Pulmonary Disease and Critical Care Medicine Fellowship

The Division of Pulmonary, Critical Care and Sleep Medicine at Saint Louis University School of Medicine offers a three-year combined ACGME-accredited comprehensive subspecialty training program that addresses all aspects of pulmonary disease and critical care medicine.

Pulmonary Disease and Critical Care Medicine Training

The program combines vigorous didactic instruction with diverse educational experiences. The subspecialty program consists of 36 months of clinical training. Rotations at SSM Health Saint Louis University Hospital include the medical intensive care unit, consultative pulmonary medicine, anesthesiology service and pulmonary function, exercise and sleep laboratories.

The clinical facilities of the hospitals together with excellent laboratory research space and a challenging intellectual environment provide an ideal setting in which to obtain clinical and research training in the diagnosis and treatment of patients with disorders of the respiratory system and in multidisciplinary critical care medicine.

All Saint Louis University graduate medical education programs are ACGME-certified including the pulmonary disease and critical care medicine specialty program.

Curriculum

Rotation Schedule

The clinical rotations are devoted to training in the diagnosis and management of patients with a broad spectrum of pulmonary diseases and acute multisystem disorders. Training occurs in the following areas:

Rotations PGY-4 PGY-5 PGY-6
Medical ICU Two months Two months Two months
Pulmonary Consults Two months Three months Three months
MICU Night Float Two months One month  
Ambulatory One month One month One month
PFT and exercise lab One month    
Anesthesia/airway  One month    
Mercy MICU  One month    
Neuro/Trauma ICU   One month  
eICU    One month  
Sleep Clinic     One month 
SLU SICU     One month 
Elective  Two months Three months   Four months

 

Medical Intensive Care Unit (MICU) Service

The MICU Service provides 24-hour comprehensive care to patients with life-threatening or potentially life-threatening medical illnesses of all major organ systems. Over the past six years our MICU service has expanded to three teams to provide higher quality and competent care of patients. Working closely with the MICU service attending physician, the three assigned MICU fellows are the team leaders for the monthly rotation block-assigned medical residents and will direct and actively participate in patient care including performance and supervision of all ICU-related invasive procedures.

Pulmonary Consultation Service

Under the mentorship of the attending physician, fellows are responsible for directing the internal medicine residents and student team assigned to the Pulmonary/Critical Care Consultation Service in addition to providing pulmonary consultations directly during this month-long rotation.

Ambulatory Pulmonary Clinic

Fellows gain experience in the outpatient management of a broad diversity of respiratory disorders. Longitudinal patient follow-up and new referrals are seen one half-day per week in the pulmonary clinic, located in the ambulatory care center across the street from SSM Health Saint Louis University Hospital. Each fellow also rotates through the Adult Cystic Fibrosis subspecialty clinic during their fellowship training.

Adult Cystic Fibrosis Clinic

Ravi Nayak, M.D., directs the adult cystic fibrosis clinic, which is sponsored by the Cystic Fibrosis Foundation. This clinic offers each fellow the opportunity to participate in the ambulatory management of adult patients with cystic fibrosis.

Polysomnography and Sleep Disorders Center

Fellows receive training in the diagnosis and evaluation of diverse sleep disorders in conjunction with divisional faculty. Aspects of training include taking a comprehensive sleep history, establishing the differential diagnosis of respiratory-related sleep disorders (e.g. narcolepsy, periodic leg movements, schedule-related disorders, insomnia and excessive daytime sleepiness), and reviewing polysomnograms with faculty. Saint Louis University is accredited by the American Sleep Disorders Association (ASDA).

Teaching and Communication Training

Fellows develop communication skills on ward rounds, ICU rounds and at various educational conferences. Fellows teach second-year medical students physical diagnosis of the chest during two afternoon sessions of the Phase II Respiratory Module curriculum.

Fellows are expected to write and submit for publication the results of their research projects under the guidance of their faculty advisors. Ample opportunity is given to present data at national meetings. Individuals completing the laboratory investigations or clinical investigation research track are well trained in research techniques related to pulmonary diseases and critical care medicine. Competence will be gained in intensive care medicine, consultative chest medicine as well as the ability to compete successfully for research funds and academic positions in pulmonary disease medicine or critical care medicine.

Supervision and Patient Care Duties

Each resident on rotation and in clinics is directly supervised at all times by an attending teaching physician who is responsible for teaching, reviewing patient care and monitoring duties. Residents are responsible for patient care in the hospital and outpatient clinics. Residents participate in direct patient care and in consultation to other physicians. Residents engage in continuity of care experiences with outpatient care.

