Neurocritical Care

The Emory University School of Medicine Section of Neuro-Critical Care is directed by Dr. Owen Samuels. The Neuro-Critical Care fellowship is directed by Prem Kandiah, MD.

Applications are currently being accepted for positions starting July 1, 2023.  There are four fellowship positions offered each year. This is a two-year position through Emory University Hospital and Emory Healthcare.

• Cultivating proficient intensivists with a specialization in Neurocritical Care through immersive experiences in high yield multidisciplinary critical care units and organ specific specialties.
• Developing mastery in Neurocritical care through graded responsibility, procedural competency and modeled compassion in the management of patients in multiple high acuity, high complexity and high volume neurointensive care units.
• Solidifying knowledge and skills through carefully designed didactic conferences, simulation experiences, case discussions, medical education and scholarly activity

Emory’s Neurocritical care program is both UCNS and CAST accredited and is compliant with ACGME work hours.  During this 24 month fellowship program, the 1st year focuses on multidisciplinary critical care skills and competencies and the second year focuses on Neurocritical Care competencies and skills. The following breakdown of program rotations is geared toward fellows who have completed a Neurology residency. Rotations will vary significantly for fellows from Neurosurgery, Emergency Medicine, Critical Care Medicine, Anesthesia, and Internal Medicine and will be tailored to specific needs and compliant with CAST, UCNS and ACGME certification requirements.    

The first year of the fellowship is carefully designed to cultivate a foundation of critical care medicine with a graded introduction to various intensive care units within the Emory and Grady healthcare system.  Fellows are required to participate as integral members of the team with direct patient care involvement when rotating in the Surgical/Transplant ICU, Cardiovascular ICU, Grady Surgical Trauma ICU, and Medical ICU. As an introduction to Neurocritical Care, fellows will also spend 3 months between Emory University Hospital and Grady Memorial Hospital Neuroscience ICUs. Our fellows have continued to find that consultatory rotations in Infectious Diseases and Nephrology are integral to enriching their comprehension and appreciation for related problems that are so prevalent in critical care units. As a commitment to proficient and safe airway management, fellows spend two consecutive months guided by our Neuro-Anesthesiologist, Dr. Alexander Papangelou to learn the fundamental skills of intubation and airway management. During these two months, fellows will also spend time learning ultrasound through multiple modalities, including: Emergency Medicine ultrasound lecture series with hands on training, hands on ECHO training within the ECHO department at EUH, and participating in a Point of Care ECHO Canvas course.

During the second year, fellows are expected to co-manage the Neurocritical service with the attending to prepare them for independent practice following fellowship. Fellows will learn to collaboratively lead a team of experienced Neurocritical care affiliate providers, Neurocritical care PharmD, and learners at varying levels. The will also participate in joint decision making with Neurosurgical and Neurological teams. The team approach to critical care is highly valued in our program and hence honing team leadership skills is crucial to the success of our fellows as future leaders in this field.  Fellows will be expected to lead goals of care discussions with families with guidance and feedback from faculty. The clinical responsibilities of the fellow extend beyond the ICU to participation in the Neurocritical care consultation service and patient care triage from outside hospitals. Teaching neurosurgery and neurology residents, affiliate provider trainees and medical students in the NeuroICU is valued and vital to the maturation of our fellows. With early planning, electives in ICU EEG, Bronchoscopy and Stroke are available to fellows during the second year.

Patient care responsibilities include daily critical care management of neurology and neurosurgery patients with a broad spectrum of diseases including high risk post-operative neurosurgical patients, subarachnoid hemorrhage, cerebral aneurysms, ischemic and hemorrhagic stroke, brain tumors, subdural hematoma, status epilepticus, neuroimmunologic and neuroinfectious diseases, neuromuscular failure and numerous other diseases. Averaging at about 250 to 300 subarachnoid hemorrhage patients per year, Emory Neurocritical care is one of the largest referral centers for subarachnoid hemorrhage in the country with one of the largest subarachnoid hemorrhage research databases in the country.  General critical care management responsibilities including airway management, respiratory failure and ventilator management, prone ventilation, cardiopulmonary resuscitation, shock, fluid and electrolyte acid base management fall under the purview of the Neurocritical care fellow guided by our faculty.

• Arterial line placement
• Central venous line placement
• Lumbar puncture/lumbar drain
• Airway Management Procedures
• Bronchoscopy
• Administration of moderate sedation
• Ventriculostomy tubing puncture
• OPTIONAL: Ventriculostomy/ICP monitoring bolt placement
• OPTIONAL: Transcranial Doppler

• Emory University Hospital
• Grady Memorial Hospital
• Emory University Hospital Midtown
• Emory St. Joseph’s Hospital

The Neurocritical Care Lecture Series is a weekly session and required for fellows to attend. These lectures are given by attendings throughout the Emory system and are intended to provide a comprehensive series on neurocritical care.  The series runs over a two-year period.  These are held every Thursday from 1:30-2:30.  

There is a complimentary multi-disciplinary critical care lecture series that follows on Thursdays from 3:00-4:00.  This covers broad critical care topics applicable to all critical care specialties. 

Morbidity and Mortality conferences are held the 4th week of every month embedded within the Neurocritical Care Lecture Series.  M&M conferences are intended to be multi-disciplinary and developed by second year fellows with the assistance of David Pearce and Jackie Kraft to help fellows learn to develop appropriate academic lectures prior to independent practice.  

Fellows have the opportunity to attend weekly stroke, vascular neurosurgery, neurosurgery, and neurology conferences as well to enhance their learning experience.

Prerequisite training/selection criteria for successful candidates are as follows:

• Board eligible and board certified neurologists/neurosurgeons, anesthesiologists, emergency medicine physicians, surgical intensivists, and medical intensivists.
• Completion of accredited training program.
• Related research, teaching, quality measures and publication history pertaining to Neurocritical care.

• 2020 – Feras Akbik, Pouya Ameli, Subin Mathew, Alexis Taylor
• 2019 – Tushar Patil, David Pearce
• 2018 – Jackie Kraft, Joao McOneil Plancher
• 2017 – Deepak Baksharan, David Campbell, Michael Mendoza
• 2016 – Cederic Pimentel, Scott Saucedo, Ofer Sadan
• 2015 – Gilbert Mbeo, Wamda Ahmed
• 2014 – Dustin Rochestie, Lilith Judd
• 2013 – Arun Sharma, Casey Hall, Vijay Johnson
• 2012 – Adam Edwards, Subashini Ramesh, Rehan Sajjad, Prem Kandiah
• 2011 – Arash Afshinnik
• 2010 – Susan Samuel
• 2008 – Sam Tsappidi
• 2007 – Adam Webb
• 2005 – As’ad Ehtisham  

Tiffany Smith, MA
Neurocritical Care Fellowship Program Coordinator
404-778-3813
Email