Inpatient and emergent consultation for pulmonary diseases and related problems is a major portion of clinical pulmonary medicine, as is management of patients with medical illness requiring admission to the MICU, CICU, and SICU. Ambulatory clinic experience provides fellows with exposure to a variety of pulmonary disorders encountered in that setting and the opportunity to gain experience in long-term patient management.
Fellows conduct daily rounds with the attending on the consult service and the MICU, CICU, and SICU services. Fellows work with an attending in the pulmonary clinic one afternoon per week and in four other clinics during the ambulatory rotation.
CONSULT: Fellows on the consult rotation work under the supervision of the pulmonary consult attending. The fellow provides consultation on all inpatient services upon request. The fellow has the opportunity to be the first person to see patients and they have the option of supervising a medical resident or student while on the consult rotation. After performing a complete history and physical exam, the fellow does a pertinent write-up and presents the patient to the attending physician for discussion, interpretation of pertinent data, and formulation of differential diagnosis and management plans. Recommendations are then communicated to the primary service.
MICU: Under the supervision of the MICU attending, the fellow is part of a team providing assessment, management, and follow-up of critically ill medical patients. As members of the MICU team, fellows work in a collaborative manner with interns, residents and medical attendings. The team works in a coordinated fashion with all consulting physicians/services, nutritional support services, physical therapy, occupational therapy, radiology, laboratory, and chaplain and patient representative services.
CICU: The fellow on CICU rotation works under the supervision of the cardiology attending. The fellow will be part of a team providing assessment, management, and follow-up of critically ill cardiac patients. As a member of the CICU team, the fellow will work in a collaborative manner with cardiology interns, residents, cardiology attendings, nursing, pharmacy, respiratory therapy, and the nutritional services. The fellow will do this rotation during the third year of the pulmonary and critical care training program. The fellow will have 2 years of experience including rotations in the MICU and pulmonary consult service.
SICU: While on SICU rotation, the fellow works under the supervision of the surgical/trauma critical care attending. The fellow will be part of a team providing assessment, management, and follow-up of critically ill trauma surgery patients. As a member of the SICU team, the fellow works in a collaborative manner with surgical interns, residents, surgical attendings, nursing, pharmacy, respiratory therapy, and the nutritional services. The fellow will do this rotation during the third year of the training program.
CLINIC: Fellows attend a continuity clinic a half day each week throughout the year. Patients may be seen for an acute consult as well as for long-term management. The clinic also provides an opportunity to follow up patients seen in the hospital. Additional ambulatory experience takes place during the ambulatory rotations. During this month the fellow spends two to three half days in the sleep clinic, attends photodynamic therapy clinic, thoracic oncology clinic, allergy clinic, and is available to see patients in the pulmonary clinic. For more information on our outpatient clinic, click here.
