Neurocritical Care Fellowship

The Mount Sinai Neurocritical Care Fellowship is a two-year United Council of Neurological Subspecialties (UCNS) accredited program. The mission of our fellowship program is to train fellows to become excellent neurointensivists, provide dedicated interdisciplinary mentorship, and groom them into future leaders who will advance the field of neurocritical care.

In our robust clinical and research programs, fellows will learn expert management of the full spectrum of neuro-emergencies, including cerebrovascular, status epilepticus, neurotrauma, neuroinfections, complex neurosurgical or combined neurosurgical and ENT cases, and neuromuscular emergencies, among others. They will also learn how to build on the fundamentals of critical care to prevent secondary neurological injuries and provide family-centered care to improve outcomes. Throughout their training, fellows will learn how to perform high-quality research.

Our Neurocritical Care Fellowship is geared towards providing you with the tools and mentoring needed to face clinical challenges of our evolving field. Whether in person or via multi-site medical video conferencing, we emphasize multidisciplinary, peer-to-peer, evidence-based practice and learning via case-based discussions, procedural simulations, traditional didactics, journal clubs, and Grand Rounds. Fellows have the opportunity to learn and place ICP monitors, EVDS, etc on neurotrauma rotation.

Ultimately, our goal is to develop our fellows into well-rounded, exceptional and compassionate clinical neurointensivists, pioneers in advancing the field, and leaders in academia.

Learn more about our curriculum

Residents during exercise

Fellows can choose a six-month track under the direct supervision of track mentors. These include critical care EEG monitoring, neurotrauma, outcomes research, cerebrovascular, health care leadership, and neurosurgical simulation/biomedical design tracks.

Critical Care Electroencephalography (EEG) Monitoring Track

Understanding an EEG is a very important part in managing critically ill patients, especially in the field of neurocritical care. Seizures or status epilepticus are commonly encountered in critically-ill patients. Often non-convulsive, these seizures may only be revealed by continuous EEG monitoring. Continuous EEG monitoring/quantitative EEG analysis is also useful in patients with acute neurological problems to detect ischemia, other acute changes in brain function, and long term trends.

Neurocritical Care Fellows participating in the Critical Care EEG Monitoring Track will learn the fundamentals of EEG interpretation and monitoring in general with a particular focus on ICU EEG monitoring, including quantitative EEG monitoring. Fellows will provide a consult service for the evaluation and management of patients in the ICUs, especially for patients with seizures or status epilepticus. In the weekly conference with NSICU staff, residents,students, and fellows present a brief talk about various topics or journals and present the week’s interesting EEG cases for discussion. During this training period, fellows are encouraged to participate in research. After 6 months of Critical Care EEG fellowship during Neurocritical Care Fellowship and an additional 6 months of supervised experience, fellows are eligible to obtain American Board of Clinical Neurophysiology, Critical Care EEG Track. Fellows on this track will be reading EEGs at The Mount Sinai Hospital.

Critical Care EEG Track Mentors and Faculty

Lara Marcuse, MD
Associate Professor of Neurology

Madeline Fields, MD
Associate Professor of Neurology

Ji Yeoun (Jenna) Yoo, MD
Assistant Professor of Neurology

Curriculum

  • Direct involvement in the management of patients with seizures or status epilepticus in the intensive care units at The Mount Sinai Hospital

  • Develop an understanding of the pathophysiology of seizures and status epilepticus

  • Develop an understanding of guidelines-based management for patients in status epilepticus

  • Understand the indications and utility of critical care EEG monitoring

  • Interpret critical care EEG monitoring along with quantitative EEG data

  • Identify artifacts

  • Participation in critical care EEG conferences and educational sessions

  • Participation in critical care EEG Quality Assurance/Performance Improvement

  • Participation in critical care EEG research and ongoing studies

Reading List

Atlas of EEG in Critical Care, Lawrence J. Hirsch and Richard P. Brenner (eds.), 2010, Wiley-Blackwell, West Sussex
Handbook of ICU EEG Monitoring, Suzette M. LaRoche (ed.), (2012), Demos Publishing, New York

Resources

Critical Care EEG Consortium
American Clinical Neurophysiology Society (ACNS)
American Board of Clinical Neurophysiology

Neurotrauma Track

The Neurotrauma Track provides an immersive experience at NYC Health + Hospitals/Elmhurst Hospital Center, one of New York City’s busiest Level 1 trauma centers. Elmhurst Hospital Center (EHC) is an affiliate of the Icahn School of Medicine at Mount Sinai and the tertiary care center for western Queens, serving a population of over one million residents. The Neurosurgery Department at Elmhurst has one of the highest neurotrauma volumes in the city, each year managing approximately 300 traumatic brain injury and 100 spine trauma cases, and performing over 75 neurotrauma surgeries. The department is fully staffed by three neurosurgery attendings, two neurosurgery residents, and several physician assistants.

