Mayo Clinic College of Medicine and Science (Rochester) Program

Neurocritical care is a rapidly evolving specialty, crucial for managing life-threatening neurological illnesses. The Neurocritical Care Fellowship at Mayo Clinic in Rochester, Minnesota, provides a comprehensive two-year training program tailored to equip fellows with the skills necessary to address critical neurological cases effectively.

The fellowship encompasses a multidisciplinary approach, ensuring fellows receive exposure to a broad spectrum of acute neurological disorders within a structured clinical environment. A primary focus of training occurs within the 20-bed Neuroscience Intensive Care Unit (ICU), which operates under a closed model of care. In this setting, all orders for patient management are written by the neurocritical care team, in conjunction with neurosurgical needs when necessary. This model promotes an integrated approach in managing complex cases from traumatic brain injuries to acute strokes.1

The critical care rotation includes significant engagement with both traumatic brain injury management at a level 1 trauma center and acute ischemic stroke interventions, comprising endovascular treatments. Furthermore, fellows become adept at evaluating and treating systemic complications resulting from neurological injuries during their rotations. A mandatory boot camp precedes clinical rotations, ensuring fellows are well-versed in essential procedures and ICU principles.1

Curriculum and Rotations

The fellowship's curriculum allocates six months in the Neuroscience ICU and three months in non-neuroscience ICUs during the first year. The second year further diversifies training through rotations in additional surgical and medical ICUs, neurology consultations, and elective opportunities. International fellows who complete an accredited residency in neurology, anesthesia, internal medicine, or related fields are eligible, with consideration given to J-1 Visa sponsorship for foreign medical graduates.2

During the year, fellows are required to spearhead relevant research projects and actively participate in clinical education, including leading consultative neurocritical care services and conducting end-of-life care conferences, enhancing both leadership skills and clinical acumen. Mentored research is prioritized with dedicated time allocated within the structure of the fellowship, facilitating publication opportunities.3

Didactics and Conferences

To supplement clinical training, fellows participate in didactic sessions that cover a wide array of critical care topics, enhancing their knowledge base and readiness for board examinations. A summer neurocritical care course, specific to acute neurological emergencies, is part of the formal curriculum. Additionally, fellows regularly present at various conferences, including Neurology Grand Rounds and critical care seminars, establishing competency in academic discourse and collaborative learning environments within the institution.3

Competitiveness and Application Process

The program is competitive, offering one position annually. Applicants need a completed residency in relevant clinical disciplines and must have undergone a minimum of four years of postgraduate training. For foreign graduates, sponsorship of J-1 visas ensures compliance with necessary residency regulations.2

The fellowship application requires submission through SF Match, including all essential documentation by March 15 preceding the start in July. Candidates undergo interviews with faculty, facilitating direct engagement with potential mentors.2

Research and Publication Opportunities

Research is a core aspect of the Neurocritical Care Fellowship, with a structured mentorship approach supporting fellows in developing and executing thoroughly vetted clinical studies. Available resources at Mayo Clinic, such as its extensive medical records system and statistical support, empower fellows to investigate a range of pertinent clinical questions, with the expectation of presenting their findings at scientific meetings or publishing in reputable journals.3

Visa and Support

The Neurocritical Care Fellowship program accepts international applicants only if they possess a J-1 Visa, which is sponsored by the Educational Commission for Foreign Medical Graduates (ECFMG), facilitating training while adhering to U.S. regulations.2

Structure of the Training Sites

Fellows gain experiential training across various intensive care environments at Mayo Clinic's campuses, notably including the Mayo Clinic Hospital, Saint Marys Campus, and the Methodist Campus, enriching their exposure to multifaceted clinical situations.

Evaluation and Growth

Ongoing evaluation of fellows is integral, ensuring that clinical, academic, and professional growth align with the program's objectives. Regular meetings with faculty mentors provide a platform for fellows to discuss progress and future career aspirations, forging a pathway towards successful practice in neurocritical care.