ELECTIVE ROTATION IN INTERVENTIONAL PULMONOLOGY
DIVISION OF PULMONARY, ALLERGY, CRITICAL CARE AND SLEEP MEDICINE
THE OHIO STATE UNIVERSITY
A one month elective in interventional pulmonology under the supervision of Dr. Shaheen Islam or other IP Faculty at The Ohio State University Medical Center in Columbus, Ohio.
Interventional pulmonology is a newly evolving specialty that embraces new technologies for the management of complex patients with an emphasis on multidisciplinary care. These involve diagnostic, therapeutic and palliative interventional methods of evaluation and treatment of patients with a variety of lung disorders within the pulmonary and critical care fields including central airway obstruction, pleural diseases and pulmonary complications of cancer. Although there is may be some exposure with the facets within the interventional pulmonology at some institutions, a well developed and structured rotation with a full complement of interventional pulmonology procedures may not exist and the infrastructure to teach such techniques may not be available at some centers. For fellows interested in learning these advanced procedures, this rotation will provide experience in this relatively new subspecialty of pulmonary medicine at an institution with a full range of interventional pulmonology services along with a high volume center, and an interventional pulmonologist experienced in teaching these specialized techniques, .
During this one-month elective, the assigned Fellow will work with the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine at The Ohio State University in the evaluation, management and follow up of inpatients and outpatients requiring interventional pulmonary procedures. The fellow will participate in interventional procedures along with the current OSU IP fellow in the bronchoscopy suite and in the operating room including but not limited to 1) Advanced diagnostic bronchoscopy including EBUS, Autofluorescence bronchoscopy, Electromagnetic navigational bronchoscopy, and Rigid Bronchoscopy in the operating room 2) Advanced therapeutic bronchoscopy and interventions including APC, electrocautery, cryotherapy, bronchial thermoplasty, Nd-Yag laser, balloon bronchoplasty and stent placement, 3)Pleural diagnostics and therapeutics including pleural biopsy, Pleuroscopy, pleural manometry, and pleural catheter placement, and 4) Complex airway management including airway stent placement or Nd-YAG laser resection, followup and management of tracheostomies. 5) Critical Care procedures such as percutaneous tracheostomies and critical care ultrasound.
The rotating IP fellow will participate in the IP procedures along with the current IP fellow at the OSU. The rotating fellow will also participate in didactic lectures, case conference, and journal club in conjunction with the pulmonary fellowship program at The Ohio State University. A simulation lab is also available for additional training in complex procedures.
During this elective, the Fellow will have no call responsibilities at OSU. The Fellow assigned will be expected to work and interact with all practitioners in a multidisciplinary environment.
(1 & 2) MEDICAL KNOWLEDGE AND PATIENT CARE: This rotation will provide the Fellow a dedicated month to concentrate on interventional pulmonary techniques. The main learning objectives for this rotation include :
• Evaluate and manage patients with complex airways, thoracic, and pleural disease.
• Recommend the most appropriate diagnostic and/or therapeutic procedure based on an understanding of accepted indications, contraindications, and additional diagnostic and therapeutic alternatives in the context of safety and timeliness.
• Demonstrate the ability to obtain an accurate and thorough preprocedure patient assessment including the identification of specific risk factors for each procedure
• Demonstrate the ability to minimize and manage anticipated and unanticipated complications
• Accurately identify, describe and communicate pertinent procedural findings.
• Develop an understanding of the required equipment, including maintenance and technical troubleshooting.
• Demonstrate the responsible use of resources for diagnostic testing and therapeutic interventions
• Obtain exposure to advanced diagnostic techniques, ablative techniques, and use of silicone and metallic airway stents.
The Fellow is expected to demonstrate the ability to provide patient care that is compassionate, respectful, timely, appropriate and effective at all times. During daily rounds and patient-care related conversations or didactic sessions, the Fellow is expected to demonstrate her/his ability to implement care that is reflective of the principles of current interventional pulmonary guidelines. This will also be assessed through the Fellow’s patient notes and orders.
(3 & 4) SYSTEM-BASED PRACTICE AND PRACTICE-BASED LEARNING: This rotation is intended to provide a direct and closely supervised experience in providing interventional pulmonary services in an Academic Medical Center. The Fellow will demonstrate awareness and understanding of the health care delivery system within The Ohio State University and the James Cancer Hospital. He/she should be able to demonstrate coordination of patient care, considerations of cost, feasibility and risk-benefit analysis and work within the multidisciplinary model in place for the care of this patient population. Throughout the rotation, he/she is expected to demonstrate his/her ability of independent critical thinking and self-assessment as judged by daily interaction with the supervising attendings.
(5 & 6) PROFESSIONALISM AND COMMUNICATION SKILLS: The Fellow is expected to behave and practice in a professional and ethical manner. He/she will demonstrate respect for patient confidentially and autonomy when appropriate while discussing medical care with patients and their families. The Fellow must demonstrate an ability to communicate effectively and professionally, both verbally and in writing, with the supervising attending, consulting physicians, nursing, respiratory staff and other members of the multidisciplinary team.
A standard Fellow’s evaluation form will be filled out at the end of the elective month by Dr Shaheen Islam of The Ohio State University either in electronic or paper form. The evaluation may completed in the format requested by the parent institution of the rotating fellow.This form includes ample space for individual comments to be added when appropriate. Dr. Islam, at his own discretion, may ask other members of the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine with whom the Fellow worked that month to also fill out an evaluation, or he may simply add their comments to his own.
A standard “rotation evaluation” form will be filled out by the Fellow at the completion of the elective month.
All evaluations become part of the general files of the Fellowship program and are reviewed by the Program Director monthly, and discussed in the aggregate with the Faculty and/or Fellows, as appropriate, no less frequently than every 6 months.
It will be the responsibility of the rotating fellow to arrange lodging during the elective month at Columbus. A suggested list of available temporary housing may be provided.
The rotating fellow must be eligible to obtain a limited training license from the Ohio Board of Medicine. A formal agreement will made by the primary