USC Vascular Neurology Fellowship

The University of Southern California Stroke Program, led by Dr. Nerses Sanossian and Dr. Sebina Bulic, offers a comprehensive, ACGME-accredited, one-year fellowship in vascular neurology.

Goals and objectives of the fellowship

Our goal is to provide quality care to both inpatients and outpatients with vascular neurologic disorders. We seek to pass down an understanding of the process of clinical research in vascular neurology and engender critical evaluation of stroke literature.

Fellows will learn from the diverse neurologic disorders seen in various patient populations and gain proficiency with the acute treatment of vascular neurologic emergencies. Furthermore, they will develop expertise in the diagnosis, management and prevention of vascular neurologic disorders, as well as acquire the skills needed to teach neurology to medical students, interns and neurology residents.

Nerses Sanossian

Nerses Sanossian, MD
Director, Vascular Neurology Fellowship Program

Sebina Bulic, MD

Sebina Bulic, MD
Associate Director, Vascular Neurology Fellowship Program

Curriculum

Fellows receive training in the diagnosis and treatment of cerebral infarction, transient brain ischemia, brain hemorrhage and all of the following areas of vascular neurology:

  • Cardiogenic brain embolism
  • Large vessel extracranial cerebral atherosclerosis
  • Large vessel intracranial cerebral atherosclerosis
  • Aortic arch cerebral and spinal embolism
  • Small cerebral artery occlusive disease (i.e. lacunar strokes)
  • Hemodynamic brain ischemia
  • Migraine
  • Hereditary and acquired hypercoagulable states, including antiphospholipid antibody syndromes
  • Disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, other hematological disorders
  • Substance abuse and drug toxicities
  • Hypertensive encephalopathy/Posterior Reversible Leukoencephalopathy Syndrome
  • Cervical artery dissection
  • Non-atherosclerotic vasculopathies including genetic/idiopathic (e.g. Moyamoya disease), inflammatory (e.g. vasculitis) and infectious
  • Radiation vasculopathy
  • Cerebral venous thrombosis
  • Genetic and metabolic disorders
  • Intracerebral hemorrhage
  • Aneurysmal subarachnoid hemorrhage
  • Subdural hematomas/epidural hematomas
  • Spinal cord infarction
  • Complications of vascular disease, including raised intracranial pressure, infections and deep venous thrombosis
  • Management of extraventricular drains
  • Indications for surgical management of brain ischemia and hemorrhage
  • Vascular malformations
  • Air/fat embolism
  • Stroke in malignancy, immunosuppression and as a consequence of systemic illnesses/conditions

Fellows also receive training in the assessment and management of critically ill vascular neurology patients, including those with stroke, intracerebral hemorrhage, raised intracranial pressure and patients undergoing therapeutic hypothermia, among others. Fellows can participate in pre- and post-op management of neurosurgical and endovascular patients with subarachnoid hemorrhage, Moya Moya disease and other vascular diseases.

Rotations

The fellowship consists of clinical rotations at the inpatient stroke service, outpatient stroke clinic including electives and protected research time. Keck Hospital of USC, Los Angeles County + USC Medical Center, Rancho Los Amigos National Rehabilitation Center and Kaiser Medical Center of Los Angeles serve as sites for the vascular fellowship. The diverse patient populations of each center offer unique learning opportunities.

The fellowship can be geared towards the individual interests of the fellow. For instance, research mentorship is available to those who want to explore clinical or basic science research. Fellows are Board-eligible for vascular neurology from the American Board of Psychiatry and Neurology, Inc., upon completion of the fellowship.

Keck Hospital of USC

Training at the Keck Medical Center of USC gives the fellow experience with patients in a major tertiary and quaternary hospital. At the Keck Medical Center of USC, teaching rounds are held daily in stroke neurology. Stroke neurology service is a part of the primary ward and the neurocritical care team for patients with stroke assigned to the neurology service and the primary consult team.

The stroke neurology team makes consists of: the vascular neurology/neurocritical care attending physician, the vascular neurology fellow, a PGY3 general neurology resident, a PGY2 general neurology resident and two medical students. New vascular neurology admissions are presented to the attending physician. The vascular neurology fellow will become familiar with all aspects of the individual stroke patient’s care. Presentations are performed for previously admitted patients. Vascular neurology fellows provide 24-hour coverage of the acute stroke neurology service, respond to sudden changes in patient condition and conduct new inpatient consultations.

LAC+USC Medical Center

Training at LAC+USC Medical Center provides fellows with experience in a large urban institution that provides care and serves as a safety net for the underserved residents of Los Angeles County. At LAC+USC Medical Center, stroke and transient ischemic attack patients are admitted to the 20-bed dedicated stroke unit/neuroscience intensive care and observation unit (Unit 4C). The stroke unit is contained within neuroscience intensive care and consists of private rooms, each equipped with cardiac telemetry and staffed by dedicated neuroscience nurses. Outpatients are seen in the neurology clinic, which is equipped with 20 examination rooms and appropriate clinic support staff.

LAC+USC medical center has 24/7 multimodal imaging, with CT scan and imaging with MRI. A library, cafeteria and private, safe on-call rooms are located onsite. The library has ample stroke and vascular neurology textbooks at the disposal of fellows. Vascular neurology fellows provide 24-hour coverage of the acute stroke neurology service, respond to sudden changes in patient condition and conduct new inpatient consultations.

Kaiser Medical Center of Los Angeles

At the Kaiser Medical Center of Los Angeles, fellows rotate on the inpatient stroke consults service, which includes rounding in the stroke unit, Neuro ICU, CCU and ICU. Transcranial doppler interpretation, telestroke examination and a one half-day of weekly stroke continuity clinic are incorporated into the rotation. The goal of the stroke service rotation is to provide fellows with an educational and hands-on patient care experience in vascular neurology, as well experience in diagnosis and management of common and more complex cerebrovascular problems.

How to Apply:

2020-2021 Interested Applicants can apply for the Vascular Neurology Fellowship through the ERAS website. Registration opens December 1, 2018. The program participates in the NRMP match.

Please visit: aamc.org/services/eras/

For more information, please contact Asima Kachroo, our Fellowship Coordinator, at kachroo@usc.edu.

Vascular Neurology Faculty

Vascular Neurologists

  • Nerses Sanossian, MD,
    Program Director, Vascular Fellowship
  • Amytis Towfighi, MD
  • May Kim-Tenser, MD
  • Zahra Ajani, MD
  • Sebina Bulic, MD
  • Peggy Nguyen, MD
  • Matthew Tenser, MD
  • Navdeep Singh Sangha, MD


Neurocritical Care Neurologists

  • May Kim-Tenser, MD
  • Gene Sung, MD
  • Benjamin Emanuel, DO

Vascular Neurosurgeons

  • Steven Giannotta, MD
  • William Mack, MD
  • Arun Amar, MD
  • Matthew Tenser, MD

Former Vascular Fellows

  • Sebina Bulic, MD 2013-2014
  • Peggy Nguyen, MD 2015-2016
  • Jared Noroozi, MD 2016 – 2017
  • Joseph Kim, MD 2016-2017

  • Mark Sabra, MD 2018-2019
  • Shauna Cheung, MD 2018-2019

Current Fellows

  • Mark Sabra, MD 2018-2019
  • Shauna Cheung, MD 2018-2019

For more information regarding fellowships please contact: kachroo@usc.edu.