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Pulmonary/Critical Care Fellowship Program

Pulmonary/Critical Care Fellowship Program. Phoenix VA/BGSMC. History. Fellowship started in 1980 Three Year Fellowship Program Leads to certification in : Pulmonary Disease Critical Care. History. As of June 2008, ALL graduated fellows: Board Certified

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Pulmonary/Critical Care Fellowship Program

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  1. Pulmonary/Critical Care Fellowship Program Phoenix VA/BGSMC

  2. History • Fellowship started in 1980 • Three Year Fellowship Program • Leads to certification in : • Pulmonary Disease • Critical Care

  3. History • As of June 2008, ALL graduated fellows: Board Certified • Graduated Fellows: primarily in Private Practice

  4. Staff Members VAMC • Richard A. Robbins • Program Director, Chief Pulmonary/Critical Care VAMC • Owen Austrheim • Associate Section Chief & Director, Sleep Medicine VAMC • Lillibeth Pineda • Patricia Rocha • John Roehrs • Clement Singarajah • Director Critical Care VAMC • Allen Thomas • Director Pulmonary VAMC

  5. Staff Members (BGSMC) • Pulmonary Associates • David Baratz (Director Pulmonary BGSMC) • Mark Gottfried • Manny Mathew • Da-Wei Liao • SAFA (Critical Care BGSMC) • Robert Rashke (Director Critical Care BGSMC) • Huw Owen-Reece • Thomas Bajo • Arizona Center Chest Diseases • Arcot Premkuar • Cameron Dick

  6. Other Affiliated Hospitals • Mayo Clinic • Pulmonary Pathology • St. Josephs Medical Center • Pulmonary transplant • SICU/Trauma • Scottsdale Shea • Pulmonary radiology • JC Lincoln • Trauma • Maricopa Medical Center • Pulmonary • MICU

  7. Current Fellows • Kevin Park (Third Year Fellow) • Evan Schmitz (Third Year Fellow) • Roxanne Garcia-Orr (Second Year Fellow) • Jessica Hurley (Second Year Fellow) • Christian Jivcu (First Year Fellow) • Henry Leudy (First Year Fellow) • Emad Wissa (First Year Fellow)

  8. Pulmonary Fellows (2011) • Tonya Whiting (Good Samaritan) • Joshua Jewell (University of Nevada)

  9. Current Fellow Demographics (includes 2011 fellows) • 4 /9 are from the Good Samaritan residency program • Other institutions include University of Massachusetts, Rutgers, St. Joseph’s in Phoenix, Maricopa in Phoenix. • 3 / 9 are international graduates.

  10. VA Staff • Fellowship coordinator (Nancy Brown) • 1 research PhD • 1 physician assistant • 1 research coordinator • Multiple respiratory therapists including • Bronchoscopy • Oxygen/CPAP • 2 section secretaries

  11. VA PulmonaryCritical Care Section • Endoscopy suite (flouro, Super Dimension) • Sleep Lab (3 beds) • MICU (10 beds) • 3 pulmonary function labs (>1000 PFTs per year)

  12. Fellowship Program Structure • 3 year Program (Clinical) • 6 months research • 30 months clinical (below is approximate and can be varied) • 10 months VA • Half pulmonary/half ICU • 10 months BGSMC • Half pulmonary/half ICU • 10 months electives

  13. Fellowship Program Structure - VA • Consultations (in-patients) • Pulmonary Clinic (1/2 day once a week at VAMC and 1/2 day once a week at private office). • MICU (closed unit with primary care responsibility).

  14. Fellowship Program Structure - BGSMC • Pulmonary • Consultation and primary care • ICU • Primary care

  15. Fellowship Program Structure Most Popular Electives • Pathology Mayo Clinic • Sleep (both VA and BGSMC) • Infectious disease (BGSMC) • Toxicology (BGSMC) • Pulmonary transplant (St. Josephs) • Pulmonary radiology (Shea)

  16. Clinical and Basic Research • Biostatitics/Epidemiology (Dr Gerkin BGSMC) • Areas of interest: • COPD • Pulmonary inflammation • Nitric oxide and oxidants • Clinical research

  17. Fellowship Program Structure • Most fellows present at national meetings (ATS or ACCP). • Case presentations at both Arizona ATS and National ATS

  18. Pulmonary/Critical Care Conferences • Wednesdays (2-4 hours) • Journal Club • Pulmonary presentation • Critical care presentations • Monthly-Arizona ATS multidisciplinary conference • Every 2 weeks-tumor board

  19. FellowshipWeekend Call • 2 fellows BGSMC • One in ICU • One in Pulmonary • 1 fellow at VA (AM only) • BGSMC pulmonary fellow covers nights at VA.

  20. Fellowship Governance • Fellowship Committee • 5 faculty • Robbins, Baratz, Rashke, Singarajah, Thomas • 3 fellows • one from each year • Meets monthly

  21. VA Pulmonary Fellowship Consults & Procedures • Consultations: >3000 • Bronchoscopies: >200 • Sleep studies: >500 • Other frequent procedures • Needle biopsies ─ Chest tubes • Thoracentesis─ Central lines • Pleural biopsies ─ Pleurexcathers

  22. VA Critical Care Fellowship Census & Procedures • Average ICU census ~ 7 • Critical Care Consults: ~50 • Procedures in ICU per year • Percutaneoustracheostomies: ~50 • Bronchoscopies: ~120 • Intubations: ~120 • Variety of other ICU procedures (lines, thoracentesis, paracentesis, etc) done mostly by residents with fellow supervision

  23. Banner GSMC Pulmonary Rotation • Average Daily Census - 25 7 ICU patients 18 ward patients • Average Consults / Day – 5 • Supervision of Residents / Medical Students that are on service

  24. Banner GSMC Pulmonary Rotation • Procedures per year • Percutaneoustracheostomies: ~50 • Bronchoscopies: ~200 • Intubations: ~ 100 • Variety of other ICU procedures (lines, thoracentesis, paracentesis, etc)

  25. Pulmonary Associates Continuity Clinic • Each fellow works a half day per week in the Pulmonary Associates office seeing private practice patients with a wide variety of pulmonary diseases. • Fellows will have direct responsibility for patients on an ongoing basis over 3 years. • An opportunity to interact with private practice pulmonary medicine

  26. GOALS • Board Certification • Consultant in Pulmonary and Critical Care • Clinical Research • Provide direct patient care especially in ICU • Competence in bronchoscopy and other procedures • Teaching

  27. Ultimate Goal LEADER IN PULMONARY and CRITICAL CARE !!!

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