The fellowship is 36 months in duration with a majority of that time devoted to hands-on clinical training. During the 36 months, each fellow will complete a minimum of the following (to total 30 months):
- 12 months of inpatient pulmonary consultation
- 6 months inpatient consult
- 6 months PH/transplant consult and PFT reading
- 9 months of medical intensive care unit (MICU; not to exceed 15 months)
- 3 months of non-medical intensive care unit
- 1 month vacation per year
- The remaining 9 months will be devoted to research projects and elective rotations.
Clinical Experience and Responsibilities
ICU and Consult
- History and Physical Exam on all new patients, review of pertinent labs, radiographs and other ancillary data
- Daily assessment of patients, including review of labs, radiographs and other ancillary data; a progress note indicating thought processes, differential diagnoses, treatment options and plans
- Scheduling and preparation for invasive procedures (i.e. bronchsocopy)
- Supervision of all invasive procedures performed by house staff
- Bedside teaching and didactic lectures as assigned by the attending physician
- F3 ICU fellows are responsible for all patients in the MICU, SICU, and SDU. In the event that a surgical resident is unavailable, the fellow will be first-call for surgical patients.
- Formal written peer evaluations at the conclusion of each rotation (completed on New Innovations website)
ICU and SDU Bed Flow
The ICU fellow is in charge of the ICU and Step Down Unit (SDU). No patient can be moved in or out of either unit without a fellow’s approval. Newark Beth Israel Medical Center maintains a combined medical and surgical ICU. The fellow will see all patients daily including overflow patients in the ED, the PACU and Surgical Step-Down. The fellow is responsible for supervising all residents in the care of these patients (medical residents on medicine patients and surgical residents on surgery patients).
Coordinate Transfers from Other Critical Care Units
Such transfers may occur only after the case has been reviewed with a service attending physician. This applies to medical and surgical patients.
Non-Medical ICU Rotations
Non-medical ICU rotation choices include the Burn Unit (SBMC), CTICU, CCU, neonatal ICU and Trauma (UMDNJ). All, except Neonatal ICU, are required as part of the fellow’s training, and a minimum of one month of each must be completed during the three-year program.
Non-medical ICU rotations must be chosen and approved by the program director in advance. This includes a rotation, a mentor or supervisor, and a learning plan for the month.
The consult #1 fellow will prepare cases for presentation at Radiology and Pathology Conferences, and notify the attendings in Pulmonary and Critical Care Medicine, Radiology and Pathology of the conferences.
Consult #2 will read pulmonary function tests using American Thoracic Society criteria and Gold criteria.
The consult rotations are not entirely independent of each other. Division of the consults and procedures between the two consult fellows is at the discretion of the consult attendings.
Cardiopulmonary Exercise Testing
The exercise lab is directed by Pratik Patel, MD, and all fellows will have experience supervising and reading the tests.
The research project, as well as a mentor and supervisor, must be identified and approved prior to the rotation. Fellows may be called upon periodically during these months to assist other fellows in clinical rotations. During a research rotation, the fellow will meet weekly with the program director to discuss his/her progress.
Fellows will be granted increasing responsibility and independence throughout their three-year fellowship in accordance with their skills and accomplishments based on collective reviews.
Senior fellows will be expected to:
- Mentor incoming fellows in their first year and assist with orientation to procedural suites, ICUs and PFT labs;
- Maintain an ongoing dialogue and research plan with their chosen research mentor as well as the program director;
- Submit abstracts or articles for presentation at one of the following conferences in their final year: American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine;
- Chief fellow will be responsible for making rotation and call schedules.
Each year, an administrative fellow is chosen by the service attending staff. The administrative fellow receives a small increase in salary and accepts additional responsibilities:
- Send weekly email reminders about all conferences
- Record and report attendance at all lectures
- Arrange attending physician lectures from multiple specialties
- Arrange lectures to be given by students and residents
- Act as secondary back-up at all times to back-up fellow, including rotation or call when the on-call or back-up fellow cannot
- Arrange for coverage of all administrative fellow responsibilities when he/she is on vacation
- Arrange and submit on-call and back-up call schedules quarterly
The Pulmonary and Critical Care Medicine Fellowship is designed to train effective subspecialty practitioners. Therefore, it is essential that fellows take a leadership role in all of their rotations in educating peers, house staff, patients and families. This will occur as bedside teaching, case presentations and lectures.
In addition, at the conclusion of each rotation block, fellows will be expected to complete peer evaluations and co-sign for procedures performed with house staff. These are done online via New Innovations and are kept up-to-date on a monthly basis.
Fellows will be evaluated by peers and supervising physicians on each rotation. During research rotations, fellows will be evaluated by their research mentor.
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