Department of Neurology and Neurosurgery Clinical and Clinical Research Fellowship Application Form

Transcription

1 Department f Neurlgy and Neursurgery Clinical and Clinical Research Fellwship Applicatin Frm Type f Fellwship: Neurcritical Care Name f the Fellwship Supervisr: Jeanne Teitelbaum MD FRCP Fellwship Infrmatin: Number f fellwship psitins requested: 2 Name f hspitals invlved in training Mntreal Neurlgical Institute Descriptin f Fellwship: Intrductin Many critically ill patients suffer primary r secndary neurlgic dysfunctin. Thrugh residency training, critical care and emergency neurlgy fellwships and cntinuing medical educatin, the neurlgical cmmunity will need t master a bdy f knwledge cncerning the Special care f the critically ill patients with neurlgical disrders and incrprate this infrmatin int clinical practice, educatin and research. T this end, the members f the Critical Care and Emergency Neurlgy Sectin f the American Academy f Neurlgy have develped a cre curriculum fr critical care and emergency neurlgy. This curriculum is intended t serve principally as a tl fr prgrams develping fellwships in critical care and Emergency Neurlgy. It als can serve as a guideline fr the integratin f the critical care and emergency neurlgy knwledge base and related skills in t the educatin f medical students, residents, fellws, and ther medical and allied health care prviders desiring educatin in this area. Definitin Critical care and emergency neurlgy is a special area f neurlgy that fcuses n the neurlgical disrders that affect critically ill patients. These can be primary neurlgic disrders r secndary t ther systemic diseases and can affect the central nervus system, the peripheral nervus system r bth. It includes understanding the effects f critical illness n the nervus system and the special vulnerabilities f the nervus system f patients in Intensive care units and ther emergency settings. It requires knwledge f the disrders that frequently ccur in these settings, and the methds f diagnsis, assessment, treatment, management and preventin f further injury. Critical care and emergency neurlgy als invlves bridges int many medical and allied health specialties, including critical care medicine, emergency medicine, neursurgery, nursing and scial wrk. Develpment f the Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc

2 specialty f critical care and emergency neurlgy recgnizes the special health needs f the ppulatin f critically ill patients with neurlgic dysfunctin, the characteristics f the nervus system in critically ill patients and the need fr interdisciplinary cllabratin in this field. Gals and Objectives The gal f the cre curricula in critical care and emergency neurlgy is t guide a training prgram that will prepare neurlgists t cmpetently care fr critically ill patients with neurlgic disrders. This training must be based n supervised clinical wrk with increasing respnsibility fr inpatients. It shuld include nt nly the specific diseases f the nervus system f different age grups but als the neurlgical cmplicatins f medical and surgical cnditins. Critical care and emergency neurlgy is particularly a prcedureriented specialty and basic training in prcedures used in neurcritical care must be included. Finally, training must have an ptin f rganized instructin in basic and/r clinical neurscience research. The verall bjective fr specialty training in critical care and emergency neurlgy is t prvide the skills and knwledge necessary t: 1. Prvide high quality clinical care and assessments f critically ill patients with neurlgical disrders, including diagnstic evaluatin, treatment, management, cunseling and scial interventin; 2. Wrk effectively with multidisciplinary teams riented t the care f these patients; and 3. Develp the capacity t pursue an academic/research career fcusing n neurlgical dysfunctin in critically ill patients. 4. Develp the capacity t teach thers in the methds and cncepts used in the care f critically ill patients with neurlgical disrders. Tpics in Critical Care and Emergency Neurlgy The tpics listed belw prvide an utline f a cre curriculum, in Critical Care and Emergency Neurlgy, fr fellwship training. Many f the tpics included can be used fr educatinal prgrams in Critical Care and Emergency Neurlgy fr medical students, neurlgy residents, Academic neurlgists and neurlgists in practice. All educatinal cmpnents f a fellwship prgram shuld relate t the prgram gals listed abve. Brain Death Cma Encephalpathies and Delirium Herniatin Syndrmes Hydrcephalus Intracranial hemrrhages: Epidural Subdural Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc

