First year fellows in Pulmonary and Critical Care Medicine will spend most of their time on clinical services, especially the Pulmonary Consultation service at the beginning of the year in order to gain early experience in bronchoscopy. The schedule is arranged so that they will acquire the experience necessary to become eligible for ABIM Pulmonary Disease certification after two years.
Fellows are expected to obtain directed patient medical interviews that are precise, logical, thorough and reliable; conduct expert, focused examinations that elicit subtle findings and are directed towards patients’ problems, and demonstrate understanding and proficiency while minimizing risk and discomfort to patients in the performance of diagnostic and therapeutic procedures while they are on Intensive Care service, Pulmonary Consultation service and Outpatient Clinics. The first year fellows will be expected to develop a meaningful approach to the diagnosis and treatment of their patients’ problems. During the initial period, the fellows will take call in the intensive care units under the close supervision of the attending physician. More senior fellows may also help orient them to their duties.
All fellows perform procedures relevant to Pulmonary Disease and Critical Care Medicine under the supervision of attending physicians. The role of the attending physician during procedures is expected to evolve from performing the procedure to being a critical observer of the fellows as they acquire necessary procedural skills. The degree of supervision will be individualized depending on the fellows' observed abilities. The fellows may perform certain procedures without the attending after developing adequate skills, as judged by the program director and the section’s Education Committee.
All fellows are assigned to outpatient clinics where they follow patients throughout their three-year training program. As in inpatient services, the fellows see and follow patients under the supervision of attending physicians.
In all settings, the fellows will learn how to deliver appropriate, effective and compassionate medical care while they demonstrate the fundamental qualities of professionalism. They will start learning how to investigate, evaluate, and improve their own clinical practices and learn about the intricacies of systems-based practice.
Second year fellows also spend the majority of their time in clinical duties generally with an increase in ICU time. Second year fellows do a trauma rotation. The fellows’ ability to perform procedures is expected to evolve during this time to a level that enables them to confidently and safely perform most procedures.
Research rotations will be included in this year contingent upon the approval of the proposal outlining of the research project. The fellows are expected to follow their patients in their continuity clinics throughout their three years, with the exception of the trauma rotation.
It is expected that the fellows will be delivering appropriate, effective and compassionate clinical care with professionalism during the second year. They will evaluate their own clinical practices and define ways to improve upon their clinical practice.
Third year fellows will complete their rotations in order to qualify for the ABIM Pulmonary and Critical Care Medicine certification examination and their research rotations. The fellows will continue to follow their patients in their continuity clinics during this year. In this year, fellows will have more time for research and elective training.
They will have to meet all the requirements defined in detail under ”Overall Program Goals, Objectives, and Curriculum” as well as those under “ACGME General Competencies.”