Neurocritical care fellows participating in the Neurotrauma Track will play an integral role in the management of acute traumatic brain and spine injury patients at EHC and learn how to provide neurotrauma interdisciplinary care. Fellows will round with the neurosurgery team on critically-ill neurosurgical patients in the Surgical-Trauma Intensive Care Unit and serve as the medical and critical care lead for patients in the Neurosurgical Step-Down Unit. Fellows will have the opportunity to perform routine bedside neurosurgical procedures, including the placement, troubleshooting, and management of external ventricular drains, intracranial multimodality monitors, and twist-drill craniotomies for the bedside evacuation of subacute/chronic subdural hematomas. Additionally, fellows are encouraged to scrub in with the neurosurgery team on neurotrauma and other emergent neurosurgical cases.

Fellows actively participate in neurotrauma conferences, quality assurance and performance improvement, and neurotrauma research during their rotation at EHC, including acting as a liaison to the New York Neurotrauma Consortium. The department has a full-time clinical research coordinator and is involved in several ongoing head and spine injury studies.

Neurotrauma Track Mentors and Faculty

Zachary L. Hickman, MD
Assistant Professor of Neurosurgery
Director, Neurosurgery at Elmhurst Hospital Center

Salazar Jones, MD
Assistant Professor of Neurosurgery
Associate Director, Neurosurgery at Elmhurst Hospital Center

Curriculum

  • Direct involvement in the management of acute traumatic brain and spine injury patients in the ICU and Neurosurgery Step-Down Units

  • Medical/critical care lead for neurosurgical patients in the Neurosurgery Step-Down Unit

  • Develop an understanding of the pathophysiology of acute traumatic brain and spine injuries

  • Develop an understanding of guidelines-based management for patients with traumatic brain and spine injuries

  • Understand the indications, advantages, and disadvantages of the various modalities of neuromonitoring, including invasive and non-invasive technologies

  • Develop the clinical and technical skills needed for the placement, management, and troubleshooting of bedside neurosurgical procedures/devices, including external ventricular drains, intracranial multimodality monitors, and twist drill craniotomies for subdural hematoma evacuations

  • Develop an understanding of the indications for surgery following head and spine trauma and the opportunity to participate in surgical procedures and post-op management

  • Participation in Neurotrauma conferences and educational sessions

  • Participation in Neurotrauma Quality Assurance/Performance Improvement

  • Participation in traumatic brain injury and spine injury research and ongoing studies

Reading List

  • Brain Trauma Foundation (BTF) Guidelines for the Management of Severe Traumatic Brain Injury, 4th Edition

  • Brain Trauma Foundation (BTF) Guidelines for the Surgical Management of Traumatic Brain Injury

  • Brain Trauma Foundation (BTF) Early Indicators of Prognosis in Severe TBI

  • American College of Surgeons (ACS) TQIP Management of Head Injury

  • AANS/CNS Joint Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injury

  • Johnson, RD et al. (2014) Head Injury. In RD Johnson and AL Green (Eds.), Landmark Papers in Neurosurgery (pp. 121-190). Oxford, UK: Oxford University Press.

  • Johnson, RD et al. (2014) Spinal Surgery. In RD Johnson and AL Green (Eds.), Landmark Papers in Neurosurgery (pp. 191-236). Oxford, UK: Oxford University Press.

  • Alderson P, Roberts I. Corticosteroids for acute traumatic brain injury. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD000196. DOI: 10.1002/14651858.CD000196.pub2.

  • Andrews PJ et al. Hypothermia for Intracranial Hypertension after Traumatic Brain Injury. NEJM 2015;373(23):2403-12.

  • Chesnut RM et al. A Trial of Intracranial-Pressure Monitoring in Traumatic Brain Injury. NEJM 2013;369(25):2471-81.

