Pulmonary / Critical Care Fellowship

Program Overview


Schedule

Year 1:

  • 2 months RMC Pulmonary Consult service
  • 1 month RMC PFT/Echocardiogram
  • 1 month RMC Quality Improvement
  • 3 months SLH Pulmonary inpatient consult service
  • 3 months UHTMC Pulmonary Consult service
  • 1 month UHTMC ICU
  • 1 month UHTMC Sleep
  • ½ day/per week outpatient clinic

Year 2:

  • 2 months RMC ICU
  • 1 month RMC Pulmonary consult service
  • 1 month RMC Quality Improvement
  • 2 months SLH Elective
  • 1 month 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
  • ½ day/week outpatient clinic

Year 3:

  • 2 months RMC ICU
  • 1 month RMC Pulmonary consult service
  • 1 month RMC Quality Improvement
  • 1 month SLH NICU
  • 3-4 months UHTMC Research
  • 2-3 months UHTMC ICU
  • 1 month UHTMC metabolic
  • ½ day/week outpatient clinic
Pulmonary Consult Service – University Health Truman Medical Center

tmchh08_200wA fellow who is in their first or second year will work under the direct supervision of a full-time faculty member from the respiratory and critical care medicine division. The fellow will 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. The fellow performs specialized procedures and provides follow up after the patient is discharged from the pulmonary clinic. The fellow will assist with the care of patients in all areas of the hospital except the medical intensive care unit. The fellow has approximately 15 new consults per week and follows 10-15 inpatients at any given time. No in-house call is required; however, the fellow 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 & Critical Care Medicine Inpatient Service – Saint Luke’s Hospital

stlukes08_200wThe first- or second-year fellow works under the direct supervision of a clinical pulmonary critical care faculty member at Saint Lukes’s Hospital. The fellow supervises approximately three internal medicine residents. The fellow must take an active role in patient management in this busy private practice setting. The fellow 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. The fellow manages approximately 20 new consults or admits per week and follows 20-25 inpatients at any given time. The fellow takes pager calls from home and is responsible for no more than two weekends a month.

Pulmonary Function, Sleep Exercise Laboratory – Saint Luke’s Hospital

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

Pulmonary and Critical Care Inpatient Consult Service – Research Medical Center

Inpatient Pulmonary Consult service:

A fellow in each of their 3 years will 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.   The fellow performs specialized procedures such as bronchoscopy, thoracentesis, and chest tube placement.  The fellow assists with the care of patients in all areas of the hospital.  The fellow has approximately 15 new consults a week and follows 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:

A fellow in their second and third years will work under the direct supervision of a full-time Pulmonary and Critical Care faculty member.  The ICUs at Research are open units and we provide consultation for the management of the critically ill and patients on mechanical ventilation. The fellow provides the initial consultation and the daily recommendations for continuing care.  The fellow performs specialized procedures commonly done in the ICU setting.  The fellow on average has approximately 10 to 15 new consults a week and follows 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. The 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 fellows’ responsibility to identify a faculty member to collaborate with. Please report this information to the Program Director as soon as possible. Minimum expectation for fellows are 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

A. Formative Evaluation
Fellows are evaluated each month of their 36-month fellowship. The following areas are evaluated:

  • clinical judgment
  • clinical skills
  • medical knowledge
  • humanistic qualities
  • medical knowledge
  • humanistic qualities
  • commitment to scholarship
  • medical care
  • professional attitudes
  • behavior
  • clinical competence

Fellows are evaluated in these areas each month and their performance reviewed and discussed with a faculty member. Semi-annually the fellow receives structured feedback from the program director. Their performance is reviewed with appropriate counseling and any necessary remedial actions.

B. 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 appeal. See Disciplinary Action Policy located on the UMKC GME website.

C. Evaluation of Faculty and Program
The fellow evaluates each rotation monthly and provides confidential feedback to the program director on the performance of the faculty and merits and deficiencies in the training program. The teaching staff meets with the fellow 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, 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.