RESIDENTS AND FELLOWS CORNER
Broadening Our Horizons: Attracting Fellows
from a Variety of Residency Specialties
By Jennifer Kim, MD, PhD, and Anand Venkatraman, MD
Neurocritical care has long attracted intensivists from a variety of
training backgrounds. More recently many fellows are neurologytrained.
As our field expands, NCS wants to continue attracting
trainees from all fields to draw on the strengths of such diversity.
We interviewed six non-neurology trained neurointensivists to see
why neurocritical care interests them and how to attract others in
their respective specialties. (Responses paraphrased for brevity)
Firas Abdulmajeed: Assistant Professor
University of Pittsburgh
Marin Darsie: Assistant Professor
University of Wisconsin
Jonathan Elmer: Assistant Professor
University of Pittsburgh
Joshua Medow: Associate Professor
Director of NCC-University of Wisconsin
David Miller: Associate Professor
University of Alabama Birmingham
Casey Olm-Shipman: Assistant Professor
University of North Carolina at Chapel Hill
1. What is your training background and how does that
influence your current job position?
(FA) I trained in Internal Medicine, which provided me
job opportunities in locations that want to become
comprehensive stroke centers, but do not have enough
volume for dedicated Neuro ICUs. This gave me the
opportunity to take care of neurologically, medically, and
surgically critically-ill patients.
(MD) I completed a residency in emergency medicine
before completing a fellowship in neurocritical care. I am
currently an assistant professor at the University of
Wisconsin and split my time between the Emergency
Department and Neuroscience ICU.
(JE) I trained in emergency medicine at Partners in
Boston, then did a critical care fellowship at the
University of Pittsburgh Medical Center. The
neurocritical care fellowship was just starting, but I
tailored my training to fulfill the neurocritical care
requirements within my two-year fellowship. I spend 25
percent of my time attending on the Neurotrauma and
Post-cardiac arrest services, and 75 percent doing
research.
(JM) I trained as a neurosurgery resident and
endovascular fellow at the University of Wisconsin. I am
now Director of Neurocritical Care at UW and I split my
time between the Neuro ICU and operative, spending
50-70 percent in the former and 30-50 percent in the
latter. I am also interested in clinical informatics and
pursuing a PhD.
(DM) I started as a general surgery resident at the Mayo
Clinic in Scottsdale, and then transitioned to an
anesthesia residency and critical care fellowship at the
University of Alabama. My surgical experience helped
with procedural tasks in the Neuro ICU while anesthesia
helped frame protocol and outcomes-oriented thinking.
My multifaceted experience enables me to connect well
with a diverse range of colleagues, which I enjoy.
(CS) As a medical student, I enjoyed both adult and
pediatric neurology. I pursued child neurology, but
intentionally selected Partners in Boston for its in-depth
exposure to both adult and pediatric care. I subsequently
completed a fellowship in acute stroke and neurocritical
care and now practice at the University of North Carolina
at Chapel Hill in the divisions of Neurocritical Care,
Stroke, and Child Neurology. In selecting a faculty
position, I sought opportunities that would enable me to
care for both children and adults.
2. How did you get interested in neurocritical care? At what
stage of training were you exposed to neurocritical care?
(FA) When I was a resident, I was always interested in
critical care medicine, but I decided to be a hospitalist
before pursuing fellowship. With my first job I was
exposed to neurologically critically ill patients, and
dealing with these cases was challenging. That’s when I
decided I wanted to pursue neurocritical care.
(MD) Rotating though various critical care services is
standard in Emergency Medicine training. I trained at the
University of North Carolina at Chapel Hill, which
uniquely had us rotate through the Neuro ICU in
addition to other ICUs. After my neurocritical care
rotation, I wanted to pursue a critical care fellowship. Dr.
Rhonda Cadena, who also trained in EM before
completing fellowships in both stroke and neurocritical
care, mentored me. With her guidance, I began my
neurocritical care fellowship at UNC-Chapel Hill.
(JE) I was looking for research projects during residency
and wound up studying ARDS in ICH. I became
interested in the balance between managing what the
brain and body need. My first exposure to a Neuro ICU
was my first fellowship rotation. I remain interested in
the brain-body balance and am now pursuing a master’s
and applying for a K23.
(JM) As a PGY-2 neurosurgery resident, I had a patient
with aneurysmal subarachnoid hemorrhage who had
great surgical results, but poor medical management/
complications. The critical care doctors didn’t know how
to manage subarachnoid hemorrhage and the
neurosurgeons didn’t know how to manage the medical
complications. During residency I did one year of MICU
training and then an endovascular fellowship. As a
resident, we had a small neurosurgical ICU, but all
neurology patients went to the MICU. Now we have a
newly expanding combined neuroscience ICU.
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