Lungs (Pulmonary Medicine)
The combined Pulmonary and Critical Care Medicine Fellowship at Montefiore Medical Center and the Albert Einstein College of Medicine is a rigorous three-year program, providing an academically stimulating environment based on the direct treatment of patients and investigation. Fellows develop skill in performing and interpreting pulmonary function tests, become facile in chest medicine diagnostic procedures, and gain acquisition of complicated concepts of pulmonary science. Upon completion of the program, fellows are able to practice medicine in any desired setting.
Clinical training consists of practical learning on the pulmonary wards and consultation services, during which evaluations are conducted with a member of the pulmonary faculty. Additionally, a continuity clinic is maintained throughout the three years with specialty clinics offered during specific rotations.
The first year is devoted to clinical pulmonary medicine, medical intensive care, sleep medicine, and pulmonary physiology. During the second year, fellows continue clinical services with time for electives and further emphasis on sleep and physiology training. For six months, fellows rotate through the subspecialty intensive care units at Montefiore's Moses and Weiler Divisions. This includes the cardiothoracic surgery, neurosurgery, and general surgery intensive care units. A Trauma rotation is also incorporated into the second year, during which fellows become active members of the Trauma Team at Jacobi Medical Center.
The third and final year is divided between clinical work and research. Elective time is allotted to pursue such fields as sleep medicine, chest radiology, interventional pulmonary medicine, interventional radiology, allergy and immunology, thoracic surgery, echocardiology, and burn services. Fellows also have the opportunity to rotate at the Lung Transplant service at Columbia University Medical Center during the third year.
It is expected that fellows become proficient in a wide range of pulmonary and critical care tests and procedures. These include:
- Fiberoptic bronchoscopy and percutaneous pleural biopsy
- Interpretation of pulmonary function
- Exercise and sleep studies
- Insertion techniques and monitoring of central venous and swan-ganz catheters
- Mechanical ventilation and percutaneous chest tube placement
During their training, fellows also participate in weekly, monthly, and quarterly conferences and in the Fundamentals of Critical Care Support (FCCS) course, which offers training on a human patient simulator: a talking, breathing, automated mannequin. In-services are established for ultrasound-guided procedures, thoracentesis kits for pigtail catheters, and mechanical ventilators.