Pulmonary & Critical Care Medicine Fellowship Clinical Training | NYU Langone Health

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Pulmonary & Critical Care Medicine Fellowship Pulmonary & Critical Care Medicine Fellowship Clinical Training

Pulmonary & Critical Care Medicine Fellowship Clinical Training

As part of our Pulmonary and Critical Care Medicine Fellowship, we offer clinical training that gives fellows a broad understanding of lung physiology and how to manage related pathologies. Fellows benefit from the breadth of the pulmonary and critical care rotations available at NYU Langone and our affiliates.

As a fellow, you receive training in both inpatient and outpatient pulmonary disease management and gain valuable exposure to various research projects in our divisional centers and programs.

Throughout your training, you become adept at performing numerous invasive and noninvasive pulmonary and critical care procedures.

Before starting clinical rotations, first-year fellows attend mandatory simulation workshops to develop competency in airway assessment, code situations, line placement, point-of-care ultrasound, bronchoscopy, and leadership skills. This training is complemented by on-site clinical training in our intensive care units (ICUs).

Training sites include NYU Langone’s Tisch Hospital and Kimmel Pavilion, NYC Health + Hospitals/Bellevue, and the VA NY Harbor Healthcare System. We also train at NYU Langone Hospital—Brooklyn.

Inpatient Rotations for Fellows

Our many inpatient rotations provide fellows with comprehensive training in pulmonary and critical care medicine.

Bellevue Pulmonary Consult Service

During your rotation on the Bellevue pulmonary consult service, you treat patients with a wide variety of acute and chronic chest diseases, including opportunistic infections accompanying HIV. As a first-year fellow, you consult for all clinical services, including medicine, general surgery, surgical subspecialties, obstetrics and gynecology, neurology, and psychiatry.

Bellevue Chest Service

During your second year, you rotate as “chest chief” for the Bellevue Chest Service, where you care for inpatients with tuberculosis, exacerbations of asthma or chronic obstructive pulmonary disease (COPD), lung cancer, or opportunistic infections. You supervise direct patient care and perform procedures and lead case discussions in a bimonthly pathology conference, a weekly thoracic tumor board, chest radiology conferences, and chest service multidisciplinary rounds. You also interact with patients who may be eligible for clinical research protocols.

You lead and supervise first-year fellows, rotating residents, and medical students, particularly on procedures such as thoracentesis. You are also responsible for presenting cases at a weekly tuberculosis conference.

Bellevue Medical Intensive Care Unit and Critical Care Consult Service

As a first-year fellow in the Bellevue medical ICU (MICU), you supervise medical house staff, consisting of four interns and three residents. You oversee morning rounds, where you formulate MICU patient management plans that you and the residents then implement. You perform any necessary procedures under the supervision of the MICU attending. Taking the lead in conducting interdisciplinary family meetings is another responsibility. Twice a month, you present cases at a weekly ICU physiology conference.

As a second-year fellow in the Bellevue MICU, you provide support to the first-year MICU fellow and are responsible for critical care consults in the other adult Bellevue ICUs. These include the cardiac care unit (CCU), the surgical ICU (SICU), the neurosurgical ICU, and the emergency ward.

Bellevue Anesthesiology Service

Your rotation on the Bellevue anesthesiology service teaches you basic principles of airway management, including airway inspection, nasal and oral airway insertion, bag–mask ventilation techniques, and endotracheal intubation. You also become proficient in direct and video laryngoscopy and gain exposure to the management of difficult airways. Your rotation is supervised by an anesthesiology attending.

NYU Langone Hospital—Brooklyn Surgical Intensive Care Unit

At NYU Langone Hospital—Brooklyn, you oversee and coordinate a closed SICU. The SICU specializes in preoperative assessment and postoperative care of critically ill trauma patients. You work together with trauma and critical care specialists to care for trauma and neurosurgical patients.

VA NY Harbor Healthcare System Consult Service

The VA NY Harbor Healthcare System is a general referral center for advanced bronchoscopy and endobronchial ultrasound (EBUS) in the management of intrathoracic pathology. During your second year, you rotate on the consult service and work closely with the pulmonary attending.

