Graduate Medical Education

Curriculum

Pulmonary Critical Care Medicine Fellowship

Education is the central mission of St. Luke’s University Health Network where comprehensive care of both pulmonary disease patients and those with critical illness is of paramount importance. Over the course of training, pulmonary & critical care medicine fellows will staff their own weekly continuity clinic and have increasing levels of responsibility and autonomy with faculty support. Time is spent among three locations - Bethlehem, Allentown, and Anderson Campuses - broadening fellow’s inpatient and outpatient exposure to varying patient populations. Critical care procedures will include central venous catheter placement, intubation and airway management skills, pleural drainage, invasive and noninvasive ventilator management, and resuscitation of various shock states. Pulmonary based procedures will include standard diagnostic and therapeutic bronchoscopy techniques, endobronchial ultrasound (EBUS), navigational bronchoscopy, bronchoscopic lung volume reduction, chest tube placement and management, tunneled pleural catheter placement and management, percutaneous tracheostomy placement, and pulmonary function testing interpretation.

Throughout the fellowship, St. Luke’s pulmonary and critical care medicine fellows will participate and present at multidisciplinary Thoracic Tumor Board, Clinical-Pathological-Radiographic case conferences, and multidisciplinary critical care conferences.


First Year (PGY-4)

In the first year, pulmonary & critical care fellows primarily train at our flagship St. Luke’s Bethlehem campus with dedicated blocks in both the inpatient pulmonary consult service, outpatient pulmonary clinic, and our medical intensive care unit. Procedural training includes critical care based procedures, bronchoscopy, EBUS, and pleural space management. One month will be preserved for research and scholarly activity – please see research section for further information. Training will also include dedicated radiology, sleep medicine, and Point of Care Ultrasound (POCUS) educational experiences.


Second Year (PGY-5)

In the second year, pulmonary & critical care medicine fellows experience graduated levels of responsibility and autonomy on the inpatient pulmonary consult service, outpatient pulmonary clinics, and medical intensive care unit at St. Luke's Bethlehem as well as time at our Allentown and Anderson campuses. Lung transplant experience will be obtained during a 4-week rotation at the Temple Lung Center. Three to four rotations will be dedicated to research.

Since pulmonary & critical care fellows often have to decide if they want to apply for an interventional pulmonary fellowship early in their training, we have broad exposure to multiple thoracic interventional procedures through both Thoracic Surgery and Interventional Pulmonary rotations at St. Luke’s. This is an excellent exposure to the collaborative nature of Thoracic Surgery and Pulmonary medicine. Procedural experiences include endobronchial tumor management (stenting, debulking, laser therapy), navigational bronchoscopy, varied lung resection procedures, pleural management including VATS and bronchopleural fistula interventions, and other interventional procedures.


Third Year (PGY-6)

Pulmonary & critical care medicine fellows are expected to demonstrate advanced levels of competency over the course of training and increased autonomy in the third year. Rotations during the third year include Critical Care Rotations at our Allentown and Anderson campuses, surgical/trauma critical care, neuro critical care, dedicated research block, one month at the Temple pulmonary transplant center in Philadelphia, PA, and elective blocks (see below).

Throughout the fellowship, pulmonary & critical care medicine fellows will participate and present at multidisciplinary Thoracic Tumor Board, Clinical-Pathological-Radiographic case conferences, and multidisciplinary critical care conferences.


Elective

To accommodate fellow’s interests and advance professional goals, an elective experience can be arranged in radiology, interventional pulmonary, pathology, transplant pulmonary, cardiac critical care, advanced heart failure and pulmonary hypertension, burn critical care, neuro critical care, various internal medicine specialties (nephrology, infectious disease, etc), Ear-Nose & Throat physicians, and toxicology (with permission from the course director).


Moonlighting

Second and Third Year Fellows are permitted to moonlight with program director approval. Hours will count toward the maximum allowance of 80 hours per week, averaged over 4 weeks.


Research

Pulmonary & critical care fellows at St. Luke’s University Health Network are expected to complete and publish an original research project of their choice. Research blocks are in every year of training to allow continued progression of research projects. To advance fellow’s professional development and research experience, dedicated research faculty members provide additional support and expertise. Current faculty research interests interstitial lung disease, ventilator management and liberation, lung cancer, Post ICU Syndrome, complicated pleural space management, and venous thromboembolism.


Sample Rotation Schedule

PGY-4
Blocks Rotation Description
2 SLB Inpatient Pulmonary Inpatient PULMONARY rounding-procedures - Bethlehem Campus
2 Inpatient Pulmonary Inpatient PULMONARY rounding-procedures – Allentown & Anderson Campus – single rotation each
2 MICU Inpatient rounding & procedures at medical intensive care unit/Bethlehem
2.5 Night MICU Night ICU Coverage, admissions, & procedures at medical intensive care unit/Bethlehem Campus
2 SLB Outpatient Outpatient clinic & procedures at Bethlehem
1 Research Project development, IRB submission and approval, case reports
.5 SLEEP Sleep Medicine Rotation
1 BOOT Boot Camp Month – Orientation to each Campus, Respiratory Therapy, Radiology, Ultrasound, Procedure Labs, Core Lecture Series
PGY-5
Blocks Rotation Description
3-4 Research Data Acquisition, Data Analysis, Manuscript development
1 MICU Inpatient rounding & procedures at medical intensive care unit/Bethlehem Campus
1.5 Night MICU Night ICU Coverage, admissions, & procedures at medical intensive care unit/Bethlehem Campus
1 ICU Inpatient rounding & procedures at medical intensive care unit Allentown or Anderson Campus
1 SLB Inpatient Inpatient rounding & procedures at Bethlehem Campus
1 Inpatient Pulmonary Inpatient rounding and procedures at Allentown or Anderson Campus
1 Thoracic Thoracic surgery rotation at Bethlehem Campus
1 Interventional Interventional Pulmonary Rotation Bethlehem Campus
1 SLB Outpatient Outpatient clinic & procedures at Bethlehem
.5 Sleep Outpatient Sleep Medicine Rotation
1 Transplant Inpatient Transplant Rotation – Temple Lung Center
PGY-6
Blocks Rotation Description
1 Neuro Neuro ICU rotation – Bethlehem Campus
1 Trauma Trauma Surgical ICU rotation – Bethlehem Campus
2.5 Night Night ICU Coverage Bethlehem Campus
2 ICU ICU Daily Rounding & Procedures – Allentown Campus & Anderson Campus
1 Outpatient Outpatient Pulmonary Rotation - Bethlehem
3.5 Electives Burn ICU, CT Surgery, CHF Cardiology, IM Specialties, etc
2 Research Completion of projects, manuscript writing and submission