Program Overview

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Pulmonary and Critical Care Medicine Fellowship

The Pulmonary and Critical Care Medicine Fellowship at Columbia University Irving Medical Center is a comprehensive program designed to provide fellows with a broad range of clinical and research experiences in pulmonary and critical care medicine.

Program Structure

• Curriculum: The fellowship program includes a curriculum that covers all aspects of pulmonary and critical care medicine, including advanced consultative pulmonary medicine, sub-specialty training in advanced lung diseases, lung transplantation, and numerous types of critical care exposure.
• Conferences: Fellows participate in various conferences, including pulmonary and critical care medicine conferences, journal clubs, and research seminars.
• Clinical Training: Fellows receive clinical training in pulmonary and critical care medicine, including inpatient and outpatient care, and participate in various rotations, such as pulmonary consults, lung transplantation, and interventional bronchoscopy.
• Research Training: Fellows are encouraged to participate in research projects and receive training in research methods, including study design, data analysis, and manuscript preparation.

Clinical Training

Pulmonary Medicine Training

Columbia University has active clinical and research programs in sub-subspecialties of lung disease, including cystic fibrosis, interstitial lung disease, COPD (LVRS), alpha-1 antitrypsin deficiency, sleep medicine, lung cancer, interventional bronchoscopy, LAM, and lung transplantation, providing a rich clinical experience in pulmonary medicine with diverse pulmonary pathology.

Pulmonary Consults

During the six months of inpatient pulmonary consult at Milstein Hospital, fellows diagnose and manage common and rare pulmonary diseases, and supervise medical students and medical residents on the consult service.

Lung Transplantation

The lung transplantation program is one of the oldest in the United States and is the major center for lung transplantation in the New York tri-state area. On this rotation, fellows are exposed to a wide variety of advanced lung diseases, including rare interstitial lung diseases, pulmonary hypertension, and cystic fibrosis, and they learn about post-transplant management, diagnosis, and management of lung transplant complications.

Interventional Bronchoscopy

Fellows are trained in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under direct supervision by one of our interventional bronchoscopists. Fellows perform EBUS in varied rotations, including the pulmonary consult service, interventional rotation, and are encouraged to perform outpatient bronchoscopies on their own patients.

Pulmonary Physiology

Fellows have a two-week block dedicated to pulmonary physiology training at the beginning of their first year. During this block, fellows learn to read pulmonary function tests (PFTs), participate in Cardiopulmonary Exercise Testing (CPETs), and partake in asynchrony physiology teaching sessions.

Sleep Medicine

The Cardiopulmonary Sleep and Ventilatory Disorders Center provides expert education in sleep medicine and physiology to our fellows, who receive instruction in the interpretation of polysomnography, diagnosis and treatment of sleep disorders, and the techniques of measurement and interpretation of the physiology of sleep and breathing.

Ambulatory Care Training

Chest Clinic

Fellows maintain a continuity clinic throughout their three years of training, where they learn the outpatient management of patients with a broad range of pulmonary disease. Continuity clinic is a ½ day session per week.

Sub-Subspecialty Clinic

Fellows have outpatient rotation where they participate in various sub-subspecialty clinics. Fellows also have the opportunity to have subspecialty clinic ½ day per week in addition to their continuity clinic as a third-year fellow. The fellows gain expertise in the diagnosis and outpatient management of advanced lung disease and experience the highly specialized, multidisciplinary approach implemented in these clinical centers to optimally manage these complex diseases.

Critical Care Training

Columbia University Irving Medical Center has 117 Intensive Care Unit beds, not including Pediatric and Neonatal ICUs. The fellows spend between 6 and 8 months rotating in our Medical Intensive Care Units, which are comprised of two active 12-bed units (MICU-A and MICU-B) and a 12-bed mixed medical/surgical ICU at the Allen Hospital.

Medical Intensive Care Unit

MICU-A is a 12-bed unit, staffed by full-time nurse practitioners (NP) and is the home of our medical ECMO program. MICU-A offers a unique opportunity for fellows to manage patients supported by ECMO.

Allen Intensive Care Unit

The Allen ICU is a 12-bed mixed medical/surgical ICU where fellows work with internal medicine residents in an urban community hospital setting.

Critical Care Consult Service

Fellows provide critical care consultative service to all patients in the medical intermediate care unit and the non-medical intensive care units (neurologic intensive care unit, cardiac care unit, surgical intensive care unit).

Extracorporeal Membrane Oxygenation (ECMO) Program

As part of the Center for Acute Respiratory Failure, our adult ECMO program is one of the largest in the world. During the MICU/ECMO rotation, fellows participate in screening and discussing potential outside hospital ECMO transfers and are involved in the daily management of our medical ECMO patients.

Anesthesia Rotation

First-year fellows have a two-week rotation on the anesthesia service where they learn endotracheal intubation by direct laryngoscopy and laryngeal mask airway placement in a controlled environment.