Scholarship and lifelong learning are fundamental to a successful career in medicine. Fellows must posses or develop a commitment to maintain and renew their knowledge and clinical skills throughout their career. They must be skilled in obtaining and interpreting medical information and realizing its limitations. They should participate in scientific and clinical studies and meetings. They should be able to evaluate critically new information relevant to Pulmonary, Critical Care and Sleep Medicine.

Fellows are expected to perform basic or clinical research under the guidance of faculty, attend relevant research meetings, present their results at a scientific meeting and author or co-author at least one paper resulting from their research. The fellows are expected to supervise and teach residents and medical students assigned to their services.

The program will ensure that its fellows possess knowledge in established and evolving biomedical and clinical science and apply it to clinical care. Fellows are expected to demonstrate rigor in their thinking about clinical situations.

The curriculum will cover the following topics during a three-year period:

Pulmonary Medicine

•Obstructive lung diseases including asthma, bronchitis, emphysema, bronchiectasis, bronchiolitis, and cystic fibrosis
•Pulmonary malignancy, primary and metastatic
•Pulmonary infections, including pneumonia, tuberculosis, fungal infections, and those in the immunocompromised host
•Diffuse interstitial lung diseases
•Pulmonary vascular diseases, including pulmonary thromboembolism, pulmonary hypertension, the vasculitiditis and pulmonary hemorrhage syndromes
•Occupational and environmental lung diseases
•Iatrogenic respiratory diseases, including drug-induced disease
•Acute lung injury, including radiation, inhalation, and trauma
•Pulmonary manifestations of systemic diseases, including collagen vascular diseases
•Respiratory failure, including the respiratory distress syndrome, acute and chronic respiratory failure in obstructive lung diseases and neuromuscular and respiratory drive disorders
•Disorders of the pleura and mediastinum
•Genetic and developmental disorders of the respiratory system
•Sleep disorders

Critical Care Medicine

•Physiology, pathophysiology, molecular biology, diagnosis and therapy of disorders of the cardiovascular, respiratory, renal, gastrointestinal, genitourinary, neurologic, endocrine, hematologic, musculoskeletal, immune, and reproductive systems
•Electrolyte and acid-base physiology, pathophysiology, diagnosis and therapy
•Metabolic, nutritional and endocrine effects of critical illnesses
•Hematologic and coagulation disorders secondary to or causing critical illnesses
•Life-threatening obstetric and gynecologic disorders
•Management of the immunosuppressed patient
•Management of anaphylaxis and acute allergic reactions
•Pharmacokinetics, drug metabolism, and excretion in critical illness
•Use of paralytic agents
•Ethical, economic, and legal aspects of critical illness
•Biostatistics and experimental design
•Principles and techniques of administration and management
•Psychosocial and emotional effects of critical illnesses
•Iatrogenic and nosocomial problems in critical care medicine
•Personal development, attitudes and coping skills of physicians and other health care professionals who care for critically ill patients
•Occupational Safety and Health Administration (OSHA) regulations and universal precautions and protection of health care workers

Experience will also be provided in the analysis of data pertaining to the following:

•Parenteral nutrition
•Cardiac output determinations by thermodilution and other techniques
•Evaluation of oliguria
•Management of massive transfusions
•Management of hemostatic defects
•Interpretation of antibiotic levels and sensitivities
•Monitoring and assessment of metabolism and nutrition
•Calculation of oxygen content, intrapulmonary shunt and alveolar arterial gradients

The program will provide the environment and resources for the fellow to acquire knowledge of and ability to interpret the following:

•Imaging procedures, including: chest radiographs, computed axial tomograms, radionuclide scans, pulmonary angiograms, and other radiologic and ultrasound procedures
•Sleep studies
•Inhalation challenge studies
•Pulmonary function tests to assess respiratory mechanics, gas exchange and respiratory drive, including spirometry, flow-volume studies, lung volumes, diffusion capacity, arterial blood gas analysis
•Cardiopulmonary exercise studies
•Slides of basic lung pathology

The program will provide the environment and resources for fellows to develop competence in monitoring and supervising special services, including:

•Critical care units
•Pulmonary function laboratories
•Respiratory physical therapy and rehabilitation services
•Respiratory care techniques and services