this website.

Electives/rotations

  • Neuroradiology
  • Palliative care
  • Customized schedule (per fellow interest, requires a faculty mentor and written goals/objectives submitted in advance)
  • Fellow will have one week of his elective weeks for continuing medical education (CME) conference - American Academy of Neurology (AAN) annual conference, annual International Stroke Conference (ISC) conference or Wake Forest transcranial doppler (TCD) course.

Supervision

The fellows will be directly supervised by one of the stroke attendings at all times during their rotations. Feedback will be provided directly and immediately to the fellow by the attendings. Our division maintains an "open door policy." Fellows are encouraged to discuss their concerns, stresses, challenges and plans with any of the stroke attendings at any time. 

Grand rounds

Fellows will be responsible to present one grand rounds topic. Topic can be of their own choosing, but ideally related to research.

Stroke journal club

Fellows will be responsible for presenting two novel journal articles over the course of the academic year.