Vascular Neurology Fellowship

Fellows gain extensive clinical experience in the hyper-acute management of acute ischemic and hemorrhagic stroke while spending 6 months rotating on the inpatient stroke service at IU Health Methodist Hospital. This comprehensive stroke center cares for more than 1,000 acute stroke cases per year from central Indiana and the surrounding area.

While on service, fellows lead the acute stroke response team—assessing patients, interpreting diagnostic images, making treatment decision regarding thrombolysis, and collaborating with our neuroendovascular team in real time. Fellows also lead the inpatient stroke service, following and managing acute stroke patients throughout their hospital stay. The inpatient stroke service, staffed exclusively by vascular neurologists, provides both admitting and consultative services and cares for patients both in the neurocritical care unit and on our 14-bed stroke unit. On the stroke unit, fellows participate in multidisciplinary rounds with hospitalists, nurses, case managers, social workers, dieticians, and other members of the healthcare team. They also teach neurology residents and medical students.

Fellows follow acute stroke patients longitudinally in outpatient stroke clinic experiences at the IU Neuroscience Center and the Roudebush VA Medical Center. In clinic, fellows learn the principles of secondary stroke prevention and how to manage post-stroke complications (e.g., depression, spasticity, cognitive dysfunction, vision loss), while providing continuous care to stroke patients.

The IU Stroke program also operates a Mobile Stroke Unit (MSU) and is developing a telehealth network. Fellows spend one month rotating on the MSU and telehealth service. Here they have the opportunity to ride along on stroke calls, assess patients and deliver thrombolytics both in person (on the MSU) and remotely, thereby learning the intricacies and subtleties of telestroke care. Fellows also participate in MSU/Telehealth organizational meetings, allowing them to see the multidisciplinary, multi-system, multi-agency cooperation that is required build robust systems of care that optimize resource utilization and the delivery of care to underserved and geographically isolated areas.

Our fellows also rotate on the neurocritical care service where they learn the principles of airway management, increased intracranial pressure management, and blood pressure management in neurologically ill patients. Here they have the opportunity to care for a variety of neuro- and neurovascular related conditions including ICH, ischemic stroke, status epilepticus, intracranial neoplasms, spinal cord injury and traumatic brain injury.

Fellows also rotate in the neurointerventional suite, gaining insight into the evaluation and management of large vessel occlusion, aneurysms, and vascular malformation. With guidance from the endovascular team, fellows are provided extensive training in the interpretation, indications, and potential limitations of cerebral angiography.

Finally, fellows spend 2 weeks rotating at the Rehabilitation Hospital of Indiana, a world-class rehabilitation center that provides comprehensive rehabilitation services to patients recovering from traumatic brain injury (TBI), stroke, spinal cord injury (SCI), transplant and other trauma.

During the clinical fellowship year, fellows are instructed in the principles of basic science and clinical research. In addition, fellows are offered the opportunity to join and participate in faculty research projects or develop projects of their own, which they can work on during a dedicated research month. Our program’s goal is to give all fellows the chance to submit abstracts to national stroke meetings and manuscripts for publication by the end of their first fellowship year.

After completing the ACGME-certified fellowship year, trainees will be eligible for board certification in vascular neurology through the American Board of Psychiatry and Neurology. Additionally, after completing the clinical fellowship year, opportunities for further research training are available for those interested, including opportunities in health services research and development funded through the Roudebush VA Medical Center and in cooperation with the Regenstreif Institute.