University of Wisconsin
School of Medicine and Public Health

Fellowship Training Information

Curriculum

Goal:

  • Provide the Pulmonary & Critical Care fellow with the basic formal teaching and supervised experience necessary to acquire expertise as an Intensivist and as a consultant in Pulmonary & Critical Care Medicine.

Highlights:

  • Fellows are involved in the diagnosis and care of patients with a wide variety of pulmonary diseases.
  • The two hospitals are large and serve clinically diverse patient populations.
  • Through a combination of didactic lectures, clinical conferences, journal clubs and clinical experiences (closely supervised by Faculty Attendings), fellows gain extensive experience with the following disease types:
    • obstructive lung disease
    • pulmonary infections
    • malignancies
    • interstitial lung disease
    • disorders of the pleura and mediastinum
    • complications of immunosuppression and transplantation
    • acute lung injury
    • respiratory failure
    • genetic and developmental disorders
    • sleep disorders.
  • Incorporated into this exposure to a multitude of pulmonary diseases, is training and experience in specific procedures such as:
    • Interventional pulmonary procedures
    • Interpretation of radiographs
    • Performance of bronchoscopy, thoracentesis, thorocastomy tube placement to name a few.
    • Interpretation of pulmonary function tests
    • Exercise and bronchoprovocation tests
    • Interpretation of sleep studies.

Objectives

The educational goals and objectives of this program will be met by providing the environment and resources for fellows to have clinical experience with, and to acquire knowledge of, a broad spectrum of pulmonary diseases and critical care illnesses. A major proportion of these goals will be met by direct clinical experience with a wide variety of patients, while some of the goals will be met by direct 'hands-on' experience, such as with procedures. These topics, plus areas of knowledge not routinely covered by patient care activities, will be addressed through ongoing structured seminars, didactic case conferences, and lectures that round out the educational curriculum.

Training/Rotation Schedule

 

During each of the three years, fellows spend a total of 6-9 months in clinical activities. Each fellow typically spends 20-22 months on clinical rotations, with the remainder of the fellowship devoted to scientific investigation in an area of interest.

Rotations are split amongst the 2 hospitals, the University of Wisconsin Hospital and the Middleton Veterans Administration Hospital. The majority of each fellow's time will be spent at the University Hospital.

Of the 12 months in each year, a fellow will spend:

  • 2-4 months on the TLC (Trauma and Life Support Center) service at UW Hospital.
  • 1-3 months on the consult service at UW Hospital.
  • 1-3 months will be spent on the Advanced Lung Disease Service. This service will also perform inpatient consultations at the VA Hospital.

 

Per Year
TLC 2-4 months
UW Consult Service 1-3 months
Advanced Lung Disease Service 1-3 months
Research*/Elective+ 3-6 months

 

*Basic or Clinical Research.

+Available electives: Anesthesiology, Cardiology, Subspecialty clinics, Neurosurgical critical care, Trauma, Thoracic Surgery and LifeFlight advanced medical transport service.

All fellows attend a Continuity Pulmonary Clinic one-half day per week, with weekly clinics alternating between the VA Hospital and the UW Hospital.

For each of the clinics, the fellow will follow his/her own panel of patients, with appropriate Faculty supervision.

Clinical & Research programs/labs available to fellows

CME Program-wide Conferences

Listed below are ongoing seminars/conferences/lecture series that comprise the Pulmonary and Critical Care training program:

  • Pulmonary Core Lecture Series (Required of all first-year fellows). Two to three sessions per week, 12 pm to 1 pm, July-August each year.
  • Pulmonary Lecture Series (Required of all fellows). Weekly, 12 pm to 1 pm, Thursdays, September through June. Didactic seminar format. Course Director: James Runo, MD
  • Chest Conference (Required of all fellows). Weekly, 1pm to 2 pm, Mondays. Case-based Discussion format.
  • Journal Club (Required of all fellows). Biweekly, 12 pm to 1 pm, Wednesdays.
  • Research Conference (Required of all fellows). Biweekly, 12 pm to 1 pm, Wednesdays.

What to Expect as a Fellow

Attending physicians work side-by-side with fellows during their rotations. On both the TLC and Consult Services, the Fellow and Attending often spend several hours together each day, making rounds, reviewing radiographs, and doing procedures. In addition, each fellow has ready access to the pager, office phone, and home phone of every Attending.

Pulmonary/CCM fellows provide supervision to Medical Residents who rotate on both the TLC and the Pulmonary Consult Service. They generally oversee cases first evaluated by the Residents, and provide some of the formal teaching for these individuals. On the Consult Service, Fellows supervise the internal medicine residents and 4th year medical students who rotate on this service as an elective. They see patients with the residents/students, review their findings, and share in the presentations to the Attending.

Our program strictly follows the ACGME guideline for having the post-call fellow leave the hospital within 6 hours of the end of a 24-hour on-call period. In addition, the post-call fellow is not expected to attend clinic when he or she is post-call.

TLC

The TLC is a closed multidisciplinary unit, and therefore all medical patients are automatically assigned to the Critical Care Service. The Fellows are directly involved in the evaluation and care of all of these patients. Patients are assigned to the Fellow and his/her team in the ICU on a rotating basis every other day.

The call experience for the fellow will revolve around nighttime and weekend coverage of the TLC services. At present, each fellow can expect to be on call every 7th to 8th night, on average, over the course of the year. The TLC Fellow on call is expected to remain in the hospital for the duration of his/her on-call responsibilities. There is a reserved on-call room for the TLC Fellow.

The TLC is staffed by 2 Attending-led teams at all times (1-2 Pulmonary/Critical Care Medicine attendings and/or 1-2 Anesthesia/ID/Critical Care attendings), each with an assigned fellow. In the TLC, the Attending Physicians are directly responsible for overseeing the care that Fellows provide to patients. The entire team, including an Attending, the Fellow, and medicine/surgery/anesthesiology residents - round together on each patient at least once a day. In addition, the Fellow and Attending convene on an informal basis as needed, as well as during formal afternoon sign-out rounds to make certain that the fellow fully understands the diagnostic and treatment issues of the patients for whom they are providing care. Furthermore, there are several didactic educational sessions to directly address relevant critical care issues.

Trauma Life Support Center Website

Consult Service and Advanced Lung Disease Service

On the Consult Service, the fellow will provide both inpatient and urgent outpatient consultations, including consultation on ventilator-dependent patients.

On the Advanced Lung Disease Service, the fellow will gain experience caring for patients post-lung transplantation, along with in-patients with cystic fibrosis.

The Consult Service and Advanced Lung Disease service are each staffed by a Pulmonary Faculty Attending, who sees every patient and discusses the evaluation and the management with the Fellow.

Benefits and Compensation

For information on benefits and compensation please refer to the UW House Staff website.