The mission of the Pulmonary and Critical Care Medicine program is to develop outstanding pulmonary and critical care medicine physicians. On the completion of their fellowship, all graduates should be highly qualified to practice pulmonary and critical care medicine competently and independently. Research-track graduates should understand their research area and methods, have presented and published, be equipped to obtain an early career grant and be prepared to assume a successful academic leadership faculty position. Clinical-track graduates should be equipped to become leaders in the clinical arena, which includes being a leading clinician, consultant, teacher, and scholar and enhancing the programs to which they belong with leadership and life-long improvement.
The goal of the University of Illinois’ Pulmonary and Critical Care Medicine fellowship is to develop outstanding physicians who will be leading clinicians, consultants, teachers, and scholars enhancing the programs to which they belong.
Fellows provide comprehensive and high quality care that is responsive to patients’ needs. The program stresses good clinical judgment, extensive medical knowledge, humanistic qualities, commitment to scholarship, and ethical behavior. We highly value the ability to communicate effectively, accept responsibility, and be proficient as consultants and teachers. Under faculty guidance, fellows advance with graded independence and are well qualified to excel on their own at the end of their fellowship.
Scholarship and lifelong learning are fundamental to a successful career in medicine. Fellows become skilled in obtaining and interpreting medical information and realizing its limitations. They participate in scientific and clinical studies and national meetings. We believe that teaching is a strong part of learning. Fellows direct and teach residents and medical students assigned to their services. They supervise residents in ultrasound-guided thoracentesis, placement of central lines, and cardiopulmonary resuscitation. They give lectures to the whole division at the weekly conferences and conduct the case conferences. They may also volunteer to teach medical students and participate in the many programs available at the University to enhance their teaching and leadership skills. They may volunteer to staff the DuPage County Tuberculosis Clinic.
Fellows have the opportunity to learn a full array of pulmonary and critical care procedures, which include intubation, mechanical ventilation, chest tube insertion, central line insertion, pulmonary function tests including cardiopulmonary exercise testing, fiberoptic bronchoscopy and its related procedures such as endobronchial ultrasound, and interpretation of pathology. Additionally, they may perform or be involved in percutaneous tracheostomy, whole lung lavage, endobronchial cryotherapy, stent placement, thermoplasty, pleurodesis, laser ablation, rigid bronchoscopy, medical thoracoscopy, and intracranial pressure monitoring. Fellows start each year with a ventilator course, while our ultrasound curriculum is interwoven into activities throughout the year.
The clinical training program integrates and embraces both basic and clinical science. The division has up to 10 clinical fellows, 5 research (T32) fellows, and 2 sleep fellows. The programs of the tracks are combined. Typically, fellows who will become physician-scientists spend two years doing clinical work and two years in the advanced research training. Those enrolled in the three-year clinical track have experiences in research, sleep, and trauma. Regardless of the track, UIC’s strong clinical program provides the environment, mentoring, and resources for an outstanding and successful career.
The University of Illinois has a large, dynamic faculty that engages in research that extends the entire spectrum of respiratory disease. The Pulmonary, Critical Care, Sleep & Allergy division faculty have experts in health care delivery and many disease processes including acute respiratory distress syndrome, allergic disease, asthma, bronchiectasis, chronic obstructive lung disease, interventional bronchoscopy, lung cancer, the microbiome, mycobacterial disease, pulmonary hypertension and other forms of pulmonary vascular disease, sarcoidosis, sleep disorders, and transplant immunology.
There are more than 100 faculty members pursuing a wide range of innovative studies that advance our understanding of pulmonary processes and improving respiratory health. A strong portfolio of NIH funding, as well as grants from multiple other sources, supports these vibrant research endeavors. Dr. Patricia Finn, who chairs the Department of Medicine, heads the T32 research fellowship program. In addition, many investigators are closely affiliated with the division’s faculty enhancing its research through collaborative interactions. The Center for Lung and Vascular Biology, directed by Dr. Asrar Malik (Chairman, Department of Pharmacology), has more than 35 PhD and physician researchers. Dr. Terri Weaver, Dean of the School of Nursing, is an internationally known expert on sleep-disordered breathing, as is Dr. David Carley, Director of the Center for Narcolepsy, Sleep, and Health Research. The University of Illinois’ School of Public Health has many of the faculty members involved in different areas of respiratory health research, as do the Departments of Bioengineering, Microbiology, and Biochemistry. Together, this diverse faculty provides a fertile environment to pursue basic and clinical research related to respiratory disease.
Other important aspects of the Pulmonary and Critical Care fellowship research program includes close mentoring and follow up, access to many investigative technologies, services, and instruction, ability to obtain a Master of Public Health or Master of Science degree with tuition waiver, and promotion of the fellows’ work and career at national and international levels. Fellows completing the research fellowship will have presented at national meetings and authored several abstracts or complete works. They will be familiar with grant writing and have research skills that will allow them to become productive faculty members on graduation. The University of Illinois Pulmonary and Critical Care Medicine research fellowship provides a foundation for a highly successful academic career.
