Fellow Expectations

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All fellows in Pulmonary and Critical Care Medicine are expected to achieve excellence in the following core competencies at the completion of 3 years of training:

Medical Knowledge

Demonstrate knowledge of the evolving pathophysiological (basic and clinical sciences), epidemiological, and behavioral sciences in pulmonary and critical illness and the application of this knowledge to patients.  This includes critical assessment of the literature and scientific method applied to that literature, evidence-based decision making and life-long learning.

Practice-based Learning and Improvement

Develop skills to assess care of patients and identify areas needing improvement in their own practice of pulmonary and critical care medicine.  Additionally, the fellow will identify interventions to improve care of patients and assess the outcomes of those interventions.

Patient Care

Provide comprehensive, compassionate, and appropriate care to patients with a wide variety of pulmonary and critical illness.  This includes the appropriate use of diagnostic and therapeutic tools below:

·        Perform and document history & physical examination

·          Formulate differential diagnosis

·          Obtain and document informed consent

·          Perform pulmonary artery catheterization

·          Order appropriate consults

·          Understand the role of the pulmonary & critical care physician as a consultant to other physicians

·          Perform arterial catheterization

·          Interpret hemodynamic parameters in critically ill patients

·          Perform diagnostic flexible fiberoptic bronchoscopy

·          Interpret chest radiographs and CT images of the chest

·          Interpret therapeutic drug levels for antibiotics and other drugs

·          Understand the basic fundamentals of sleep polysomnography interpretation

·          Interpret pulmonary function tests including spirometry, lung volumes, diffusing capacity, and methacholine challenge testing

·          Interpret cardiopulmonary exercise testing

·          Perform orotracheal and nasotracheal intubation

·          Perform basic and advance cardiac life support

·          Manage mechanical ventilation in acute and chronic respiratory failure

 

·          Request continuous renal replacement therapies when appropriate

·          Perform electrical cardioversion

·          Perform transcutaneous cardiac pacing

·          Order continuous sedatives and analgesics in the critically ill

·          Perform monitored conscious sedation for invasive procedures

·          Perform intravenous anesthetic induction for intubation

·          Manage complex fluid and electrolyte disorders

·          Perform intravenous thrombolytic therapy

·          Order appropriate pharmacologic therapy for management of circulatory shock and related disorders

·          Order parenteral nutrition during critical illness

·          Perform emergency pericardiocentesis

·          Perform thoracentesis

·          Perform pleural biopsy

·          Perform tube thoracostomy

·          Perform therapeutic bronchoscopy

·          Perform bronchoscopy with transbronchial biopsy

·          Perform emergency cricothyrotomy

Interpersonal and Communication Skills

Demonstrate interpersonal and communication skills that facilitate an effective physician-patient relationship as well as exchange of information and relationships with other health professionals and the community at large.

Professionalism

Fellows will demonstrate professional and ethical behaviors in the practice of medicine including demonstrating respect of others, recognition of the diversity of others including race, age, gender, religion, etc. This also includes timely, accurate, communications with other health care professionals, ethical and accurate record keeping and business practices, and participation in professional development as well as participation in required conferences and other educational programs.

Systems-based Practice

Fellows will demonstrate understanding of the various patterns of health care delivery and the role of the physician in those systems and the utilization of resources to provide care of patients with pulmonary and critical illnesses.

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