3 Subarachnid Parenchymal (supratentrial, cerebellar, brainstem) Intraventricular Cerebral Venus Thrmbsis Acute Anterir Cerebral Artery Occlusin Acute Cartid Artery Occlusin Acute Middle Cerebral Artery Occlusin Acute Basilar Artery Occlusin Brainstem Infarctin Cerebellar Infarctin Hemispheric Infarctin Critical Care & Emergency Neurlgy Sectin Cre Curriculum Page 3 Acute Spinal Crd Syndrmes Cerebral Bld Flw and Hypperfusin Cerebral Metablism and Oxygen Demand Cerebral Edema Syncpe Brain Abscess Encephalitis: Bacterial and Viral Meningitis: Bacterial and Viral Traumatic Brain Injury Traumatic Spinal Crd Injury Status Epilepticus Guillain-Barre Syndrme Myasthenia Gravis Equipment and Technlgies: Knwledge f the basic physilgy and underlying technical principles. Cardivascular and Pulmnary Mnitring Devices Intracranial Pressure Mnitrs: Fiberptic, Intraventricular, and Epidural Nninvasive Intracranial and Extracranial Vascular Study, Including Transcranial Dppler General Principles f Management f Critically III Neurlgic Patients General Perspectives f Care in Critically III Neurlgic Patients Management f Agitatin and Pain Management f Airway and Mechanical Ventilatin Management f Nutritin Management f Intravascular Vlume Status and Bld Pressure Management f Anticagulatin and Thrmblytic Therapy Management f Intracranial Pressure Management f Neurlgic Cmplicatins in Critically Ill Patients Management f Pst-perative Neursurgical Patients Management f Systemic Cmplicatins in Critically Ill Neurlgic Patients Management f Pulmnary Cmplicatins Management f Cardiac Cmplicatins Management f Acid-Base Disrders and Hypertnic and Hyptnic States Management f Gastrintestinal Cmplicatins Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc

4 Management f Nscmial Infectins Intensive Care Unit Organizatin and Management Psychscial Issues in the Intensive Care Unit End f Life Decisin Making Transplant and Organ Dnatin Management Descriptin f activities and respnsibilities: Research activity and publicatins related t fellwship Please refer t the supervisr s CV, appended t this submissin There are many prjects that will begin in The supervisr (J Teitelbaum) in cnjunctin with Dr Jean-Paul Sucy f the Neur-imaging center, have btained a $100, grant that will allw the funding f a quantitative SPECT scan. Several research prtcls using the SPECT have been elabrated, ntably fr research in sub-arachnid and intracerebral hemrrhage. As well, we hpe t d sme wrk n prgnsis in cma pst cardiac arrest usin PET and functinal MRI. Missin statement fr fellwship The missin is t prmte: Quality Patient Care by identifying and implementing best medical practices fr acute neurlgical disrders that are cnsistent with current scientific knwledge, and that prmte cmpassinate care and respect fr patient-centered values. Prfessinal Cllabratin by prviding a frum fr cmmunicatin, cllabratin, and exchange f ideas between physicians and allied healthcare prfessinals within different specialties wh care fr critically-ill neurlgical patients. Research by fstering clinical, experimental and utcmes research fcused n develping innvative and cst-effective medical and surgical interventins fr acute neurlgical disrders. Training and Educatin by develping standards fr advanced fellwship training, prgram accreditatin, and physician certificatin in the subspecialty f neurlgical intensive care. Advcacy by making the case t patients, the public, plicy makers and ther healthcare prfessinals that cmplex, life-threatening neurlgical diseases are best cared fr by a multidisciplinary team with special expertise in neurcritical care. Surce f funding fr fellwship: Dminique Lafrance: already a fellw in Critical Care Medicine, fellwship funding will cme frm grants btained at Hôpital Ntre- Dame Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc

5 Omar Ayub: funding wuld be cming frm the University f British Clumbia (fr 2009) Names f the Teaching Faculty Jeanne Teitelbaum MD FRCP Directr f the prgram Direct supervisin in the NICU C-directr f a research prject Summary f clinical practice: full-time accredited Neurlgist Neurintensivist with 18 years f neurcritical care practice as well as previus intensive care, internal medicine and family medicine practice. Mark Angle MD FRCP Rles: chief f Neuranesthesia as well as chief f the Neur ICU Direct teaching and supervisin in the NICU Direct teaching and supervisin in the perating rm C-directrship f research prjects Summary f clinical practice: full-time accredited inensivist in medical, surgical and neurlgical critical care as well as an accredited neuranesthetist. Full time clinical practice Majr Strengths: superb clinician in neur-anaesthesia and critical care Marcell Lannes MD FRCP Rles: Full time in Neuranesthesia as well as Neur ICU Direct teaching and supervisin in the NICU Direct teaching and supervisin in the perating rm C-directrship f research prjects Summary f clinical practice: full-time accredited inensivist in medical, surgical and neurlgical critical care as well as an accredited neuranesthetist. Full time clinical practice Majr Strengths: Masters in educatin as well as superb clinical skills in neur-anaesthesia and critical care Academic Facilities The fellw will be using the facilities f the Neurlgical Intensive Care fr his clinical and academic pursuits. The unit has a cnference rm and access t internet as well as Up-t-date n it s 3 cmputers. The fellw will be able t share an ffice and have his wn desk n the 3 rd flr. Library access is available at bth the MNI and the Ryal Victria Hspital. Materials relevant t fellwship training are kept in the cnference rm and the ffice f the assistant head nurse in the NICU. Multimedia learning materials available n CD and internet. These allw learning in Neuranatmy, neurphysilgy, strke, multiple sclersis and neurcritical care. There is als access t Up T Date. Fellw Duties and Respnsibilities Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc

