Pulmonary and Critical Care Fellowship Curriculum

During the three years of fellowship training, fellows will experience a mix of pulmonary, critical care, inpatient, outpatient, clinical, academic and research activities.

Clinical Training

The pulmonary section performs more than 800 bronchoscopies (fiberoptic and rigid) per year. Fellows will develop competence in all aspects of bronchoscopy, including:

  • Bronchoalveolar lavage
  • Endobronchial and transbronchial biopsies
  • Transbronchial needle aspiration (conventional and ultrasound guided—convex and radial EBUS)
  • Navigational bronchoscopy

Additional experience in interventional bronchoscopy techniques is gained by working alongside our IP faculty. Fellows will also acquire competence in pleural procedures such as:

Thoracentesis

  • Thoracostomy tube insertion (tunneled and non-tunneled)
  • Drainage

Pulmonary diagnostic testing experience includes time learning clinical pulmonary physiology by interpreting pulmonary function tests, cardiopulmonary exercise tests, inhalation challenge studies and sleep studies.

During the ICU rotations, fellows will develop expertise in invasive and noninvasive hemodynamic monitoring procedures. They will acquire both the technical proficiency necessary for these procedures and judgmental skills essential to their appropriate use.

The remaining time during the second and third years of fellowship is designed to be flexible and individualized. Fellows may elect for additional inpatient critical care experiences involving rotations in other intensive care units, such as:

  • Trauma
  • Burn
  • Neurosurgery
  • Coronary care
  • Cardiothoracic surgery

The clinical pulmonary exposure also involves cross-specialty consultations in the transplantation programs, including:

  • Bone marrow, heart and kidney transplants
  • Thoracic oncology
  • Thoracic surgery
  • Pulmonary pathology
  • Radiology

After successful completion of the three-year program, fellows will meet all requirements for the American Board of Internal Medicine subspecialty board examinations for pulmonary disease and critical care medicine. All fellows who have graduated from the program have successfully achieved dual certification.

Clinical Rotations

Conferences and Didactics

Fellows participate in a number of weekly and monthly conferences to help broaden their understanding of pulmonary issues.

Research Opportunities

The faculty and fellows in our section are engaged in exciting and productive investigation in several areas. During the first year of fellowship, each fellow develops their own ideas for investigation with mentoring from our faculty. During the second and third fellowship years, each fellow will be given protected time to pursue their chosen project.

Our Research Curriculum is anchored by an Introduction to Research course covering the following topics:

  • Session # 1: Choosing a Research Question
    • What is Research/Choosing a Research Question
  • Session #2: Use of Library Resources
    • Hands-on Computer Class: How to conduct a literature search; EndNote and other reference management programs
  • Session #3: Wake One Data/Navigating IRB
    • Wake One Data Extraction; Navigating IRB at Wake: The Nuts and Bolts
  • Session #4: Study Designs
    • Classification of observational studies: sampling scheme and time frame; structure, advantages and disadvantages of major observational designs; importance of sampling scheme in studies of diagnostic test accuracy; practice naming designs.
  • Session #5: Stats and Data Visualization
    • Stats 1: chi-sqr, t-test, ANOVA, linear regression; data Visualization
  • Session #6: Power/Sample Size

All fellows receive at least six months of protected research time; the content, timing, and structure is individualized based on the fellow’s project and career plans. For fellows interested in establishing a research career, additional support is offered. Our Research Career Development Option includes:

  • Nine months protected time for research
  • Personal research mentoring committee
  • Application for fourth year funding opportunities, such as
    • NIH NRSA Grants
    • NIH T32 Training Grants
    • Cystic Fibrosis Foundation Grants
    • Wake Forest Department of Medicine Translational Science Fellowship
      • This fellowship includes earning a master’s degree in Clinical and Population Translational Science

All third-year fellows present a section conference where they summarize their work. Each year many of our fellows also present their work for national audiences at conferences such as ATS, CHEST, and SCCM. Several fellow projects also result in peer-reviewed publications.

Learn more about the available research opportunities.

Call Responsibilities

Call responsibilities are shared equitably by all fellows. During each two-week night rotation, two fellows share night coverage duties providing in-house coverage for MICU and pulmonary services. Additionally, a backup call schedule provides coverage in the event of personal or family emergencies.

Technology and Work Environment

Fellows have individual desktop computers in their dedicated office space with access to electronic patient records, word processing, PowerPoint and Internet. They also have access to the Coy Carpenter Library of the Medical Center with its multiple resources, including UpToDate, OVID, electronic journals and textbooks, and a shared printer. Most clinical applications are also accessible remotely through our portal website.

Fellows also receive:

  • A copy of Murray and Nadel’s Textbook of Respiratory Medicine
  • A personal copy of the Pulmonary and Critical Care SEEK board review materials
  • Membership in ATS and CHEST