Pulmonary, Critical Care and Sleep Medicine

All our fellows complete three years of clinical training, which primarily occurs at the John H. Stroger, Jr. Hospital of Cook County, a public hospital serving the residents of Cook County. The following are some of the rotations we offer:

Medical Intensive Care Unit
The hospital has 82 adult critical care beds divided between six units. The medical intensive care unit has 22 beds. The fellows supervise medical students, interns, and residents; assess and triage admissions to the MICU; and lead the cardiopulmonary arrest team in the hospital. Our fellows train to be proficient in all aspects critical care, such as airway management and intubations, advanced ventilator management, central and arterial line placements, critical care ultrasound, and resuscitation.

Pulmonary Consult Service
The fellow in consultation with an attending manages our inpatient consultation service. We offer a wide range of procedures, and our fellows routinely perform basic and advanced bronchoscopies, as well as pleural procedures. In addition to basic bronchoscopies, our graduates are expected to be proficient in EBUS-TBNA. Fellows also have the opportunity to perform advanced bronchoscopy and to participate in multidisciplinary cases in conjunction with Interventional Pulmonary and Cardiothoracic Surgery. Our fellows get ample exposure in managing pleural disease, and placing small and large bore chest tubes, along with tunneled pleural catheters and ultrasound-directed pleural biopsies.

Physiology
Our pulmonary physiology laboratory is outstanding and offers the full range of resting, exercise and Broncho provocation studies, as well as a superb pulmonary rehabilitation program. The fellows will learn how to interpret spirometry, lung volumes, arterial blood gases, Broncho provocation challenge tests, and cardiopulmonary exercise tests.

Outpatient Clinic

• The outpatient clinical exposure in our program is vast. All fellows attend a half-day general pulmonary clinic for three years. In the second year, the fellows attend an additional half-day asthma clinic and sleep clinic. In the third year, they attend the interstitial lung disease clinic, pulmonary hypertension clinic and tuberculosis clinic.
• Sleep Medicine: The fellows learn how to evaluate patients with sleep disordered breathing, as well as patients with other sleep disorders like narcolepsy, parasomnias, and insomnia. They also learn the basics of interpreting polysomnograms.

Additional ICU Rotations
Fellows also rotate through critical care units other than the medical intensive care unit such as:

• Neurocritical Care Unit – John H. Stroger, Jr. Hospital of Cook County
• Cardiovascular Critical Care Unit – Advocate Christ Medical Center
• Surgical Critical Care Unit – John H. Stroger, Jr. Hospital of Cook County

Electives include Trauma ICU at Stroger Hospital and elective rotations at other Chicago hospitals on a case-to-case basis, depending on the fellow’s clinical interests.

Anesthesia Rotation
We share a close relationship with our anesthesia colleagues. Elective anesthesia rotations provide airway experience in the operating room setting, in addition to a robust experience in the ICU.

Pulmonary Rehabilitation
The division runs a complete phase II outpatient pulmonary rehab program and offers phase III outpatient maintenance pulmonary rehabilitation. Our fellows learn how to screen the candidates for the program, how to write rehab prescriptions and how to evaluate program outcomes.

Ultrasound
The ultrasound curriculum is aimed at developing proficiency in acquiring and interpreting point-of-care ultrasound in critical care. There are dedicated ultrasound faculty that led image review and didactics.

Active participation in research is an integral part of our fellowship training. A wide range of opportunities exist for involvement in clinical research and quality improvement projects. Our faculty are involved in mentoring fellows during their research training. Fellows are introduced to research towards the end of the first year, and will receive input and help in choosing the correct mentor for their research experience.

Weekly Clinical Conferences:

• Core Conference – in conjunction with the Division of Pulmonary and Critical Care at Rush University Medical Center
• Chest Conference – Multidisciplinary Team Discussion of Cancer Patients by Pulmonologists, Oncologists, Cardiothoracic Surgeons and Pathologists
• Radiology Conference
• Journal Club
• Clinical Case Conference in conjunction with the Division of Pulmonary and Critical Care at Rush University Medical Center
• Medicine Grand Rounds

Monthly / Quarterly Conferences:

• Interstitial Lung Disease Conference – Multidisciplinary Team Discussion of Patients with Interstitial Lung Disease by Pulmonologists, Rheumatologists, Pathologists and Radiologists
• Mortality and Morbidity Conference
• Pulmonary Hypertension Conference in conjunction with the Division of Cardiology
• Research Lectures
• Ultrasound Image review