Goals And Objectives
Rush offers a three-year program for advanced training in pulmonary and critical care medicine beyond the residency level, with opportunities to extend it to four or five years. The program provides internists with excellent clinical training alongside outstanding clinical and/or bench research designed to shape future leaders in pulmonary and critical care medicine.
The educational environment is one of the few in the country that encompass both a medical school and graduate programs in biological sciences. This creates an excellent setting where fellows, physicians, scientists and researchers interact, affording many superb educational opportunities for fellows in academic medicine.
Among the areas of research and training opportunities are:
- Septic shock and acute lung injury
- Mechanisms of multiple organ dysfunction syndrome (MODS)
- Immunologic changes during bacteremia and SIRS
- Cytokine profile of tumor-infiltrating leukocytes
- Identification of markers of lung transplant rejection
- Development of a rapid in-vitro PPD assay
- Cytokine production in patients with primary hypertension and in patients with hypercholesterolemia before and after therapy
- In-vitro testing before and after inhaled steroids
- Regulation of lung cytochrome P450 and its role in the pathogenesis of acute lung injury
- Transcriptional regulation of cytokines and surface receptors on monocytes in response to inflammatory stimuli
- Clinical investigation of new pharmaceutical agents (asthma, sleep medicine, sepsis, acute lung injury, ARDS, anemia of critical illness)
- Ozone induced airway hyperactivity and the role of neutral endopeptidase
- Development of cost-effective means of health care delivery to patients with pulmonary disorders
- Development of improved methods of medical education
- Markers of endothelial function in patients with lung injury
- Angiogenesis in patients with cancer
- Impact of metabolic influences on pulmonary function and ventilator management
- Short- and long-term effects of vasodilator therapy on exercise physiology
Goals And Objectives
The Rush Medical College and Rush University Medical Center Fellowship Training Program in Pulmonary and Critical Care Medicine is designed to give the internal medicine trained individual a wide variety of clinical and educational experiences in the field of pulmonary and critical care medicine. The training program will encompass three years and provide experiences in both inpatient and outpatient pulmonary medicine, multidisciplinary training in critical care medicine, exposure to research (clinical and/or basic investigations) and experiences in sleep disordered breathing. The program will include required and elective clinical experiences, an extensive series of educational conferences, and an opportunity to participate in research with a designated mentor.
At the completion of the training program the trainee should be:
- Competent and skilled in the approach to diagnosis and treatment of common pulmonary and critical care disorders.
- Understand the indications and risks of pulmonary and critical care procedures and be safe and proficient in their performance.
- Proficient at providing mechanical ventilatory support and interpreting pulmonary function tests.
- Knowledgeable in the techniques of research investigation and the critical evaluation of medical literature.
The educational curriculum will include mandatory rotations (pulmonary consultation service, medical intensive care unit, non medical ICU, P-rotation and weekly continuity clinic), elective rotations (required electives include - sleep medicine, thoracic surgery and chest radiology), and a dedicated research experience (goal ? learn research methodology and present abstract at National meeting). There will be an extensive conference schedule and other educational opportunities that are designed to complement the clinical rotations and support the overall educational program. While there is a large service component associated with this training program, the primary goal of the fellowship training program is to provide the trainee with a superior educational experience that will give the trainee a solid foundation on which they can build for their subsequent career; whether it is in research, academic, or clinical practice. We strive to train clinical educators/scholars who can participate in the future training of safe and competent pulmonary and critical care physicians. We also hope to nurture the trainee in an environment that supports and encourages self-directed learning and critical evaluation of the evidence contained in the medical literature.
Conferences are provided to enhance the learning experiences of the trainee and support the foundation for the clinical and research rotations. A majority of the educational and clinical conferences will include faculty and fellows from John H. Stroger, Jr. Hospital of Cook County. This allows a greater variety of clinical material to be presented, as well as, makes available the faculty experience from the John H. Stroger, Jr. Hospital of Cook County Pulmonary and Critical Care Division. At the present time both Pulmonary and Critical Care Medicine Training Programs (Rush and Cook County) have an affiliation agreement to support educational training for fellows. Elective opportunities exist for fellows from both training programs to participate in rotations at either institution.
Attendance at all conferences is mandatory, unless a pressing clinical situation requires the fellow's immediate attention or they are on vacation/educational leave. A schedule of conferences and educational activities will be distributed each week. If a fellow is not able to attend or participate in an educational conference, it is expected that the trainee will independently view the material which is stored on the ?K? drive of the institution's intraNet.
