Vascular Neurology Fellowship Program Curriculum & Call Structure
Fellow Rotations
1 block = 4 weeks
Kentucky Neuroscience Institute (KNI) Stroke Clinic / Botox Clinic (3 blocks):
The fellow will see patients in a morning half-day clinic with the stroke attending. The fellow will attend KNI Botox Clinic when it is scheduled, under the supervision of stroke attending, Dr. Kara Kennedy. For each clinic session, the stroke attending and fellow will choose new patients and interesting/educational established patients the fellow can follow longitudinally and request that these patients be scheduled to follow-up in clinic with the stroke attending when the fellow is scheduled to be in clinic again. After the patient is “established” with the fellow, request that any pertinent results or messages for the patient that are delivered to the stroke attending be shared with the fellow for assistance in management.
Stroke Inpatient Service (6 blocks):
The fellow’s primary responsibilities include functioning as a junior attending, supervising and teaching residents and medical students, on daily patient rounds. For each block the fellow will rotate 2 weeks on the Stroke ICU/Consults Service and 2 weeks on the Stroke PCU Service.
Research (1 block):
Fellow is expected to participate in scholarly activity. During their Research block they will be excepted to develop a project, which is to be completed by the end of the fellowship year. A Quality Improvement Project is often chosen by the fellow to fulfill their scholarly activity requirement. The fellow is encouraged to submit at least one abstract for presentation at a national/international conference, particularly the International Stroke Conference. They may also wish to submit a journal article for publication. The fellow is required to submit to the Neurology Department’s Trainee Research Day. The fellow is required to present at Neurology Department Grand Rounds in the spring of their fellowship training. We also encourage the fellow to participate in an active stroke industry clinical trial at the University of Kentucky.
Neurosonology (1 block):
First week of this rotation block will be self-study with assigned readings. Afterward, the fellow will interpret studies with the reading stroke attending. The fellow may also shadow the vascular technologist during study acquisition. The fellow will be registered to attend the Wake Forest University School of Medicine Neurovascular US Course. If this course falls outside of the Neurosonology rotation block the fellow will be excused to attend the course. After completion of the Neurosonology rotation block and attendance to the Neurovascular US Course, we anticipate the fellow will be prepared to sit for the neurosonology certification examination administered by the American Society of Neuroimaging (ASN).
Neurocritical Care (1 block):
The fellow will join the Anesthesia Critical Care Team, with focus on Stroke ICU patients, but may also follow interesting/educational Vascular Neurosurgery ICU patients as well. The fellow may participate in procedures if interested, but not required.
Neurorehabilitation (1 block):
Off-site rotation at the University of Kentucky’s Cardinal Hill Rehabilitation Hospital, working with the Physical Medicine & Rehabilitation Team on both inpatient stroke unit and outpatient clinic. Fellow will also have the opportunity to participate in botulinum toxin injection procedures under EMG and ultrasound guidance.
Neuro-Interventional Radiology (1 block):
The fellow will join the Neuro-Interventional Radiology Team for inpatient and outpatient procedures, including emergent mechanical thrombectomy cases. The fellow may participate in procedures if interested, but not required.
Elective (1 block):
Fellow has the option of spending additional time on a particular rotation, in addition to Diagnostic Neuroradiology. Other suggestions from the fellow will also be considered.
- Stroke Clinic / KNI Botox Clinic
- Stroke Inpatient
- Neurocritical Care
- Neuro-Rehabilitation
- Neurointerventional Radiology
- Diagnostic Neuroradiology
Other Fellowship Expectations
Quality Improvement and Patient Safety
All GME trainees are expected to participate in a GME Unit Level SWARM. "SWARM" is the term used for root-cause analysis. Trainees are provided training prior to leading a SWARM. Typically during a SWARM a group of trainees lead an analysis of an event, develop a fish-bone diagram of the involved factors, and then provide recommendations, with guidance from the facilitator, on protocols that can be implemented to improve unit-level and/or patient safety.
Fellow On Call Schedule
The fellow is on call 4 nights per week (5pm-7am) while on the stroke inpatient unit and 2 nights per week (5pm-7am) when on all other rotations. While on call the fellow will receive most calls from the neurology residents staffing stroke consults overnight, but the fellow will also receive calls from outside facilities, which may be consult only or may be transfer calls. The fellow will be supervised by the on-call stroke attending for at least the first month to ensure the fellow feels confident in taking independent call.