OVERVIEW
The Division of Pulmonary and Critical Care Medicine provides training to prepare fellows to enter careers in academic medicine. The goals of the program are to provide strong clinical training, in-depth training in applied and basic research, and instruction in teaching methods that will enable fellows to develop the skills needed to sustain independent research programs and to serve as accomplished clinician-educators. Our fellows have gone on to academic careers at top medical centers throughout the country. Our three-year training program fulfills requirements of the American Board of Internal Medicine to take the certifying examination in the subspecialty of Pulmonary Diseases, and also the examination for Added Qualifications in Critical Care Medicine.
CLINICAL TRAINING
Clinical training comprises the entire first year and parts of the second and third years of the fellowship. First year fellows rotate through different services and hospitals. The fellow supervises a team doing in-patient and occasional emergent out-patient pulmonary consultations and in-patient care for post-operative lung transplants. The fellow also supervises four medical interns in providing intensive care to patients in the Medical/Transplant Intensive Care Unit (MICU), which includes post-operative liver, lung, and kidney-pancreas transplant recipients. Fellows do additional training in sleep medicine, which involves interpreting polysomnograms and attending two half-day sleep clinics per week. During this rotation, the fellow also performs and interprets cardiopulmonary exercise tests.
The fellow, along with medical and anesthesia residents, provides pulmonary consultation to all ventilated patients (including trauma, burn and neurosurgical patients) and other select patients at a busy public teaching hospital. The fellow also supervises residents in providing care to critically ill patients with neurologic injuries, working closely with the neurosurgical service. A veteran’s hospital rotation involves the fellow in critical care consultation (open unit) as well as general pulmonary consultation for in-patients. The population of the VA provides ample exposure to chronic lung disease and lung neoplasms. In addition, at the Fred Hutchinson Cancer Research Center, the fellow provides pulmonary consultation and primary critical care services to a population of in-patient bone marrow/stem cell transplant patients.
During the second and third years, fellows rotate through subspecialty clinics (adult cystic fibrosis, pulmonary vascular disease, interstitial lung disease and neuromuscular disease, tuberculosis). The fellow also spends a total of two months at the Madigan Army Medical Center, where he/she will be involved primarily in out-patient clinics providing primary and consultative pulmonary care to a large population of both active duty and retired military personnel and their families.
All second and third year fellows will attend one half-day pulmonary clinic per week at one of the primary clinical sites, and assist in teaching the residents and students, directs and/or performs clinical evaluation and procedures, and participates in chest conferences and seminars.
Several scheduled weekly conferences and seminars supplement the fellow's clinical training. These include curricula in clinical pulmonary medicine and critical care (presented by faculty and fellows) to prepare for the board exams in both areas.
Other regular division teaching activities available to fellows include weekly post-clinic conferences, a weekly pulmonary research seminar, a monthly journal club, and weekly or biweekly meetings of research interest groups in cell biology, gas exchange, pulmonary circulation, exercise physiology, and clinical research. During the second and/or third year of fellowship training, fellows will participate as small group instructors in Human Biology 541 for second-year medical students.
PROCEDURES AND AREAS OF TRAINING
Under supervision and instruction by the faculty, fellows gain mastery in all of the procedures related to the practice of pulmonary and critical care medicine, including fiberoptic bronchoscopy and related procedures, polysomnography, and exercise testing.
Procedures such as establishing central venous access, passage of pulmonary arterial balloon flotation catheters, and radial arterial catheterization are generally learned during residency training in internal medicine, completion of which is a requirement for entrance to the program. However, supplementary training in these procedures, as well as in airway management, is provided under the supervision of division faculty as required.
During their clinical training, fellows acquire a basic knowledge of all relevant areas of pathogenesis, pathophysiology, manifestations, clinical assessment, and management of pulmonary disease. In addition, they acquire in-depth knowledge in the most common and otherwise most important diseases and conditions, including chronic obstructive pulmonary disease, asthma, tuberculosis, pulmonary aspects of HIV infection, and the different forms of acute respiratory failure.
Education and training of all fellows in the areas of occupational safety and health care regulations, critical assessment and decision analysis, continuous quality improvement, psychosocial, economic, and ethical issues, teaching skills, research methodology, and professionalism, are also provided by the training program.
For additional information, visit the Pulmonary and Critical Care web site.
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PROGRAM DIRECTOR |
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PROGRAM COORDINATOR |
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Mark Tonelli, MD |
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Norma Jean Schwab |
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Program Director |
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Program Coordinator |
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Pulmonary & Critical Care Medicine |
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Pulmonary & Critical Care Medicine |
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Box 356522 |
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Box 359762 |
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Room BB-1253 |
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HMC (10EH25) |
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Phone: 206-543-9670 |
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Phone: 206-616-8378 |
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Fax: 206-685-8673 |
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Fax: 206-731-8584 |
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tonelli@u.washington.edu |
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njschwab@u.washington.edu |
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