- Medical Director, Neurovascular Laboratory
- Co-Director, Johns Hopkins Bayview Neurocritical Care Unit
- Professor of Neurology
- Professor of Anesthesiology and Critical Care Medicine
- Professor of Neurosurgery
The Johns Hopkins Fellowship in Neurocritical Care
The Neurocritical Care Fellowship Program at Johns Hopkins pioneered the training of fellows in the 1980s and continues to be the leading program in this sub-specialty, aiming to develop Neurocritical Care Clinician Scientists. We have trained more than 50 physicians from a variety of fields who went on to work at leading institutions as directors of neurocritical care programs, chairs of departments, established research investigators, institute directors, and hold key positions in professional societies related to neurocritical care.
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Fellowship at a Glance
- Duration: two years (52 weeks of clinical work, and the rest academic work)
- Eligibility: current residents and board-eligible recent graduates from an Accreditation Council for Graduate Medical Education (ACGME)-accredited residency program in neurology, neurosurgery, internal medicine, surgery, emergency medicine or anesthesiology/critical care medicine.
- How to apply: Please submit the following to the fellowship director:
- Application form (email the director to request)
- Curriculum vitae
- A letter of good standing from your residency program director
- A letter of intent or personal statement, and
- Three letters of recommendation
- Match: matching is conducted through SF Match.
Please submit inquiries about the application process and requests for an application form to Dr. Ziai at [email protected]. The division director and fellowship director will evaluate the submissions and invite selected candidates for an interview.
The strength of this program is in collaboration between faculty from departments of neurosurgery, neurology and anesthesiology and critical care medicine.
Upon successful program completion, fellows are certified in advanced cardiac life support and advanced trauma life support. They are board-eligible for the United Council of Neurologic Subspecialties Neurocritical Care examination, and have accumulated a research and publication foundation for their academic career.
Expectations and Responsibilities
- Fellows spend their first year developing patient care skills, teaching ICU medical students and supervising house staff and nurses in the bedside care of patients.
- The second year adds responsibilities of:
- Team management as a leader of the NCCU team (with the attending physician’s support)
- Formal teaching of the concepts of neurophysiology and treatment for various neuropathologic processes and general critical care issues to residents and fellows.
- Developing research activities in the critical care environment.
Procedural Training in the Simulation Center
Training for procedural competency begins immediately in July of the first year with a Simulation Center series focused on common critical care interventions. Before their clinical duties require performing these procedures for patients, fellows practice in the simulation environment:
- non-invasive ventilation
- direct laryngoscopy and endotracheal intubation
- insertion of central and peripheral venous and arterial catheters
- lumbar puncture and insertion of lumbar drains
The Simulation Center also allows for structured exposure to emergency neurological life support (ENLS) events. Finally, fellows certify for advanced cardiovascular life support (ACLS) in the simulation environment using complex, realistic scenarios that provide more problem-solving opportunities than the "megacodes" used in conventional ACLS certification testing.
Research is mandatory.
- Fellows undertake 12 months of clinical, translational or laboratory-based research. Each fellow has the combined resources of major contributing departments at their disposal.
- Once an area of interest is identified, a formal mentorship is established with a faculty member.
- In January of their first year, fellows present research ideas to the division faculty for review. Based on this presentation and the input provided during discussion, fellows submit an application to the Human Investigational Review Board or the Animal Use Committee.
- In July and again in December of their second year, fellows present progress reports of their research.
- Most of the faculty in the program author reviews and book chapters and provide editorial review for journals. Trainees may collaborate on such projects. The program gives all fellows the chance to present projects at national conferences and publish a journal article by the end of their training.
Locations and Rotations
The fellowship is based primarily at The Johns Hopkins Hospital, with fellows rotating at the Bayview NCCU, which includes intensive work on clinical neurophysiology with Dr. Peter Kaplan, the Stroke Center, Intracerebral Hemorrhage Center and Encephalitis Center.
The rotations are structured in two-week blocks to optimize clinical immersion and continuity of care while also encouraging productivity during protected research time.