VA NY Harbor Healthcare System Medical Intensive Care Unit

As a first year fellow, you rotate through the VA NY Harbor Healthcare System MICU, where you supervise house staff. You review each case with a pulmonary and critical care medicine attending, direct the diagnostic workup, perform appropriate procedures, and direct therapy. You are responsible for preliminary interpretation of all pulmonary function tests performed by the pulmonary function laboratory.

VA NY Harbor Healthcare System Surgical Intensive Care Unit

In the VA NY Harbor Healthcare System SICU, you learn about surgical critical care under the supervision of a pulmonary and critical care medicine attending during your first year. You gain exposure to cardiac, general surgery, thoracic, orthopedic, and neurosurgical cases, as well as anesthesiology in the operating room. Once a month, you present a case during the weekly ICU physiology conference.

Tisch Hospital Medical Intensive Care Unit

The first-year fellow and second-year fellow are each assigned to a Tisch Hospital ICU team and supervise the medical residents and physicians in the care of all MICU patients. After sufficient training, fellows manage all airways in ICU patients and perform critical care procedures under the supervision of critical care attendings and with assistance from a second-year critical care fellow.

Tisch Hospital and Kimmel Pavilion Pulmonary Consult Service

Under the supervision of an attending, a first- and second-year fellow on the Tisch Hospital rotation evaluate and provide consultative care to patients with a broad mix of pulmonary diseases. The first-year fellow is in charge of the Kimmel Pavilion 12th floor pulmonary service, while the second-year fellow covers consults at Tisch Hospital and Kimmel Pavilion. Fellows care for patients with advanced bronchiectasis, cystic fibrosis, lung cancer, and nontuberculous mycobacterial infections, perform flexible bronchoscopies, and participate in weekly thoracic tumor board and clinical case conferences.

Tisch Hospital Advanced Pulmonary: Pulmonary Hypertension and Lung Transplant

These rotations focus on solid organ transplant with particular attention to the lung and pulmonary hypertension. As a second-year fellow, you have both inpatient and ambulatory exposure with time spent in outpatient clinics for pulmonary hypertension and transplant, and have the opportunity to perform right heart catheterization in the Cardiac Catheterization Laboratory.

Tisch Hospital Interventional Bronchoscopy

First-year fellows have a bronchoscopy introductory rotation supervised by interventional pulmonology faculty. During the second and third year, fellows rotate on our interventional pulmonary service.

Outpatient Rotations for Fellows

Our fellows participate in rotations through a variety of ambulatory clinics to gain extensive experience in pulmonary disease management.

VA NY Harbor Healthcare System Chest Clinic

During your first year of training, you participate in a chest clinic at the VA NY Harbor Healthcare System, where you are help treat veterans with a range of pulmonary disorders, including COPD, asthma, and lung cancer. Chest clinic sessions start with an ambulatory care conference on core pulmonary topics.

Bellevue Chest Clinic

The Bellevue chest clinic accommodates 6,000 visits each year and treats people with undiagnosed lung nodules, idiopathic pulmonary fibrosis, tuberculosis, and nontuberculous pulmonary diseases, including bronchiectasis, sarcoidosis, and COPD. In your second year, you rotate through a weekly clinic to manage newly discharged patients and patient referrals, supervised by attending physicians.

Bellevue Sleep and Asthma Clinics

During your rotation at the Bellevue sleep clinic, you evaluate patients weekly. This rotation occurs either during first or second year, depending on preference.

The Bellevue asthma clinic, developed to address health disparities in asthma, serves patients with moderate to severe persistent asthma and accommodates 3,500 visits annually. As a third-year fellow on the Bellevue asthma clinic, you learn the basics of asthma management, using national and international guidelines; management of more complex and severe asthma; and techniques used in chronic disease management. You also gain exposure to numerous clinical research trials.

NYU Langone Pulmonary and Critical Care Associates

You have the opportunity to participate in the care of patients in the outpatient practice at NYU Langone Pulmonary and Critical Care Associates in an elective during your third year. This may include training in subspecialty programs in severe asthma, nontuberculous mycobacterial disease, interstitial lung disease, and sarcoidosis.

Subspecialty Clinics

During select rotations you can participate in a number of subspecialty clinics including the Bellevue interstitial lung disease clinic, Tisch Hospital cystic fibrosis clinic, Perlmutter Cancer Center interventional pulmonary clinic, bronchiectasis, transplant, and pulmonary hypertension clinics, among others.

