Neurocritical Care Fellowship

Fellows are an integral part of the care of the diverse population of critically ill patients served by UCI Medical Center. UCI Medical Center serves as the only Level 1 trauma center in the area and as a Comprehensive Stroke Center, covering a population of 3.2 million residents plus millions of tourists annually. Fellows join an amazing team that includes advanced practice, pharmacy, nursing, PT/OT/SLP and unit staff to help treat the following neurocritical conditions:

• Traumatic brain injury (TBI)
• Spinal cord injury
• Intracerebral hemorrhage
• Brain tumor with acute neurological decompensations/cerebral edema
• Subarachnoid hemorrhage
• Status epilepticus
• Post-neuro-interventional cases
• Encephalitis/meningitis
• Malignant cerebral infarction
• Acute neuromuscular injury
• Post-craniotomy cases
• Neurosurgical spine cases

Fellows also assist in the Neurology-Traumatic Brain Injury (NTBIC) Consultation Service, a consultative multispecialty collaborative service for complex TBI. Fellows will gain procedural experience in central venous catheterization, arterial catheterization, lumbar puncture, ultrasound technique, bronchoscopy and endotracheal intubation. Opportunities for external ventricular drain and percutaneous tracheostomy are also available.

Fellows will have a critical role as team leaders and educators across many multidisciplinary teams. Their responsibility will increase as they go through the program with the expectation that they will lead rounds by the end of fellowship. 

The UCI Neurocritical Care is a 12-bed dedicated neurosciences ICU within the main Douglas Hospital at UCI in Orange, Calif., with another 12-bed trauma unit for additional patients and overflow. We are the only Level 1 Trauma Center in Orange County and the only academic medical center in the area. We are opening a new eight-bed ICU in 2025 in Irvine, Calif., as a sister hospital to expand patient care across the county. 

Facilities include a dedicated neurointerventional biplane room, access to a Moberg device and multimodality monitoring for stroke, ICH and TBI patients, including hemodex, Codman, microdialysis and licox monitoring. We have 10 EEG machines available for patients on our unit as well as one VitalEEG Headset that serves as an immediate EEG, which fellows are trained how to use. Our neurophysiology lab offers 24/7 EEG technologist coverage. We also have two MRI scanners, two PET/CTs, one portable and one non-portable SPECT, and three CT scanners. We have 18 operating rooms in total, with three dedicated to neurosurgical patients. 

Virtual tour of unit

Our fellows have numerous didactics scheduled weekly as well as protected time for asynchronous learning: 

• Monday: One-hour ultrasound lecture 
• Tuesday: One-hour critical care conference, with focus on a wide range of general critical care topics 
• Wednesday: One-hour protected dedicated neurocritical care didactic with a focus on neurocritical care topics scheduled in a progressive way throughout the year and incorporating regular discussion of landmark articles related to the topic 
• Thursday: One-hour pulmonary critical care lecture 
• Friday: Entire day off for didactics and research, including virtual attendance at Neurology and Neurosurgery Grand Rounds. 

Every other month, there is also a multidisciplinary neurotrauma conference focusing on neurocritical care, neurosurgery, SICU and trauma surgery, where we discuss and present cases and cutting-edge literature related to TBI care. Fellowship education is also supplemented with simulation center experiences. 

A dedicated fellow-education didactic series occurs every week, taught by expert invited faculty covering topics in neurocritical care and general ICU care. This series is customized to the needs of the fellows. Some recent topics include:

• Stroke ICU care
• Critical care EEG and quantitative EEG
• End-of-Life care and ethics
• Autoimmune encephalitis
• Heart failure in the ICU
• Renal replacement therapy and renal failure

Fellows rotate through the following units in two- to four-week blocks, acting as the primary fellow on all services: Anesthesia, NeuroICU, CTICU MICU and SICU. Electives are based on fellow interest and have included (but are not limited to) interventional pulmonology, ultrasound, critical care EEG, neurosurgery and research. 

On NeuroICU blocks, fellows are the daytime fellow Sunday through Thursday. Friday is an academic day dedicated to independent study and research, and Saturday is a day off from service. Home call is taken no more than three nights per week, and always with attending support, once fellows have established sufficient competencies in neurocritical care. Fellows do short rotations on dedicated night float.

Fellows receive four weeks of vacation per year.

Throughout the fellowship, each fellow will be provided with support and time to complete academic projects and research. Fellows will have dedicated research blocks in addition to the weekly Friday research/didactic day, which is separate from their day off of all clinical and research duties on Saturday. Fellows can also participate in quality improvement (QI) and education-related projects as an academic project, and there are many opportunities to participate in guideline-protocol development.

Our faculty have various research interests, including stem cells, TBI, ethics, education and post-cardiac arrest care, as well as qEEG and imaging AI integration. Fellows select a research or QI project and a research mentor in the first six months of their fellowship.

One of the main goals of our fellowship is to support the development of clinical scientists in neurocritical care. Prior fellows have been successful at publication and/or abstract presentation at national conferences. Fellows will demonstrate scholarly activity through the following activities:

• Presentation of their research plan/topics for feedback at monthly division NCC meeting 
• Presentation of related Journal Clubs twice during the fellowship 
• Presentation of abstracts related to their projects at research group meetings and with individual mentors 
• Presentation of final research project at the annual Neurology Research Symposium 
• Presentation at national conferences

For current information regarding fellow salary and benefits, please visit the Residents & Fellows Salary, Benefits, Policies page on our UCI Graduate Medical Education website.

Salary & Benefits