The curriculum allows for—and encourages—elective rotations to other critical care areas. The Johns Hopkins Hospital Medical Intensive Care Unit, the Johns Hopkins Hospital Surgical Intensive Care Unit and the R Adams Cowley Shock Trauma Center are popular choices.
The Johns Hopkins Hospital Neurocritical Care Unit (NCCU) is a 24-bed intensive care unit devoted to the care of patients with neurological diseases such as stroke, epilepsy, trauma, subarachnoid hemorrhage or primary neurological cancer.
The acuity of patients’ conditions and rapid turn‐over offer high intensity clinical experience. Faculty takes special care to acclimate fellows with a dedicated two-week clinical orientation as the first rotation block.
Three fellows are assigned to each rotation. Two NCCU teams, each led by a member of the neurosciences critical care division, round on patients and perform necessary critical care procedures.
- One team consists of an attending physician, a fellow and several residents from anesthesia and critical care medicine, neurology and neurosurgery.
- The other team consists of an attending physician, a fellow and 2‐3 nurse practitioners.
Fellows are responsible for leading rounds and providing support and guidance for residents, with medical decisions and procedures directly supervised by the attending physician.
A fellow and resident are assigned to the NCCU 24 hours a day. Fellows take call one in three nights, with clinical activities beginning at 6:30 a.m. with sign-out rounds, followed by morning rounds focused on teaching and clinical planning for the day. In the mid‐afternoon, teams reconvene for afternoon rounds and treatment planning for the night. Clinical responsibilities for the post‐call fellow end after sign-out rounds the next morning.
Rotations at this 14-bed unit provide the fellow with the experience of managing an NCCU more similar to those found in most academic centers in terms of patient turn‐over and acuity. This rotation also introduces effective practice of telemedicine, as fellows often provide guidance to residents from home using telephone, electronic medical records and web conferencing.
In contrast to the JHH NCCU, the BMC NCCU functions as an open unit, meaning that primary cross-cover and overnight patient care decisions are the responsibility of the primary neurology or neurosurgery service.
The BMC NCCU is staffed by a member of the neurosciences critical care division who, in concert with the assigned Fellow, rounds on patients to set care plans and then performs critical care procedures as required. Medical decisions and procedures are supervised directly by the attending physician.
Aljazi Al-Mana, MD
Medical School: Weill Cornell Medical College in Qatar (2019)
Internal Medicine: New York-Presbyterian Queens Hospital (2019-2020)
Neurology: Temple University Hospital (2020-2023)
Junaid Ansari, MBBS
Medical School: Rajshahi Medical College (2011)
Internal Medicine: Louisiana State University (2019-2020)
Neurology: Louisiana State University (2020-2023)
Brenda Auffinger, MD
Medical School: Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria (2008)
Internal Medicine: NorthShore University/The University of Chicago (2019-2020)
Neurology: The University of Chicago (2020-2023)
Bhagyashri Bhende, MBBS
Medical School: Dr. D.Y. Patil Medical College (2014)
Internal Medicine: Einstein Medical Center Philadelphia (2019-2020)
Neurology: Einstein Medical Center Philadelphia (2020-2023)
Jonathan Gomez, MD
Medical School: Universidad Central Del Caribe School of Medicine (2017)
General Surgery: Montefiore Medical Center (2017-2018)
Anesthesiology and Critical Care: The Johns Hopkins Hospital (2019-2022)
Abdullah Bin Zahid, MBBS
Medical School: Faisalabad Medical University, Pakistan (2012)
Internal Medicine: Lincoln Medical & Mental Health Center (2018-2019)
Neurology: University of Florida (2019-2022)
Matthew Bower, MD
Medical School: University of California, Irvine (2018)
Internal Medicine: University of California, Irvine (2018-2019)
Neurology: University of California, Irvine (2019-2022)
Daniel Gouger, M.D.
Medical School: East Tennessee State University (2017) Anesthesiology: Virginia Commonwealth University (2018-2022)
Nefize Turan, MD
Medical School: Marmara University, Turkey (2013) Internal Medicine: St. Elizabeth's Medical Center (2018-2019) Neurology: Tufts University (2019-2022)
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