Program Overview
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The fellowship in Pulmonary Medicine is a combined two year program with Palmetto Health Richland and William Jennings Bryan Dorn VA Medical Center. It is directly affiliated with the University of South Carolina School of Medicine. We accept three fellows per year. All applicants should be board eligible or board certified in Internal Medicine and should have completed at least 3 years of Internal Medicine Residency in an ABIM accredited residency. All fellows are expected to be fully competent in usual procedures, consultative skills, and to pass the internal medicine board exam in Pulmonary Medicine after program completion.
Pulmonology Fellowship Program Objectives:
The Curricular goals will be achieved through a variety of methods. Specific educational goals and objectives are present for each rotation, including assigned readings. Fellows will be encouraged to develop self directed learning skills. Required topics will be covered in didactic conferences, rotation experiences including subspecialty clinics, and directed readings.
Specific Objectives:
Pulmonology Medicine Knowledge
Fellows will demonstrate knowledge of the pathophysiology and perform appropriate diagnosis and management of patients with the following conditions:
- Lung disease caused by infections, obstruction, inflammation, and occupation/environment
- Pulmonary vascular diseases
- AIDS
- Common issues of post-op lung transplantation
- Pulmonary neoplasms
- Pleural and mediastinal disorders
- Chest trauma and acute lung injury
- Developmental abnormalities/congenital disorders
- Respiratory failure
- Hypersomnia and sleep disorders
Critical Care Medicine Knowledge
Fellows will learn pathophysiology and how to diagnose and manage patients with the following:
- Disorders which can cause patients to be come critically ill, including cardiovascular, respiratory, neurologic, endocrine, hematologic, and musculoskeletal; infectious diseases; obstetric and gynecological disorders; and anaphylaxis and acute allergic reactions
- Disorders secondary to critical illness, including shock states; electrolyte, nutritional, and endocrine effects of critical illness; hematologic and coagulation disorders secondary to critical illness; pharmacokinetics, pharmacodynamics, drug metabolism, and drug excretion in critical illness
Pulmonary Medicine Practice Skills
Fellows will demonstrate skills in the following areas:
- History taking
- Physical exam
- Data interpretation
- Physiologic data relevant to pulmonary problems
- radiologic imaging studies relevant to pulmonary problems
Critical Care Medicine Practice Skills
Fellows will demonstrate skills in the following areas:
- History taking
- Physical exam
- Lab data interpretation
- Radiologic data interpretation
Patient Care Evaluation Plan
By the end of the two-year fellowship program, patient care in pulmonary diseases and critical care medicine is expected to reach a level appropriate to a practicing pulmonary subspecialist. Standards are being developed for each rotation and stage of training regarding required/desirable levels of performance on testing/evaluation as follows:
- Mini-CEX forms
- Attending evaluation form
- Procedure logs
- Consult logs
- Clinic patient logs
- 360° evaluation
Procedural Patient Care
Fellows will demonstrate the technical skill necessary to use specialized equipment and perform specialized procedures used to diagnose and manage problems pertinent to Pulmonary Medicine. Use of lectures, models, and simulators early in the fellowship will be emphasized so as to minimize risk of injury to patients during learning. Mastery of these skills is best done through direct patient care under careful supervision of the attending staff.
Fellows will learn:
- indications, contraindications, complications, and proper use of specialized equipment for managing patients with pulmonary problems
- data analysis of specialized data pertaining to pulmonary and critical care
- technical skills of performing specialized procedures
Interpersonal and Communication Skills and Professionalism
Fellows will demonstrate ability to apply knowledge, practice skills, and technical skills to diagnose and manage patients with problems pertinent to pulmonary medicine. You will develop the skills necessary to function as a sub-specialty consultant. Considerable overlap occurs in the domains of interpersonal and communication skill with professionalism in the realm of the internist consultant.
Fellows will learn:
- the basic constructs of the referral-consultant relationship for managing or co-managing the care of patients with pulmonary problems or patients who are critically ill.
- when to refer patients for procedures to be performed by a thoracic surgeon or other specialist
- to demonstrate attitudes, values, and habits of a dedicated academic sub specialist in Pulmonary Medicine. The Pulmonary fellow will learn to model and live as a consummate Professional
- constructive coping skills for physicians (including yourself) and other health care professionals who care for chronically ill pulmonary patients.
Systems Based Practice
Fellows will demonstrate knowledge of how the care of problems pertinent to Pulmonology fit into patients' overall health plan. By working on quality improvement projects, teaching, and participating in medical direction roles, the fellows will gain understanding of how systematic, large scale societal issues may impact patient outcomes in both positive and negative ways and how large-scale systems may improve patient care.
Practice Based Learning
Pulmonology Fellows will learn from their patient results and outcomes. The scientific method will be used to analyze practice patterns of the fellow, their peers, and the division so as to investigate, evaluate, and improve patient care.