Program Overview

Schedule

The following schedule shows what fellows will focus on, and for how long, at each of our three area hospital affiliates — University Health Truman Medical Center (UHTMC), Saint Luke's Hospital (SLH) and Research Medical Center (RMC).

Year 1

  • RMC Pulmonary Consult Service (2 months)
  • RMC PFT/Echocardiogram (1 month)
  • RMC Quality Improvement (1 month)
  • SLH Pulmonary Inpatient Consult Service (3 months)
  • UHTMC Pulmonary Consult Service (3 months)
  • UHTMC ICU (1 month)
  • UHTMC Sleep (1 month)
  • Outpatient Clinic (half day per week)

Year 2

  • RMC ICU (2 months)
  • RMC Pulmonary Consult Service (1 month)
  • RMC Quality Improvement (1 month)
  • SLH Elective (2 months)
  • SLH MICU (1 month)
  • SLH Pulmonary Inpatient Consult Service (1 month)
  • SLH CVICU (1 month)
  • UHTMC Pulmonary Consult Service (1 month)
  • UHTMC ICU (1 month)
  • UHTMC Research (1 month)
  • Outpatient Clinic (half day per week)

Year 3

  • RMC ICU (2 months)
  • RMC Pulmonary Consult Service (1 month)
  • RMC Quality Improvement (1 month)
  • SLH NICU (1 month)
  • UHTMC Research (3-4 months)
  • UHTMC ICU (2-3 months)
  • UHTMC Metabolic (1 month)
  • Outpatient Clinic (half day per week)

Rotation Descriptions

Pulmonary Consult Service at UHTMC

Fellows in their first or second year work under the direct supervision of a full-time faculty member from the respiratory and critical care medicine division. Fellows provide direct supervision to an internal medicine resident and a senior medical student. The consult service provides initial consultations and daily recommendations for continuing care. Fellows perform specialized procedures and provide follow-up after the patient is discharged from the pulmonary clinic. They will assist with patient care in all areas of the hospital except the medical intensive care unit. Fellows have approximately 15 new consults per week and follow 10-15 inpatients at any given time. No in-house call is required; however, fellows will take pager calls from home. Weekend coverage at the hospital, including critical care units, is divided between the fellow assigned to the MICU and the fellow on the pulmonary consult service.

Pulmonary and Critical Care Medicine Inpatient Services at SLH

First- or second-year fellows work under the direct supervision of a clinical pulmonary critical care faculty member at Saint Luke’s Hospital. Fellows supervise approximately three internal medicine residents and must take an active role in patient management in this busy private practice setting. Fellows will provide initial and ongoing consultative service and work with internal medicine residents and clinical faculty members. Fellows direct patient care for those patients admitted to the pulmonary and critical care group practice. They manage approximately 20 new consults or admits per week and follow 20-25 inpatients at any given time. Fellows take pager calls from home and are responsible for no more than two weekends per month.

Pulmonary Function, Sleep Exercise Laboratory at SLH

Fellows are assigned to a faculty member in the laboratories. An extensive bibliography is given to them to guide reading and studying. While observing and performing these studies, practical experience in the technical aspects is provided. The faculty member provides one-on-one instruction and feedback on interpreting the studies. Fellows are not required to be on call. They will receive Level I sleep training at the American Sleep Disorder Association's (ASDA) certified lab at Saint Luke’s Hospital under the direction of two ABSM-certified faculty. Fellows take pager calls from home and are responsible for no more than two weekends a month.

Pulmonary and Critical Care Inpatient Consult Services at RMC

Inpatient Pulmonary Consult Service

In each of their three years, fellows work under the direct supervision of a full-time pulmonary and critical care faculty member. The Pulmonary Consult Service provides initial consultations and daily recommendations for continuing care. Fellows perform specialized procedures such as bronchoscopy, thoracentesis and chest tube placement. They also assist with the care of patients in all areas of the hospital. Fellows have approximately 15 new consults per week and follow 10-20 inpatients at any given time. There are no call requirements, in-house or at home. Weekend coverage is divided between the fellow on the pulmonary consult service and the ICU fellow.

Critical Care Service

In their second and third years, fellows work under the direct supervision of a full-time pulmonary and critical care faculty member. The ICUs at RMC are open units, and we provide consultation for the management of the critically ill and patients on mechanical ventilation. Fellows provide the initial consultation and daily recommendations for continuing care. They also perform specialized procedures commonly done in the ICU setting. On average, fellows have approximately 10 to 15 new consults per week and follow 10-15 ICU patients at any given time.

Medical Meeting (CME)

Fellows are allowed one week for approved continuing medical education (CME) meetings each year. Leave must be taken during the respective year of training and is not accruable. If the fellow is scheduled for a clinical rotation, it is their responsibility to find any needed coverage.

Conferences

Monthly

  • Clinical Conferences (monthly, assigned to fellow)
  • Basic Science Conferences (monthly, given by faculty)
  • Journal Club (monthly)
  • Research Conference (monthly)
  • Core Curriculum Conference (weekly)

Bi-Monthly

  • Pulmonary/Thoracic Surgery Conference

Research

Fellows work with a faculty member of their choice. It is the fellow's responsibility to identify a faculty member to collaborate with. Please report this information to the program director as soon as possible. At minimum, fellows are expected to complete one clinical research project and one laboratory project at the end of the three years. At least one of these projects must be the primary idea and work of the fellow. The faculty member provides assistance and guidance. Internal funds are available to fellows for research projects. No call is required during research months.

Evaluation

Formative Evaluation

Fellows are evaluated in the following areas each month during their 36-month fellowship:

  • Clinical judgment
  • Clinical skills
  • Medical knowledge
  • Humanistic qualities
  • Medical knowledge
  • Commitment to scholarship
  • Medical care
  • Professional attitudes
  • Behavior
  • Clinical competence

Their performance is reviewed and discussed with a faculty member each month. Semi-annually, fellows receive structured feedback from the program director. Their performance is reviewed with appropriate counseling and any necessary remedial actions.

Summative Evaluation

Semi-annually, the program director completes a written evaluation of each fellow based upon review of monthly evaluations by the fellowship evaluation committee. These evaluations stipulate the degree to which the fellow has mastered each component of clinical competence and has acquired proficiency in each of the required procedural skills. Fellows may appeal judgments of academic deficiencies or misconduct before the professional standards committee at UHTMC. See the Disciplinary Action Policy located on the UMKC GME website.

Evaluation of Faculty and Program

Fellows evaluate each rotation monthly and provide confidential feedback to the program director on the faculty performance, merits and deficiencies in the training program. Teaching staff meet with fellows semi-annually to evaluate the utilization of the resources available to the program, the contribution of SLH and UHTMC to the program, financial and administrative support, the volume and variety of patients available to the program for educational purposes, the performance of members of the teaching staff, the quality of supervision of fellows, and the effectiveness of the program in achieving the stated goals and objectives.