Administration Basic Sciences Clinical Sciences Centers of Excellence
 
 

LSUHSC-New Orleans Pulmonary/Critical Care Medicine Fellowship
Ochsner Medical Center- Kenner

Fellowship Rotations at Ochsner Medical Center- Kenner

  • Pulmonary Consults / Critical Care

Curriculum in Clinical Pulmonary and Critical Care Medicine

Educational Goals & Objectives

Training in Inpatient Care and Management

Fellows are expected to develop the skills necessary to obtain a history and perform a complete respiratory physical examination. Subspecialty trainees are also expected to gain experience adequate to fulfill the roles of primary physician and consultant to other physicians in the management of patients with pulmonary disorders. Fellows have direct responsibility for performing these functions under the supervision of the faculty in the Pulmonary / Critical Care Medicine Section in proportion to the experience and qualifications of trainees.

Training in Understanding, Diagnosis, Prevention, and Treatment

Subspecialty trainees are expected to develop expertise in pathogenesis, pathology, risk factors, natural history, differential diagnosis, diagnostic work-up, medical/surgical management, complications, and prevention of pulmonary diseases. Areas of study include: acute lung injury; airway diseases; congenital lung diseases; infections of the respiratory tract; interstitial lung diseases; neoplastic pulmonary diseases; occupational lung diseases; pleural diseases; pre-operative pulmonary risk assessment and peri-operative management of lung disease; pulmonary manifestations of systemic disorders; pulmonary vascular diseases; respiratory failure; sleep-disordered breathing; and pulmonary complications of organ transplantation. Fellows also become competent in the diagnosis and management of common presentations of pulmonary signs and symptoms such as chest pain, cough, daytime somnolence, dyspnea, fevers with radiographic infiltrates, hemoptysis, lung mass by chest radiograph, pleural effusions, stridor, and wheezing. Under faculty guidance, subspecialty trainees are expected to develop competence in procedures essential to the diagnosis and management of pulmonary disorders including indications, contraindications, complications, performance, and interpretation of results. Fundamental procedural competence includes: arterial blood gas sampling and interpretation; bronchoscopy; chest tube thoracostomy; endotracheal intubation and ventilatory management; advanced airway management including percutaneous tracheostomy; oximetry monitoring; management of supplemental oxygen including O2 conserving techniques and placement of SCOOP catheters; pathology; peak flow monitoring; vascular access placement (arterial and venous); pulmonary artery catheterization; pulmonary function testing including cardiopulmonary exercise and bronchoprovocation testing; radiology including plain films, computed tomography, nuclear medicine, magnetic resonance, interventional radiographic techniques including percutaneous needle biopsy, and newer modalities such as PET; skin testing for tuberculosis; thoracentesis; and pleural biopsy.

Principal Teaching Methods

During clinical rotations in Pulmonary Medicine, trainees are trained by supervising attendings. All attending staff are faculty members of Louisiana State University Health Sciences Center at New Orleans. Supervising faculty on the inpatient Pulmonary rotation are Board-certified in Pulmonary Diseases. The style of teaching is unique to each attending but is typically "hands on" and "patient-directed" based upon topics suggested by clinical consultations.

Additional teaching occurs through the didactic series of lectures including the weekly Chest Conference, Pulmonary Fellows Journal Club, and weekly didactic core lectures. These conferences include a broad array of subject matter and speakers from within and without the Division. Conferences are considered an integral component of the educational process for fellowship training and attendance is mandatory for these seminars.

Fellows are expected to augment the above by independent reading. Along with complementing the more organized components of the program, this commitment to self-study and acquisition of new knowledge is considered integral to achievement and maintenance of lifelong expertise in Pulmonary and Critical Care Medicine.

Educational Content

During this rotation, the subspecialty trainee is expected to develop skills in general pulmonary diseases and critical care medicine. The fellow aims to master peri-operative and post-operative pulmonary management of patients, infectious diseases in normal and immunocompromised hosts, pulmonary vascular diseases, neoplastic diseases involving the lungs, pleural diseases, interstitial lung diseases, and immunologic disorders affecting the respiratory system. As the primary referral location for hospitalization of those patients followed at LSU faculty clinics, Kenner Regional Medical Center serves as a vital experience in continuity of care between the outpatient and inpatient arenas.

The on call fellow provides coverage of the pulmonary consultative or critical care responsibilities after-hours and on weekends from home as determined by the monthly call schedule. On call responsibilities include coverage for patients followed by Pulmonary / Critical Care Medicine faculty. Subspecialty fellows share weeknight and alternate weekend "on call" coverage.

Under the guidance of supervising LSU pulmonary faculty, trainees are responsible for evaluating all patients on the service during initial and follow-up care over the course of hospitalization. One to two medical residents are assigned to the consult service, and the pulmonary fellow participates in supervision and education of residents assigned to this service and to this training site under the guidance of the attending physician.

While fellows may provide consultation for patients of non-university physicians under the supervision of LSU faculty, trainees are not responsible for primary patient care needs for non-teaching patients. There are no absolute limits to the number of patients followed on the service, but the average daily census is typically 4 to 8 patients with 1-2 new patients each weekday.

Method of Evaluation of Fellows

Fellows are evaluated by supervising faculty at the conclusion of each rotation. Employing the standard 9-point ABIM evaluation form, written assessments are completed in a timely manner prior to submission to the Fellowship Program Director. To provide feedback to trainees, faculty members are encouraged to verbally review performance during and at the conclusion of each rotation. In addition, fellows undergo periodic performance reviews with the Program Director and Section Chief to assure continued communication.

Method for Evaluation of Faculty and Rotations

Fellows are expected to complete an evaluation form at the conclusion of each rotation for both supervising faculty and the rotation itself. In addition, the Program Director solicits input from the fellows regarding the quality of training rotations and means of improving the academic character of the fellowship program.

Departments and Centers Feedback School Home Search