  • Chesnut RM et al. A Consensus-Based Interpretation of the Benchmark Evidence from South American Trials: Treatment of Intracranial Pressure Trial. J Neurotrauma 2015;32(22):1722-4.

  • Cooper DJ et al. Decompressive Craniectomy in Diffuse Traumatic Brain Injury. NEJM 2011;364(16):1493-502.

  • Forsyth RJ, Raper J, Todhunter E. Routine intracranial pressure monitoring in acute coma. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD002043. DOI: 10.1002/14651858.CD002043.pub3.

  • Giacino JT et al. Placebo-controlled Trial of Amantadine for Severe Traumatic Brain Injury. NEJM 2012;366(9):819-26.

  • Hutchinson PJ et al. Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension. NEJM 2016;375:1119-30.

  • Le Roux P et al. The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care. Neurocrit Care 2014;21(Suppl 2):1-361.

  • Lewis SR, Evans DJW, Butler AR, Schofield-Robinson OJ, Alderson P. Hypothermia for traumatic brain injury. Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No.: CD001048. DOI: 10.1002/14651858.CD001048.pub5.

  • Ma J, Huang S, Qin S, You C, Zeng Y. Progesterone for acute traumatic brain injury. Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD008409. DOI: 10.1002/14651858.CD008409.pub4.

  • Roberts I, Sydenham E. Barbiturates for acute traumatic brain injury. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD000033. DOI: 10.1002/14651858.CD000033.pub2.

  • Robertson CS et al. Effect of Erythropoietin and Transfusion Threshold on Neurological Recovery After Traumatic Brain Injury: a Randomized Clinical Trial. JAMA 2014;312(1):36-47.

  • Sahuquillo J. Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD003983. DOI: 10.1002/14651858.CD003983.pub2.

  • Temkin NR et al. A Randomized, Double-Blind Study of Phenytoin for the Prevention of Post-Traumatic Seizures. NEJM 1990;323(8):497-502.

  • Thompson K, Pohlmann-Eden B, Campbell LA, Abel H. Pharmacological treatments for preventing epilepsy following traumatic head injury. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD009900. DOI: 10.1002/14651858.CD009900.pub2.

  • Wakai A, McCabe A, Roberts I, Schierhout G. Mannitol for acute traumatic brain injury. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD001049. DOI: 10.1002/14651858.CD001049.pub5.

Cerebrovascular Track

The Mount Sinai Hospital is a Joint Commission-ertified Comprehensive Stroke Center with over 100 large vessel occlusion thrombectomy cases annually and a Center of Excellence for Subarachnoid Hemorrhage (SAH). Mount Sinai West is Mount Sinai’s Center of Excellence for Intracerebral Hemorrhage (ICH) and a Joint Commission-designated Stroke Center.

Cerebrovascular Track Mentors

Johanna T. Fifi, MD
Associate Professor of Neurosurgery, Neurology, and Radiology
Assistant Director, Cerebrovascular Center
Director, Endovascular Stroke Program

Christopher P. Kellner, MD
Assistant Professor of Neurosurgery
Director, Intracerebral Hemorrhage Program

Reading List

Society of Vascular Interventional Neurology

Resources

American Heart Association
Society of Interventional Neurosurgery (SNIS)
Society of Vascular and Interventional Neurology
The Joint CV section of AANS and CNS
Stroke: Official Blog of the Journal
Stroke Trials App

Neurosurgical Simulation and Biomedical Design Track

The Neurosurgical Simulation and Biomedical Design Track provides fellows a unique opportunity to learn about innovation in biomedical design and advanced medical image analysis. Fellows will learn about 3D printing for neurosurgical simulations with the Neurosurgery Simulation Core, how to use different medical image analysis software, product development, and filing patents. The curriculum and plan for this rotation will be developed in consultation with the track’s’ mentors to help fellows make the most of their rotation.

Neurosurgical Simulation and Biomedical Design Track Mentors

Anthony B. Costa, PhD
Assistant Professor of Neurosurgery
Scientific Director, Neurosurgery Simulation Core

Thomas J. Oxley, MD, PhD
Clinical Instructor of Neurosurgery
Director, Innovation Strategy

Electives

Fellows may also choose do shorter electives in the above tracks, in addition to the following elective rotations in other ICUs or critical care services, such as:

  • Medical ICU

  • Surgical ICU

  • Cardiovascular ICU (to learn more about the management of patients on ECMO or LVADs)

  • Vascular Line Service

  • Rapid Response Team

  • Neurotrauma

  • Stroke

  • Critical care EEG

  • Transplant ICU

Our fellowship training program accepts two new fellows per year. The fellows for 2019-20 are as follows.