Pulmonary Disease and Critical Care Medicine Conferences

  Monday Tuesday Wednesday Thursday Friday
Week 1 Research meeting PCCM Divisional Conference PCCM Core  Curriculum  Chest Radiology Conference

A.M.: IM Grand Round

P.M.: Board Review Thoracic Cancer Tumor Board

Week 2 Journal Club PCCM Divisional Conference PCCM Core Curriculum Multidisciplinary Chest Conference

A.M.: IM Grand Round

P.M.: Board Review Thoracic Cancer Tumor Board

Week 3 CPET Case Discussion

A.M.: Director/Fellow Meeting

P.M.: PCCM Divisional Conference

PCCM Core Curriculum Chest Radiology Conference

A.M.: IM Grand Round

P.M.: Board Review Thoracic Cancer Tumor Board

Week 4 Ultrasound Conference PCCM Divisional Conference

A.M.: QI Conference

P.M.: PCCM Core Curriculum

Multidisciplinary Chest Conference

A.M.: IM Grand Round

P.M.: Board Review Thoracic Cancer Tumor Board

 

Weekly Conferences

Pulmonary Disease/Critical Care Medicine Divisional Conference

Grand Rounds, Topic in Review and Research presentations are given by faculty and fellows from our division, faculty from the Department of Internal Medicine and faculty from various departments and divisions throughout Saint Louis University School of Medicine as well as visiting professors and speakers.

Course Director: Ravi Nayak, M.D.
Tuesdays at 12 p.m.

Pulmonary Disease/Critical Care Medicine Core Curriculum Conference

This conference is divided into the following areas: Pulmonary Anatomy and Physiology Course, Pulmonary Diagnostics Course, Pulmonary Pathology Course and Pulmonary Therapeutics Course. Division faculty as well as guest speakers present pertinent topics in these areas.

Course Director: Joseph Espiritu, M.D.
Wednesdays at 12 p.m.

Internal Medicine Grand Rounds

The Division of Pulmonary, Critical Care and Sleep Medicine is responsible for presenting four lectures throughout the year at the Internal Medicine Grand Rounds. Three are presented by current faculty members. The fourth is a national guest speaker who presents at the Annual Dr. Herbert Sweet Memorial Lecture (first Friday in October).

Fridays at 7:30 a.m.

Thoracic Cancer Multidisciplinary Tumor Conference

Fridays at 12 p.m.

 

Biweekly Conferences

Multidisciplinary Chest Radiology Conference

Thoracic imaging cases presented.
Course Director: Nadeem Parkar, M.D.
First and third Thursday of each month at 12 p.m.

Multidisciplinary Chest Conference

Fellows currently on pulmonary consult rotation present cases and a group discussion is held by conference attendees.

Course Director:  Soophia Naydenov, M.D.
Second and fourth Thursday of each month at 12 p.m.

Monthly Conferences

Journal Club

Articles presented by fellows followed by discussions.
Course Director: Sadashiv Santosh, M.D.
Second Monday of the month at 12 p.m.

CPET of the Month

Interesting case presented by fellows followed by discussion.
Course Director: Soophia Naydenov, M.D.
Third Monday of the month at 12 p.m.

Ultrasound Conference

Course Director: Zafar Jamkhana, M.D.
Last Monday of the month at 12 p.m.

Director/Fellows Meeting

Monthly meeting between program director and fellows.
Course Director: Ravi Nayak, M.D.
Third Tuesday of the month at 7:15 a.m.

QI Conference

Course Director: Zafar Jamkhana, M.D.
Fourth Wednesday of each month at 7 a.m

Application Process

The Saint Louis University School of Medicine Pulmonary Disease and Critical Care Fellowship accepts applications via Electronic Residency Application Service (ERAS) only and we participate in The National Resident Matching Program (NRMP). Applications for the Fellowship are accepted annually beginning July 15.

We do accept candidates with J-1 visas and H-1B visas.

All required documents must be submitted before your application will be reviewed for interview consideration.

Required documents:

  • ERAS Application
  • USMLE or COMLEX-USA Transcript
  • Medical School Transcripts
  • MSPE (Dean's Letter)
  • Three Letters of Recommendation
  • ECFMG Status Report
  • Personal Statement

If you are selected for an interview, you will receive an invitation to interview via your ERAS email account. All interviews will take place between Aug. 15, 2017 and Nov. 3, 2017. All interviews will be conducted on Tuesdays and Fridays only.