Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine - Fellowships
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Fellowship in Neuroanesthesia


The Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital (MGH) is pleased to offer a Fellowship in Neuroanesthesia to anesthesiologists who desire a one year program with the option to extend for an additional year to pursue further training in neuromonitoring, neurocritical care, or research. This program is a combined program with the Brigham and Women's Hospital (BWH), Department of Anesthesia.

The overall goal of the program is to provide comprehensive advanced training for anesthesiologists in all aspects of the care of the neurosurgical patient, whether it occurs in the operating room, interventional radiology suite, or neurointensive care unit. One fellow will be accepted each year, spending approximately 2-3 months at each institution (MGH and BWH). She/he will use the remaining months to complete her/his pediatric neuroanesthesia training at the Children's Hospital, neurocritical care at the MGH/BWH and other elective rotations (e.g. research, neurophysiology, academic project). The fellow will develop technical and cognitive skills needed to manage patients undergoing a broad variety of intracranial, spinal, and radiological procedures; gain sufficient experience and interpretive knowledge of various modes of neurological monitoring including electroencephalogram and evoked potentials, intracranial pressure, blood flow velocity (TCD), and cerebral oximetry.

This program will provide a comprehensive experience in the technical, intellectual, and intuitive skills needed to manage neurosurgical patients in the operating room, interventional radiology suite, and intensive care unit. Mentoring will be an integral part of this experience. The fellow will be mentored informally by all participating faculty on a day-to-day basis and will also be assigned a faculty mentor with whom he/she will be required to meet quarterly.

The successful applicant will
  1. have an M.D. or equivalent;
  2. have completed a core residency program in anesthesiology, with at least one year of clinical training being in an ACGME accredited program or its equivalent; and
  3. be certified or in the process of obtaining certification from the American Board of Anesthesiology or its equivalent.


OVERALL OBJECTIVES

A) Educational Objectives:

Advanced knowledge acquisition in:

  1. Cerebral physiology (control of CBF, CBV, ICP, CPP, CO2 reactivity etc.)
  2. The influence of anesthetic agents and techniques on cerebral physiology in normal brain and after pathophysiological changes.
  3. Perioperative and critical care of neurosurgical patients: tumor surgery, epilepsy surgery, intracranial aneurysm, carotid endarterectomy, transphenoidal pituitary, AVM, Chiari malformation, spine surgery, head trauma, intracranial bleeding, craniectomies, craniosynostosis, positioning.



B) Practical Objectives:

Patient Management Skills:
The neuroanesthesia fellow will gain the experience and skills needed to successfully and independently manage:

  • Patients with acute head injury.
  • Patients with supratentorial tumors
  • Patients with posterior fossa lesions.
  • Epilepsy surgery and neurosurgery for movement disorders
  • Anesthetic management of cerebral vascular surgical procedures including aneurysms, arteriovenous malformations, carotid endarterectomy, extracranial-Intracranial bypass procedure
  • Prone, lateral and seated positioning for neurosurgical procedures.

Technical Monitoring Skills:
- Familiarity with EEG, somatosensory and brainstem auditory evoked potentials. - Proficiency in the use and interpretation of transcranial Doppler ultrasonography ICP, NIRS (near infrared spectroscopy), jugular bulb O2 saturation

C) Scholarly and Administrative Experience:
Fellows will gain experience in the supervision of residents and CRNAs; preparation of cases; communication with the surgical team and reviewing the pre-anesthetic workup and directing the post anesthetic care of the patients. They will gain academic experience by participating in an academic project or preparing and delivering a lecture or abstract at a national meeting.


 
Office Information

Department of Anesthesia,
Critical Care and Pain Medicine
Gray-Bigelow 444
55 Fruit Street
Boston, MA 02114

Public Transportation Access: Yes
Disabled Access: Yes