Ankit Bansal, MD
St. George's School of Medicine, MD
AtlantiCare Regional Medical Center, Internal Medicine Residency

Justin Granstein, MD
Weill Medical College of Cornell University, New York MD
Dartmouth College, MPH
University of Washington, Internship
University of Washington, Neurology Residency

Group of residents

Applications are available through San Francisco Match (SFMatch). All applicants must complete their residency training in Neurology, Neurosurgery, Internal Medicine, Anesthesiology, Surgery, Emergency Medicine, or Pediatrics before applying. The following needs to be included for your application:

  • SF Match application
  • Curriculum Vitae
  • Personal statement
  • Three letters of recommendation (one is required to be from your current program director)
  • United States Medical Licensing Examination transcripts
  • Headshot photo
  • International medical graduates must also provide a copy of your Educational Commission for Foreign Medical Graduates certificate

Residents at computer

Our world renowned faculty members offer a broad range of teaching experiences in a multidisciplinary setting for fellows, providing experience in direct patient management.

Core Faculty:

Neha S. Dangayach, MD, MSCR
Assistant Professor, Departments of Neurosurgery & Neurology
Co-Director, The Mount Sinai Hospital Neuroscience Intensive Care Unit
Director, Neurocritical Care Fellowship

Cappi C. Lay, MD
Assistant Professor, Department of Emergency Medicine
Co-Director, The Mount Sinai Hospital Neuroscience Intensive Care Unit

Kaitlin J. Reilly, MD
Assistant Professor, Departments of Neurosurgery & Neurology
Director, Multimodality Brain and Spine Monitoring

Alexandra Reynolds, MD
Assistant Professor, Departments of Neurosurgery & Neurology
Director, TeleNeurocritical Care

Jignesh S. Patel, MD
Assistant Professor, Department of Neurology

John W. Liang, MD
Assistant Professor, Department of Neurosurgery & Neurology
Associate Director, TeleNeurocritical Care

Rupendra Swarup, MD
Assistant Professor, Department of Neurosurgery
Director, Neuro-ICU, Mount Sinai West

Zachary Hickman, MD
Assistant Professor, Department of Neurosurgery
Director, Neurosurgery Department at Elmhurst Hospital Center

Interdisciplinary Faculty:

Cerebrovascular Neurosurgery and Neurology
Joshua B. Bederson, MD
J Mocco, MS, MD
Stanley Tuhrim, MD
Johanna T. Fifi, MD
Christopher P. Kellner, MD
Thomas J. Oxley, MD. PhD
Reade A. DeLeacy, MD
Hazem M. Shoirah, MD

Epilepsy
Lara Marcuse, MD
Madeline Fields, MD
Jiyeon Yoo, MD

Critical Care Medicine
Roopa Kohli-Seth, MD
Errol Gordon, MD (UCNS board certified)
John Oropello, MD (UCNS board certified)
Samuel Acquah, MD, FCCP (UCNS board certified)
Adel Basilly Marcus, MD (UCNS board certified)
Umesh K. Gidwani, MD

Brain Tumors
Adilia Hormigo, MD, PhD
Amy M. Chan, MD
Raj K. Shrivastava, MD
Isabelle M. Germano, MD
Kalmon D. Post, MD

Sinai BioDesign
Anthony B. Costa, PhD
Eric K. Oermann, MD

Neurotrauma
Konstantinos Margetis, MD, PhD
Divaldo Camara, MD
Zachary Hickman, MD


Spine Surgery
Tanvir F. Choudhri, MD
John M. Caridi, MD

Research is an integral part of the Neurocritical Care Fellowship Program. Every fellow will be encouraged to identify at least one academic project. Our strength is outcomes research in neurocritical care, stroke, critical care, critical care EEG, and clinical trials. For fellows interested in any clinical or basic science research area, we will encourage dedicated mentorship from experts across departments and institutes in the Icahn School of Medicine at Mount Sinai.

Resources
Neurosurgery Research
Neurology Research
Neurosciences Research