ICPNT

ICPNT Fellow in the Spotlight 

By: Dr. Matthew Vengalil

Dr. Matthew Vengalil 

Dr. Matthew Vengalil is the current Neuroanesthesiology Fellow at University of Michigan in Ann Arbor, USA (Neuroanesthesiology Fellowship | Anesthesiology | Michigan Medicine | University of Michigan (umich.edu). The University of Michigan, Ann Arbor achieved ICPNT accreditation in 2020 for its Neuroanesthesiology Fellowship Program. The Program Director is Dr. Vijay Tarnal.

ICPNT Fellowship Experience at University of Michigan, Ann Arbor, USA

I found neuroanesthesia to be so much more than just a fun and challenging rotation in residency. Neuroanesthesia plans were elegant and methodically tailored. The pathology I saw was vast and varied—one day I was caring for a healthy young patient with a newly discovered tumor, the next I was helping to manage an acute brain bleed in an elderly patient found down at home. Awake brain surgery amazed me—that we dared to keep patients conscious through delicate, painstaking surgery, providing soothing reassurance when discomfort and anxiety could not simply be medicated away, was nothing short of magic. Ultimately, I was drawn compellingly to the collaborative culture of the field, the intellectual challenge and exquisite nature of the cases, as well as the opportunity to make a meaningful contribution to a relatively young and rapidly growing discipline.

I enthusiastically signed on to be University of Michigan’s Neuroanesthesia Fellow for the 2022-2023 academic year. And I am so glad I did.

My first and foremost goal coming into this fellowship was to develop confidence in caring for the sickest neurosurgical patients, and I am proud to say that objective has already been achieved thanks to the robust support and offerings of my program. Our division is vastly experienced and almost exclusively fellowship-trained, making for an incredibly rich educational experience, from dedicated didactic teaching to experiential learning. We care for a large volume of nearly every kind of neurosurgical cases, and these numbers will only continue to grow as we look to open a new tower of neurosurgical care with 20 Operating Rooms and 3 Interventional Radiology suites in the fall of 2025.

My attendings are consummate physicians, experts in every aspect of neuroanesthesia care from difficult airway management to critical care physiology, and have fast become some of my life’s greatest cheerleaders and exemplars of clinical excellence. As this year has progressed, they have encouraged me to take on greater responsibility in my cases, and at this point, I function independently in most neurosurgical rooms—of course, still maintaining support and guidance within close reach.

One of the other great strengths of my fellowship program is its flexibility. While my schedule is divided into month-long blocks to ensure a robust number of craniotomies, complex spine cases, interventional procedures, MR-OR cases, as well as dedicated exposure to intraoperative neuromonitoring and basic, translational, and clinical research at Michigan’s Center for Consciousness Science (https://consciousness.med.umich.edu/) and Psychedelic Neuroscience Center (https://michiganpsychedelic.med.umich.edu/), this schema is meant as guidance, not prescription. I am highly encouraged to be involved in any and all neuroanesthesia cases I find interesting. On occasion, I can be found shadowing in the head and neck and liver transplant rooms, acquiring the knowledge I ultimately intend to leverage in my care of complex neurosurgical patients.

The flexibility of this fellowship program has also been key to achieving my other professional goals: developing my skills as a clinical educator and mentor and exploring my interest in neurocritical care.

This year has offered me ample opportunity to work with residents and medical students and learn how to best support and encourage them on their unique journeys. Teaching is an iterative practice and between in-room OR teaching, formal resident didactics, and journal club presentations, I have grown greatly in my ability to be an effective teacher and mentor.

I started this fellowship with a strong inclination that I would pursue an additional year of formalizing training in critical care medicine. Thanks to my adaptable schedule, I was able to spend two months in our neurointensive care unit, a formative experience further solidifying my passion for caring for the sickest of the sick and my love for forming deep and extended relationships with patients and their families in the Intensive Care Unit. I have now been formally accepted to the University of Michigan’s anesthesia critical care fellowship and intend to focus clinically on neurointensive care.

In summary, I am so grateful I took that leap of faith in residency when I committed to a career in neuroanesthesia and pursuing my training at the University of Michigan. This has truly been my most educational year of medical training and one I will certainly cherish in the years ahead. The opportunities here and in the field are endless and the future only continues to shine bright. I am more than happy to speak with anyone interested in neuroanesthesia training at the University of Michigan or elsewhere, or for whom my path resonates more generally. Please get in touch.

Figure A, B, D: Neuroanesthesiology team at University of Michigan in Ann Arbor, USA Figure C: Composite image of the new hospital building at the University of Michigan that will house a state-of-the-art neuroscience center