Division Center and Program Rotations for Fellows

Our divisional training programs provide fellows with a wide range of clinical training opportunities. Many of these programs provide exposure to basic and clinical research in pulmonology.

André Cournand Respiratory Physiology Research Laboratory

As a first-year fellow at the André Cournand Respiratory Physiology Research Laboratory, housed in Bellevue, you learn the basics of lung function measurements (spirometry, plethysmography, and diffusion studies), and concepts related to airway hyper-reactivity, ventilatory control, exercise physiology, and lung compliance. You also serve as the consult for patients with respiratory failure and obesity hypoventilation. Fellows are responsible for holding a weekly physiology case review for rotating chest service second-year residents. Learn more about the pulmonary physiology research at this laboratory.

NYC Health + Hospitals World Trade Center Environmental Health Center

At the NYC Health + Hospitals World Trade Center Environmental Health Center, third-year fellows learn about the environmental impacts on lung disease through the treatment and study of community members affected by 9/11. Throughout your fellowship, you have access to experts in the field of environmental lung disease. We also offer opportunities in asthma, airways, and the environment research.

NYU Langone Cystic Fibrosis and Bronchiectasis Program

Through NYU Langone’s Cystic Fibrosis and Bronchiectasis Program, you gain exposure to inpatients and outpatients with cystic fibrosis and non–cystic fibrosis bronchiectasis. NYU Langone hosts an annual regional symposium and numerous patient education projects on these conditions. You may also pursue a year of research in bronchiectasis and nontuberculous mycobacteria lung disease or cystic fibrosis.

Pulmonary Oncology Program

Under the direction of Daniel H. Sterman, MD, our division director, a multidisciplinary pulmonary oncology program has been inaugurated that encompasses interventional procedures and translational research related to the care of patients with thoracic malignancies. During your third year, you have an opportunity to work closely with these patients, as well as to conduct novel research as part of the NYU Pulmonary Oncology Research Team (NYU PORT).

Interventional Pulmonology Program

As a fellow rotating in NYU Langone’s Interventional Pulmonary Program, you learn advanced diagnostic and therapeutic bronchoscopy, in addition to the latest airway management techniques and diagnostic and therapeutic pleural procedures. You also acquire skills in bronchoscopic management of advanced emphysema, severe asthma, lung cancer, nonmalignant airway disorders, malignant pleural effusions, and pneumothorax. We also offer a one-year dedicated Interventional Pulmonology Fellowship.

Advanced Lung Diseases and Interstitial Lung Disease Program

NYU Langone’s advanced lung diseases program provides you with exposure to all aspects of advanced lung diseases, including interstitial lung disease, advanced COPD, severe asthma, pulmonary vascular disease, cystic fibrosis, bronchiectasis, and mycobacterial lung disease.

Lung Transplant Program

Our lung transplant program teaches you about the evaluation and severity of advanced lung disease, as well as the indications and implementation of lung and heart–lung transplant. You also learn about the management of post-transplant immunosuppression and the mitigation of post-transplant rejection. Under the direction of Luis F. Angel, MD, medical director of lung transplantation, the program cares for patients through every stage of the lung transplant process.

Pulmonary Hypertension Program

Through the pulmonary hypertension program, you learn about the comprehensive diagnostic and therapeutic services offered to patients with all forms of the condition. This program is overseen by Roxana Sulica, MD, and collaborates closely with the Leon H. Charney Division of Cardiology.

Simulation Training Program

Simulation training is a cornerstone of our fellowship. Faculty at the VA NY Harbor Healthcare System, Manhattan campus, run a dedicated pulmonary and critical care simulation center. We also use the New York Simulation Center for the Health Sciences (NYSIM), a collaboration between The City University of New York and NYU Langone Health, located within Bellevue.

Core curriculum simulation modules help you become adept at all procedures, including bronchoscopy, ultrasound, vascular line placement, cardiopulmonary resuscitation protocols, and airway assessment. Simulation sessions are also used in our ethics and toxicology curriculum blocks. Each year one fellow chooses to pursue a research track in simulation at the VA NY Harbor Healthcare System simulation center.