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Selectives - Medicine

Pulmonary Selective

Selective Number: (Oasis S42c) 1645

Rotation Supervisor: Dr. Y. Michael Shim

Available: all Rotations

Duration: 2 weeks

Report to: Pulmonary fellow's room 3rd floor main hospital. Contact Y. Michael Shim (Page or email) first day

Time to Report: 8:30 am

Typical Day: 8:00 am - 5:00 pm

Number of students per rotation: 2

Course Description: Students will participate in both outpatient and inpatient venues. They would begin the week immersed in a variety of clinics. By mid-week, they will join the consult team and participate with residents and fellows in pulmonary consultation where they will observe procedures, see and follow initial consultations, and attend didactic sessions, including the MICU core lecture series. Experience in Pulmonary Function Laboratory will include first hand experience with procedures. On alternate weeks, students will begin the week in MICU, rounding with the respiratory therapists and MICU nurses on ventilated patients. On alternate weeks students will attend the Cystic Fibrosis, Pulmonary Hypertension, and Interstitial Lung Disease clinics. Students will attend the joint conference with Pathology to review recent cases from the consult and outpatient services.

Learning Objectives:

  1. Detail the treatment algorithms for common pulmonary conditions including COPD, Asthma, pulmonary hypertension, chronic cough.
  2. Understand the work up of chronic cough and dyspnea.
  3. Detail and describe the workup for interstitial lung diseases.
  4. Understand the diagnostic workup and management of obstructive sleep apnea.
  5. Understand details of respiratory management and treatment of mechanically ventilated, critically –ill patients.
  6. Understand the selection criteria for lung transplant candidacy.
  7. Interpret pulmonary function tests and cardiopulmonary exercise tests.
  8. Describe the following procedures: bronchoscopy and thoracentesis.

Expectations:

  1. Everyday is divided into Am and Pm blocks.

    a. Attend about 50% sub-specialty outpatient pulmonary clinics: Use group practice like approach: one person will be in clinic, and the other person will cover inpatient service.
    b. All blocks other than the pulmonary clinics, students are expected to report to pulmonary inpatient consult fellow to round with the inpatient consult team (Report to pulmonary fellow’s room, 3rd floor Main hospital)
    c. Students are not to be in pulmonary clinic during pulmonary fellow’s clinic.
    d. Didactic lectures: (1) Tuesday at noon (Pulmonary didactic conference); (2) Wednesday at 1pm (Pulmonary case conference); (3) Tuesday at 4pm (Pulmonary research or Journal Club: ask consult fellows about specifics).
    e. No need to work in weekends.
    f. STRONGLY RECOMMENDED: If schedule permits, attend MICU core curriculum lecture at 2pm on Mon, Wed, Friday in the MICU conference room.

  2. Attend all sub-specialty clinics in pulmonary clinic

    a. Lung transplant clinic (Dr. Enfield, Dr. Weder)
    b. Sleep Clinic (Dr. Esau, Dr. Suratt, Dr. Brown)
    c. Pulmonary Hypertension Clinic (Dr. Gay)
    d. CF clinic (Dr. Indihar, Dr. Brown)
    e. COPD clinic (Dr. Shim/Dr. Brown/Dr. Gay/Dr. Truwit

  3. Recommended reading

    a. Major reference: Textbook of Respiratory Medicine by Murray and Nadel
    b. Major reference: Fishman’s Pulmonary Disease and Disorder

  1. Pulmonary clinic master schedule

    a. Pulm = all pulmonary patients
    b. Dr. Indihar/Brown on Tuesday PM has different clinics depending on which week of the month.

DAY
Monday
Tuesday
Wednesday
Thursday
Friday

AM Clinic

 

Enfield& Weder (Transplant )
Rose (Pulm)
Mehrad (ILD)
Shim (COPD)
Suratt (Sleep)
Rose (Pulm)
Fellow’s Clinic
Verghese (Pulm/ILD)
Brown (Sleep)
PM Clinic
Fellow’s Clinic Brown (Sleep)
Indihar (2nd & 4th week, CF)
Suratt (Sleep)
Gay (Pulm)
Patel (Pulm)
Esau (Pulm/Sleep)
Gay (Pulm HTN)
Fellow's clinic