Curriculum

The block schedule is designed to provide the fellow with opportunity to lead the stroke team and develop the competency to manage the care of all kinds of patients with cerebrovascular disease in any setting.

There are 13 blocks for the academic year of 4 weeks each divided as follows:

Inpatient Stroke Service (6 blocks): The stroke fellow will lead the inpatient vascular service leading a team including residents and advanced practice providers.  This team will have both primary stroke patients and a consultative role in the neurocritical care unit. Acute stroke evaluations for patients presenting at CSC during regular daytime hours will be performed by the resident and AP team under the supervision of the stroke fellow as well as coordination of patients requiring direct mechanical stroke interventions.

Neurocritical Care (2 blocks): The stroke fellow will spend 2 months as the fellow in the Neuro-ICU with primary management of patients with a variety of neurocritical care needs under the supervision of the neurocritical care attending. During this time fellows will gain expertise in the initial management of patients with cerebrovascular disease requiring ICU level care including those who are immediately post procedure.

Interventional Neurosurgery (1.5 blocks): During these weeks the stroke fellow will work directly with the interventional neurosurgery team performing thrombectomy as well as other emergent stroke interventions and will also get time in the neurosurgery outpatient vascular clinic and operating room for vascular cases. Rotation time is divided into weeks coving emergencies coupled with teleneurology/telestroke the fellow will be able to respond to emergency cases with flexible responsibilities the following day, and other weeks with a regular schedule in the clinic and OR without emergency coverage responsibilities.

Outpatient Vascular Clinic (1 block): In addition to their continuity clinic, the stroke fellow will spend at least one full block in an ambulatory setting developing the skill set to maintain appropriate secondary stroke prevention, support patients through stroke rehab and recovery, and take over cases seen initially in the hospital setting.

Research (1 block): One block is set aside for research. In addition to the option to participate in national and regional stroke trials through the St. Luke’s Stroke Center the fellow will have the opportunity to engage in the full research process. Each fellow is expected to complete at least one original research or QI/PI project during their time at St. Luke’s. If a fellow completes their research requirement during other rotations and desires this time for additional elective opportunities that is possible with the approval of the program director

Vascular Ultrasound (0.5 blocks): The fellow will participate in the vascular neurology ultrasound course at Wake Forrest (with travel and course fees covered).  This will provide a basis for the performance and interpretation of transcranial doppler and carotid doppler.

Elective (1 block): The fellow can choose from several helpful electives including stroke program management (the fellow will spend time working with the stroke director, stroke program manager/coordinator, and stroke nurse navigator to gain understanding of how a stroke program runs and coordination with JCHAO and other entities) among others. Custom elective options are available depending on the fellows interest level with the approval of the program director.

Continuity Clinic: Through the one year course the fellow will maintain a continuity clinic of vascular patients consisting of ½ day per week EXCEPT during the critical care and interventional blocks.

Call: During the inpatient stroke service blocks fellows will have one night per week of home call and will work 1 weekend day every other week (2 weekend days per block). During other rotations the fellow will have one night call shift every other week except for during the critical care blocks (the fellow will follow the call requirements of the neurocritical care group) and the interventional neurosurgery blocks.