6 Call respnsibilities t cver service: the fellw is n call ne in 4 week days as well as ne week-end per mnth. He is n first call frm hme and replaces the NICU attending. He r she des nt replace the neurlgy r neursurgery resident whse jb it is t assess and admit the patient. The resident ges ver admissins with the fellw. The attending is n as secnd call t supervise the fellw. The fellw is expected t supervise residents rtating thrugh the ICU with the help and instructin f the attending. The fellw with a backgrund in Critical Care will rtate nly at the Mntreal Neurlgical Institute and hspital. The fellw with a backgrund in Neurlgy will rtate at the Ryal Victria, in the medical/surgical intensive care. Rtatins are nt fixed in advance and will vary accrding t the needs f the candidate. What are the utpatient clinic respnsibilities: there are n utpatient clinic respnsibilaties. What are the teaching respnsibilities twards residents: the fellw is expected t present ne subject a week at 2PM teaching runds. Outline participatin in academic activities invlving the residents: the resident will participate in service runds. The fellw will either present r assist the 2PM teaching runds. Describe any supprt staff available t the fellw: the fellw will have access t the strke nurse clinician and the secretary. Prpsed meetings t be attended by the fellw: the fellw will be expected t attend the American Neurcritical Care cnference, this year in Miami, as well as the Trnt Critical Care cnference. What is the research prductivity/publicatins expected by the Fellw: ne prject, hpefully with a subsequent publicatin. Curriculum In rder t create an envirnment cnductive t academic activity, the intensivist may invlve residents whse time is dedicated t the unit, in the active care f patients. This will be cmplimentary t the respnsibilities f the referring services wh will maintain their primary rle. The resident in training will actively invlve himself / herself in the mnitring f all admitted patients. The resident shuld be present in the ICU frm 8AM t 5PM. Chart ntes n a daily basis are required. Bedside runds ccur each mrning and the resident is expected t attend, alng with the nurse respnsible fr the patient and the NICU attending. The resident will actively participate in teaching runds within and utside the ICU cntext. Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc

7 Call in the NICU is taken frm hme. Frequency is never mre than 1 in fur, with ne weekend per mnth, and can vary accrding t individual requirements. Intended case lad fr the Fellw: there are a ttal f 14 beds in the NICU. The Fellw is respnsible fr the care f these patients under the supervisin f the attending. He will als crdinate the activities f the residents rtating thrugh the NICU. Intended percentages f the varieties f cases: there is a large variety f cases, 60% surgical pathlgy, 40% neurlgical pathlgy as the primary prblem. All the pathlgies listed in the sectin called tpics are mre than likely t be encuntered. What regular reading materials are t be prvided (if any): There is a small library in the NICU that cntains the latest textbks in Neurcritical Care. These are available t the resident n a cnsultative basis. There are als textbks n cma, Neurlgy, and the Neurlgical exam. Unlike the US, mst f ur fellws are likely t be internal medicine and critical care residents rather than Neurlgy residents. In these cases, teaching f basic Neurlgy becmes ne f the gals f the fellwship and the textbks reflect this. Outline the weekly / mnthly cnference schedule Afternn curse frm 2 t 3 PM 3 days per week, 3 ut f 4 weeks Neurlgy service runds: nce per week Grand Runds in Neurlgy: nce per week Grand runds in Neursurgery: nce per week Strke runds: nce per mnth What rle will the Fellw play in attending, rganizing, and presenting runds/cnferences The fellw will present ne afternn curse per week Evaluatin: The fellw will be evaluated every mnth using CANMEDS criteria. They will als be able t write a practice exam based n the American Neurcritical Care subspecialty exam. Y:\PGME\PGME-CmmnShare\6B - FELLOWSHIPS\Fellwships by Prgram\Critical Care\neurcriticalcare_fellwship_august2015.dc