The Pulmonary and Critical Care Medicine fellowship program at the University of Illinois at Chicago (UIC) is carried out mainly at two institutions: University of Illinois Hospital & Health Sciences System and Jesse Brown VA Medical Center.
University of Illinois Health System and the Jesse Brown VA are located in the West Side Medical District of the UIC campus.
The university hospital is a tertiary care medical center that serves as the primary teaching hospital for the program. The section of Pulmonary, Critical Care, Sleep & Allergy directs the medical intensive care unit. The section also provides consultative services to the cardiac intensive care units, surgical intensive care units, stem cell and solid organ transplant unit, and the neurosurgical intensive care unit as well as to inpatients and outpatients on all adult services. The section runs several outpatient pulmonary, allergy, and sleep clinics on the medical campus. The Center for Sleep and Ventilatory Disorders, which opened in 2007 has modern monitoring equipment, is administered by the section which coordinates a multi-disciplined management of patients with sleep disorders. The pulmonary function laboratory and bronchoscopy suite are fully equipped to perform routine and specialized studies. There is also an interventional service that offers a full range of invasive procedures including endobronchial ultrasound, ultrasound-guided pleural biopsies, percutaneous tracheostomy, PluerX catheter, and medical thoracoscopy.
The Jesse Brown VA Medical Center serves as an integral part of the fellowship program. The new luxuriant state-of-the-art medical intensive care unit is under the direction of the section. The section also provides services to surgical intensive care patients as well as inpatient consultations and outpatient services. The pulmonary function laboratory and bronchoscopy suite are equipped to perform all routine and specialized tests.
A level-1 trauma rotation is also completed at Christ Hospital, another large teaching hospital. Other institutions are available for elective experiences.
Work at these institutions exposes fellows to a large variety of patient populations with an array of respiratory and critical care problems. The University of Illinois Health System serves patients with rare and complicated diseases as well as common respiratory problems. A large number of patients with lung cancer and obstructive lung disease are seen at the Jesse Brown VA, whereas immunocompromised patients and a relatively younger patient population are encountered at the Univeristy of Illinois Hospital and Health Sciences System. The Sleep and Ventilatory Disorders Center at the health system provides for many referred patients with sleep disorders, including patients as young as 12.
Fellows play a central role in the diagnosis and consultative management of patients. They see patients with a wide variety of diseases at both the University of Illinois and Jesse Brown VA Medical Centers. They gain expertise in interpreting studies such as chest radiographs, pulmonary function tests, thoracic ultrasound and cardiopulmonary exercise tests. They also develop procedural skills including bronchoscopy and thoracentesis.
Critical Care Medicine
Fellows spend at least a year in the intensive care units, where they direct residents, students, and other team members. They perform or supervise critical care diagnostic and therapeutic procedures. They develop proficiency in the ventilator management of critically ill patients and procedures, such as central venous catheter placement, thoracentesis, and chest tube placement. The fellows become skilled in critical care ultrasonography and perform bronchoscopies on ventilated and critically ill patients. The fellows lead a team of house officers and have considerable teaching responsibilities for residents and students rotating through the ICU through scheduled lectures and bedside teaching.
On the Sleep rotation, fellows see outpatients with sleep disorders, as well as interpreting polysomnograms. They work with the sleep fellows and faculty in the interpretation of sleep apnea screening that is based at the VA. They may present cases at the case conference. Research opportunities are available to interested fellows with attendings from the Center for Narcolepsy, Sleep, and Health Research.
This rotation occurs during the fellows’ second year at Advocate Christ Hospital Trauma Center. As one of the busiest trauma centers in the nation, this experience gives fellows an opportunity to carry out a number of invasive procedures and manage acute trauma events. The fellows work with the trauma team in the trauma bay (Emergency Department) as well as follow up care in the trauma intensive care unit.
Fellows spend the majority of their time working with Dr. Kevin Kovitz developing skills in both basic and advanced bronchoscopy, including endobronchial ultrasound and bronchothermoplasty. They are exposed to other invasive pulmonary procedures including percutaneous tracheostomy, rigid bronchoscopy, bronchial stenting, endobronchial laser procedures, thoracoscopy, indwelling pleural catheter placement, and pleurodesis. They attend the Procedures Clinics and orchestrate the Multidisciplinary Tumor Board conference.
On this rotation, fellows see patients in the Bronchiectasis and Mycobacteria Clinic, Allergy Clinic, Pulmonary Hypertension Clinic, Sarcoidosis and Rheumatic Diseases Clinic, and Sleep Clinics. They may follow these patients beyond clinic, if they are admitted or have further procedures.
Fellows maintain continuity clinics at both the University of Illinois Hospital and the Jesse Brown VA. Fellows are assigned to a half-day clinic per week on alternating weeks. Clinics are supervised by teaching attendings but fellows assume the primary role in patient interactions, developing a treatment plan, and following up results.
Sunit Singla, MD
Director, Fellowship Program
Coordinator, Fellowship Program