The objective of our clinically rigorous fellowship program is to provide fellows with clinical knowledge and experience, procedural skills, clinical judgement, professionalism, and interpersonal communication skills required as a neurointensivist.

For those interested in a career as an investigator, a specially constructed three-year training curriculum will combine the time and educational requirements of early governmental and non-governmental awards and the rigors of clinical training.

The training will prepare fellows to function as clinicians, investigators and leaders in neurocritical care when they graduate.

The majority of practice is in the Neurointensive Care Unit at Barnes-Jewish Hospital, a 32-bed ICU in a Level 1 trauma and comprehensive stroke centers. Fellows will take on stepwise responsibility and be exposed to direct and indirect learning, one-on-one mentorship, simulation for procedural competency, and rigorous bedside teaching. In addition to rotating in the Neurointensive Care Unit, fellows will gain broader exposure by rotating through the surgical and medical ICUs, and each fellow will further have the ability to personalize their training with a selection of other electives.

Throughout their training, fellows will receive frequent written & verbal feedback from faculty regarding their performance to aid them in becoming a well-rounded, competent neurointensivist.

Patients per year

The disease states and procedures are outlined below, highlighting the high volume and variety of disorders encountered in our busy unit (complemented by additional exposure in other ICUs).

Cerebrovascular disorders

Ischemic stroke*50
Intracerebral hemorrhage200
Subarachnoid hemorrhage100
Cerebral venous sinus thrombosis10
Annual Total~400
* Including malignant hemispheric infarction, basilar artery occlusion and vasculopathies (e.g. Moya-Moya, RCVS), MELAS


Severe closed head injury60
Penetrating head injury10
Subdural hematomas100
Spinal cord injuries20
Annual Total~200

Other conditions treated

Status Epilepticus40
Neuromuscular Disorders 130
CNS Infections60
Neuroendocrine disorders 240
Perioperative neurosurgical care 3200+
Brain death 460
1. Including Myasthenia Gravis, Guillain-Barre, ALS
2. Including pituitary apoplexy, panhypopituitarism and DI
3. Including craniotomy, third ventriculostomy, major spinal procedures
4. Evaluation of catastrophic brain injury, diagnosis of brain death including apnea testing (coverage for entire hospital)

General critical care

  • Respiratory: airway management, mechanical ventilation (invasive and non-invasive) bronchoscopy, ARDS, management of chest tubes
  • Cardiac/Circulatory: performance and interpretation of bedside echocardiography, cardiac output monitoring, CPR, and evaluation and management of shock
  • Renal: initiation of hemodialysis, diagnosis and management of acute renal failure
  • Gastrointestinal: management of GI bleeding, open abdomen, acute abdomens
  • Hematologic: evaluation of coagulation status and coagulation disorders, hypercoagulable conditions, and use of transfusion products
  • Infectious Disease: management of antibiotic therapy

Procedural competencies

Approximate number per year for fellow experience:

Central venous catheter placement100
Arterial catheter placement150
Endotracheal intubation100
Lumbar puncture50
Thoracentesis and chest tube10-20
Bedside ultrasonography and echocardiography200-300
Pulmonary artery catheterization5
CPR / ACLS20-30
Continuous EEG monitoring150