Clinical Experience - Vascular Neurology Fellowship Program

• 767-Bed Comprehensive Stroke Center located in New Orleans with 8 dedicated Vascular Neurology attendings on-site
• 2nd Comprehensive Stroke Center located in north Louisiana at Ochsner LSU Health Shreveport campus
• > 50 Tele-Stroke spokes across Louisiana, Mississippi and Alabama with a dedicated Ochsner Flight Crew serving the gulf south region
• 34-bed Neurocritical Care Unit within new critical care tower opened in 2018
• 40 bed Neuro-Progressive Stepdown Unit (NPU)
• > 1700 vascular neurology consultations per year at Jeff Hwy Campus
• > 4000 tele-stroke consultations per year (~ 30% thrombolysis rate)
• > 600 Tele-Vascular Inpatient Rounding Consults per year
• > 175 Thrombectomy Cases per year

• Intake – Consisting of a dedicated attending, plus a resident and/or advanced practice provider, this team handles all acute stroke codes and other non-emergent stroke consults (ER, Floor, ICU, etc.) throughout the day.
• Stroke Primary Service – Our inpatient service on the 9th floor NPU. Multidisciplinary rounds begin at 9am and involve the input of a wide range of services supporting the comprehensive care of our admitted patients. This includes the stroke service attending, stroke team APP(s) and/or resident(s), hospital medicine co-rounding attending, pharmacy staff, case management, clinical research coordinators, charge nurse, rehab and therapy services, medical and nursing students.
• Stroke Consult Service – Established consult patients, majority within our 9th floor NCC Unit. Rounds begin at 1 pm and include the service attending as well as a dedicated team of advanced practice provider(s) and/or resident(s). A large portion of these patients are in the acute stages of their admission, immediately after thrombolysis or thrombectomy or those with intracerebral or subarachnoid hemorrhage.
• Acute Tele-Stroke – 24/7 attending service line for > 50 spokes across the 3-state region. A large portion of transfers for acute stroke management will come via this service line.
• Tele-Vascular Inpatient Rounds/Consults – Virtual rounds on patients admitted to several affiliate hospitals within the network. This allows us to extend subspecialty level follow-up care throughout the region.

This is the core acute stroke experience of the fellowship

• The Inpatient Service Block is meant to expose the fellows to acute stroke care and the management of the hospitalized stroke patient, and involves overnight home call on certain evenings. The fellow is the point person for the triage and management of all acute stroke patients with attending supervision and guidance. While on home call, acute stroke codes may be managed virtually via tele-stroke as you assess patients simultaneously with our in-house resident or advanced practice provider.
• While the primary responsibility and prioritization will be the Intake service line (stroke codes & non-emergent consults), fellows have a dedicated secondary role during the service block, either the Stroke Primary Service or the Consult Service. Here they will perform the duty of a Junior Attending, managing and educating team members and supervising their medical decision making.
• In an effort to appropriately dose tele-stroke exposure and balance responsibilities, fellows will be introduced to a select volume and number of sites within our expansive network. In a graduated fashion throughout the year, fellows may also gain the opportunity to perform Tele-Vascular consultations at our surrounding hospitals.

Provides critical time for academic exploration, mentorship and feedback

Vascular Neurology Fellow Clinic – Tuesday and Wednesday afternoons. Fellows will gain experience in the management of ambulatory/outpatient vascular neurology patients.

Electives – taking place as half-day mornings, fellows are able to customize their own learning pathway from a selection of electives typically adjunctive to the field of vascular neurology. Electives not listed can be requested by the fellow on an individual basis.

• Research – projects to be set up on individual basis with mentor
• Neuro-IR
• Neuroradiology
• Neuro-Rehabilitation
• Neurosonology
• Vascular Surgery
• Stroke Cardiology
• Neuro-Ophthalmology
• Cognitive Neuro/Vascular Dementia

Self Study & Research – the afternoons of this block provide adequate protected time for self-learning, research, presentation preparation, and board prep

Fellow’s Corner – a more structured, but informal way to touch base with your mentor or program director during your off-service weeks to generate more customization. Things such as . . .

• Shared feedback and suggestions
• Review particular cases or images, etc. the fellow has questions about
• Small group, 1:1 literature / topic review, landmark trials, etc.
• Get advice on presentations, journal club selections, etc.
• Career or fellowship advice and planning