Neuroanesthesiology

About the Neuroanesthesiology Fellowship

The UW Department of Anesthesiology & Pain Medicine offers a one-year, faculty fellowship in neuroanesthesiology accredited by International Council for Perioperative Neurosciences Training (ICPNT).

Our program’s mission is to equip anesthesiologists with the advanced knowledge and skills required to safely manage and monitor neuroanesthesia cases and provide research and educational experiences to develop leading academic neuroanesthesiologists for the future. By the end of their year-long fellowship, graduating fellows will be skilled in performing preoperative assessments on patients with neurological and neurosurgical diseases, developing and executing appropriate anesthetic planning and monitoring techniques, and providing high quality perioperative management for these patients.

Academic

Basic knowledge acquisition

  • Understanding of cerebral physiology (control of CBF, CBV, ICP, CPP, CO2 reactivity etc.)
  • Understanding of influence of anesthetic agents and techniques on the normal control mechanisms.
  • Understanding of the influence of disease pathology on normal cerebral physiology and pharmacology.

Research experience

  • Understanding of basics of hypothesis formulation, literature review, experimental design, methodology, data acquisition, statistical analysis, interpretation of data, penmanship, peer-review process, and publication of results.
  • Participation in clinical research in neuroanesthesia.

Practical

Patient management skills

  • Understanding of anesthetic management of acute head injury.
  • Understanding of anesthetic management of cerebral vascular surgical procedures including aneurysms, arteriovenous malformations, carotid endarterectomy, extracranial-Intracranial bypass procedure.
  • Understanding of anesthetic management of supratentorial tumors.
  • Understanding of anesthetic management of posterior fossa lesions.
  • Understanding of anesthetic management of the seated position.

Technical monitoring skills

  • Proficiency in cannulation of the jugular bulb.
  • Proficiency in the use of transcranial Doppler ultrasonography
  • Proficiency in the use of EEG, somatosensory and brainstem auditory evoked potentials for interested parties. The Department of Anesthesiology & Pain Medicine does not actively participate in the monitoring program, but arranges with Department of Rehabilitation Medicine for this experience.

NOTE: Actual experience and knowledge acquired during the fellowship is variable and dependent on the fellow’s own learning objectives, area of interest, level of motivation, enthusiasm and effort.

This is a one-year program with two position openings each year. In this unique program, our fellows split their time between working as a neuroanesthesiology fellow (80%) and serving on faculty as a clinical instructor attending in the general OR (20%). Our training program primarily includes:

  • Clinical experience with a variety of neurosurgical procedures.
  • Clinical experience of relevant neuroscience specialties including neuroradiology and neurointensive care.
  • Clinical research experience under faculty supervision.
  • Formal educational activities including didactics, journal clubs, and case presentations.

Education

Our fellowship incorporates multiple didactic programs to help fellows gain proficiency in caring for patients who undergo neurological procedures. Fellows are expected to attend the following educational programs and conferences provided by our program:

  • Weekly Grand Rounds
  • Weekly anesthesiology educational conferences at Harborview
  • Weekly neuroradiology teaching conference at Harborview
  • Monthly neuroanesthesiology journal club
  • Bi-monthly neuroanesthesiology academic / research meeting
  • Monthly neuroanesthesiology case conference
  • Quarterly faculty fellowship evenings
  • Annual departmental academic evening
  • Other educational activities:
    • Participation in developing clinical guidelines
    • Teaching residents on neuroanesthesiology rotation
    • Conducting oral exams for residents on neuroanesthesiology rotation

Clinical experience

In Neuroanesthesiology fellowship, 80% of the fellowship year is devoted to educational opportunities and 20% of the fellowship year is devoted to time as a junior attending with clinical, supervisory, and call commitments. Throughout their training, our fellows participate in a variety of cases, procedures and electives. Fellowship activities are based primarily at Harborview Medical Center, which is a leading level-1 adult and pediatric trauma center renowned for complex cerebrovascular surgery.

Neurosurgical anesthesiology rotation

The goal of this rotation is to maximize direct clinical experience including invasive procedure. Our fellows provide anesthesia for major neurosurgical cases and are directly supervised by a senior neuroanesthesia attending. Fellows are expected to discuss the cases with supervising attendings, engage in academic discussions and perform post-operative follow up. The fellows will provide direct anesthesia care for complex neurosurgical procedures including, but not limited to, intracranial bypass procedures, aneurysm clippings, resection of AVMs, tumors and seizure foci, microvascular decompression, trans-sphenoidal resection of pituitary tumors, craniotomy for evacuation of intracranial hematoma, and interventional neuroradiological procedures. Fellows are encouraged to actively approach faculty for feedback.

Transcranial doppler (TCD) ultrasonography laboratory rotation

Harborview features a world-renowned TCD lab, and many neuroanesthesiology faculty are widely renowned for their expertise with this technique. During this rotation, our fellows learn to perform, report and interpret TCD examinations. Fellows typically shadow the TCD lab technicians as they perform tests on inpatients and outpatients and then personally perform the TCD examinations and learn application of TCD for cerebral vasospasm, carotid endarterectomy, cerebral circulatory arrest, cerebral autoregulation and CO2 reactivity tests, and emboli monitoring for stroke.

Neuroradiology rotation

During this rotation, our fellows work alongside neuroradiology faculty and learn to interpret basic neuroradiological imaging and understand interventional neuroradiology principles and techniques.

Intraoperative neurophysiological monitoring rotation

During this rotation, our fellows learn the basic principles and techniques of intraoperative evoked potential monitoring, including somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), visual evoked potentials (VEPs), brainstem auditory evoked potentials (BAEPs) and electroencephalography (EEG) as well as their intraoperative use during brain and spinal cord surgery.

Elective rotations

We offer elective rotations that are tailored to suit our fellows’ individual needs. Popular elective rotations include neurointensive care, neurosurgery, and the stroke unit.

Research experience

Our fellows typically receive one month dedicated to completing a fellowship research project. They are also mentored by faculty in the Division of Neuroanesthesiology & Perioperative Neurosciences and receive research support from regulatory specialists and biostatisticians. This research month is in addition to the one academic day that our fellows receive every week to pursue fellowship-related educational activities.

Financial support

Annual Stipend: We are proud to offer competitive salaries for our faculty fellowship positions.

Academic Allowance: Subject to available funding, faculty fellows will receive $1,500 each academic year as “all inclusive” support of their general academic expenses incurred during their time of training.

We are currently accepting applications for positions beginning in Fall 2023.

Application documents:

  • Current Curriculum Vitae 
  • Application for Faculty Fellowship
  • Letter of intent/personal statement 
  • Three current reference letters, including one from your residency program director or current director 
  • Copy of medical school diploma 
  • Copy of anesthesia degree (if applicable) 
  • Current medical license 
  • USMLE (all three steps) 
  • ECFMG documentation (if applicable) 
  • Documentation supporting citizenship status (if applicable)  
  • H1B Visa holder or eligible (if applicable) 

Please send application and supporting documents (or questions) to: 

Nicole Sullivan, Neuroanesthesiology Fellowship Administrator: nicolsul@uw.edu 

Interviews 

Interviews for 2023-2024 UW Neuroanesthesiology Faculty Fellowship positions will be conducted remotely through Zoom or another appropriate videoconferencing platform. Interview dates will be provided upon invitation.