Curriculum

During your one-year fellowship training, you will be primarily at Hartford Hospital.  The remainder of the time will be spent at the University of Connecticut Health Center in Farmington.

INPATIENT CONSULT SERVICE

The neurovascular fellow will be a part of the inpatient acute stroke consult team which also includes a vascular neurology attending, an APRN, rotating psychiatry/medical residents, and/or medical students.  The fellow will respond to any acute stroke beeper call on the inpatient service as well as fielding possible acute stroke transfers from outside community hospitals on weekdays, from 8am-5pm. 

During these inpatient months the fellow will sharpen his/her clinical skills in the rapid assessment and management of acute ischemic/hemorrhagic strokes.  He/she will be responsible for overseeing the implementation of treatment recommendations as well as the standard secondary prevention protocols outlined in the stroke critical pathway at Hartford Hospital. 

The fellow will also be familiar with all selection criteria for ongoing stroke clinical trials at Hartford Hospital and be an active participant in the clinical trials.  There will be no night call except for one night at Hartford Hospital in late February/early March to cover for the neurology residents taking their in-service exam.

NEURO-RADIOLOGY

The rotation for neuro-radiology is divided as follows: 

In the first month, the vascular fellow will be responsible for reading head CT/CTA/CTP with a neuroradiologist in the morning.  He/she will then spend the afternoon in either the Interventional Suite with Dr. Gary Spiegel (neuro-interventional radiologist) and participate in any ongoing endovascular procedures or in the interpretation of cerebral angiograms. 

During the second month, the mornings will be spent on the interpretation of brain MRI/MRA/MRP/MRV with the neuro-radiologists.  The afternoon will be spent in the Endovascular Suite with Dr. Spiegel. 

The last month  will focus on SPECT/PET scan of the brain (2 weeks each) under the guidance of Drs. Schwarz and Rock to learn cerebral autoregulation and metabolism in normal and pathological states.

NEUROSONOLOGY/NEUROCRITICAL CARE

The vascular fellow will be an integral part of the neurocritical care team.  He/she will round on all inpatients in the critical care unit and be personally responsible for any acute stroke admissions.  Patient care will also include the performance of Transcranial Doppler ultrasound if needed.  Typically the fellow will spend the morning in the critical care unit and in the afternoon he/she will participate in the reading and interpretation of TCD data with Drs. Lee or Gomez (during in the first month) and reading and interpretation of carotid duplex scans in the vascular lab (during the second month).

INPATIENT WARD SERVICE

During the last 2 months of the vascular fellowship, the fellow will function as a junior attending at John Dempsey hospital.  He/she will be responsible for any acute stroke evaluation arising from the emergency department and/or the inpatient service.  He/she will take call no more than once every 4th night, sharing the responsibility with other faculty members.  Part of the responsibility will be educating rotating medical residents and students on the management of acute stroke.

RESEARCH

This protected month of research will be assigned in November during the fellowship year since a research proposal either in Clinical or in Basic Science will have been delineated in the first 2 months of the fellowship.  The month is designated strictly for research and will allow the fellow enough time to gather all information needed to write an abstract that may be submitted to the national meeting for presentation.

NEUROVASCULAR CLINIC

Location: Hartford Hospital  Duration:  12 months. 

The fellow will spend one-half day per week as part of a multidisplinary team that also includes a neuro-interventional radiologist, 3 vascular neurologists, and a neurosurgeon to evaluate complex neurovascular cases (e.g. vascular malformations, aneurysms, extra- and intra-cranial vascular disease).  This also serves as a continuity clinic for acute stroke follow-up at 3 weeks, 6 months, and 12 months.  During the follow-ups, functional outcome measures will be obtained and entered into the longitudinal stroke database. 

On another one half-day per week the fellow will attend the Clinical Trials Clinic where all necessary data is gathered from patients enrolled into any stroke trials.