Education & Training
Vascular Neurology Training Curriculum
The Vascular Neurology Fellowship Program curriculum is designed to develop proficiency in the emergent and urgent treatment of vascular neurologic conditions, comprehensive care throughout the continuum, and preventive care. Experience in administration, an understanding of stroke systems of care and the importance of conducting quality initiatives are essential to future roles in stroke center management. Fellows begin their training taking an introductory course on epidemiology, outcomes and statistics and as a Cleveland StrokeNET center, gain experience in conducting clinical research, clinical trial design and participate as co-investigators in ongoing clinical trials in vascular neurology.
There are ample opportunities to further physician-educator skills of curriculum development and public speaking working closely with the University Hospitals Cleveland Medical Center Neurology Residency program, the Neuroscience Nursing Program and the University Hospitals Emergency Medical Systems Training Institute.
Regional and national conferences, special seminars and lectures are offered to all vascular neurology fellows and are attended regularly.
Comprehensive Stroke Training
Fellows receive comprehensive training in the diagnosis and treatment of ischemic and hemorrhagic stroke, transient brain ischemia, occlusive and hemorrhagic diseases as relevant to mastery required of the American Board of Psychiatry and Neurology Vascular Neurology board examination, such as:
- Air/fat embolism
- Aneurysmal subarachnoid hemorrhage
- Aortic arch cerebral and spinal embolism
- Cardiogenic brain embolism
- Cerebral venous thrombosis
- Cervical artery dissection
- Complications including raised intracranial pressure, infections, pneumonia, and deep venous thrombosis
- Encephalopathy Syndrome
- Genetic and metabolic disorders
- Hemodynamic brain ischemia
- Hereditary and acquired hypercoagulable states, including antiphospholipid antibody syndromes, disseminated intravascular coagulation, thrombotic thrombocytopenic purpura
- Intracerebral hemorrhage
- Lacunar strokes and microangiopathic white matter disease
- Large vessel extra-cranial cerebral atherosclerosis
- Large vessel intra-cranial cerebral atherosclerosis
- Migraine and stroke mimics
- Non-atherosclerotic vasculopathies including those that are genetic, inflammatory, or infectious
- Radiation vasculopathy
- Reversible Vasoconstriction Syndrome/ Posterior Reversible
- Spasticity and neurorecovery after stroke
- Spinal cord infarction
- Stroke in malignancy, immunosuppression, and as a consequence of systemic illnesses/conditions
- Subdural hematomas/epidural hematomas
- Substance abuse and drug toxicities
- Surgical management of brain ischemia and hemorrhage
- Vascular malformations
Core Curriculum Blocks
The core curriculum consists of training in the inpatient setting on the stroke service (four months) and the neuroscience intensive care unit (two months), in acute rehabilitation at the UH Rehabilitation Hospital (one month), and in several stroke prevention clinics (two months in addition to a year long longitudinal experience) as well as research (one block) and electives (two one/half blocks).
There is flexibility in the curriculum to provide some customization to reflect the fellows' prior experience during their neurology or other training and to ensure that fellows gain that experience and training that will be comprehensive but optimized to meet the challenges of their future career goals.
Evaluation of progression to competency in the areas of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice is based on the Vascular Neurology Milestones.
You will be asked to evaluate yourself on these milestones at entry into the fellowship - to determine where you think you are and identify gaps which would become areas of focused study; mid-way through your training to see how far you have progressed and reevaluate your goals; and near the end of your training to ensure your preparation for graduation and the next phase of your career.
The Portfolio is an important tool to guide mentoring and coaching, evaluating your academic resume and planning the next phases of a successful career. In addition, you will be asked to evaluate your attending faculty as well as the Vascular Neurology Fellowship Program and participate in the formal review and performance improvement activities of the training program as an appointed member of the Vascular Neurology Program Evaluation Committee.
Administrative Tasks and Other Policies
In accordance with Accreditation Council for Graduate Medical Education (AGCME) policies, administrative duties are similar to those required during your residency, such as timely submission of duty hours and evaluations and monitoring for fatigue as well as participation in quality activities as an appointed member of the Stroke Quality Committee and University Hospitals System Stroke Program Committee. Moonlighting is permitted during the fellowship and available within the Department of Medicine at UH Cleveland Medical Center, as consistent with ACGME policies on respecting duty-hours and avoid interfering with your primary training.