Pulmonary and Critical Care Medicine Core Curriculum Conference: This conference is held on Mondays at noon in the Field Auditorium of the Cohn Research Building. This conference will consist of core curriculum educational lectures and presentations designed to cover the program's core curriculum of topics over the 3 years of training. Some topics will be repeated on a yearly basis, while others are covered only once during the three-year cycle in a formal didactic presentation. The core curriculum will incorporate basic physiology, basic science, genetics, molecular biology, ethics, and pathology as necessary for the training of safe and competent pulmonary and critical care medicine fellows. There will also be additional didactic sessions at the beginning of each academic training year to cover basic topics that are felt to be essential areas of knowledge for the trainee. Senior fellows will participate in the conference presentation to give them skill at preparing and giving educational lectures. This will complement their training to become clinical scholars/educators. If a fellow is not able to attend or participate in an educational conference, it is expected that the trainee will independently view the material which is stored on the ?K? drive of the institution's intraNet.
Pulmonary and Critical Care Medicine Supplemental Conference: This conference is held on Tuesdays at noon in 780 Jelke. A number of topics will be presented to complement and augment others educational experiences. One Tuesday each month is devoted to Research Conference (see below). Other Tuesday supplemental conference topics include a monthly morbidity and mortality conference for the MICU and pulmonary and critical care medicine journal club (see below).
Pulmonary Research Conference: Current, future, and completed research from fellows, attendings, and invited guests will be presented and discussed at a monthly conference held at noon one Tuesday each month.
Clinical Case Conference in Pulmonary and Critical Care Medicine: The Pulmonary and Critical Care Medicine Clinical Conference meets on Thursday morning at 7:30 AM in the Radiology Conference Room (147 Kellogg). Faculty and trainees from both Rush and John H. Stroger, Jr. Hospital of Cook County will attend this conference. During this conference, the Fellows and/or Attendings present interesting clinical cases and discuss aspects of their diagnosis and/or management. All faculty and Fellows are expected to attend this conference. This conference provides an opportunity to discuss patients in whom difficult diagnostic or therapeutic decisions must be made with other faculty members. This conference also provides an opportunity for the Fellows to give short literature reviews concerning specific issues related to patient care. This conference is also attended by Chest Radiologists, Thoracic Surgeons, Critical Care Pharm D's, Pathologists, Pulmonologists in private practice at other hospitals, as well as other interested individuals.
Pulmonary and Critical Care Medicine Journal Club: Journal Club in pulmonary and critical care medicine will be held monthly at noon one Tuesday each month. Articles relevant to the essential knowledge base or practice of Pulmonary and Critical Care Medicine are presented and discussed. Emphasis in the journal club is placed on the hypothesis, experimental design, methods, data analysis, appropriateness of conclusions, and clinical importance of the articles. The conference is designed to emphasize a critical review of the literature and determination of what level of evidence is necessary to impact practice management.
Monthly Critical Care M&M Conference: Surgery and surgical subspecialties, anesthesia, and internal medicine and medical subspecialties attend this discussion of interesting M&M cases from all of the adult critical care units.
Monthly MICU M&M Conference: Nurses, Fellows, and Attendings in Pulmonary and Critical Care Medicine, along with other interested individuals or invited guests will discuss the significant morbidities, mortalities, and autopsies from the prior month.
Medical Grand Rounds: The Department of Medicine's Medical Grand Rounds are held every Wednesday at 12:00 noon. All Faculty and Fellows are expected to attend this conference.
Thoracic Oncology Conference: The Medical Oncologists, Thoracic Surgeons, Radiation Oncologists, Radiologists, CytoPathologists, and Pulmonary and Critical Care Medicine residents, fellows, and staff will meet at 10 am weekly on Thursdays in the radiology conference room to discuss thoracic oncology patients. Fellows and attendings in Pulmonary and Critical Care Medicine are encouraged to attend. The fellow on the Thoracic Surgery elective rotation is required to attend this conference as part of the rotation.
Thursday Fellow's Conference: On Thursdays at noon, there may be a Fellow's conference which is run by the Chief and/or senior Pulmonary and Critical Care Fellow and is designed to provide enhanced discussion of various Pulmonary and Critical Care Medicine Topics. Other Thursday conferences will consist of board review questions, case management discussions, topic discussions, and medical jeopardy. Attending physicians are encouraged to attend and participate in this educational conference.
Sleep Conference: The sleep medicine clinical conference and weekly grand rounds take place on Fridays at 11 AM. Fellows on the Sleep rotation are required to attend. Trainees involved in the 4th year of sleep training are expected to attend this conference. Interested Pulmonary and Critical Care Medicine trainees are also encouraged to attend.
Faculty and fellows of the Rush University Medical Center also have access to online training and reference materials.