Pediatric Pulmonary Medicine Clinical Training Requirements
Each Clinical Science Translational fellow has a total of 12 months of clinical time, divided over the three years of fellowship. In addition to inpatient service, clinical time includes learning the principles and interpretation of pulmonary function testing, exercise testing, bronchoscopy and polysomnography, and participation in clinic sessions each week.
Clinical experience will be acquired in a variety of settings, including:
- Inpatient: Primary management of inpatients with lung diseases, such as cystic fibrosis, bronchopulmonary dysplasia, asthma, dysphagia and aspiration, congenital malformations of the respiratory tract and disorders of ventilatory control. Fellows participate in rotation on the night and weekend call schedule for the Pediatric Pulmonary Service for 10 to 12 weeks per year (for all three years of fellowship) in weeklong blocks.
- Consultation: Consultation on inpatients, including those in the NICU, PICU and oncology units. The inpatient fellow typically covers all inpatient consultation requests while on service.
- Subacute care: Fellows have the opportunity to gain experience in pulmonary rehabilitation programs at Mt. Washington Pediatric Hospital and the Kennedy Krieger Institute with an emphasis on long-term respiratory care and home mechanical ventilation.
- Outpatient: Fellows are precepted to follow their own patients in a general pulmonary clinic for one half-day clinic session per week throughout the three years of fellowship when not on inpatient service. Fellows are also scheduled for an additional half-day cystic fibrosis clinic once a week for two months per year, and an additional half-day sleep clinic once a week for one month per year. Fellows may also attend other faculty-run clinics, including aerodigestive, asthma, ataxia-telangiectasia, bronchopulmonary dysplasia, congenital diaphragmatic hernia and neuromuscular clinics as well as additional cystic fibrosis and sleep clinics depending on their interests. Fellows are also involved with the preoperative evaluation and postoperative management of children undergoing lung transplantation.
- Intensive experience is provided in the pulmonary function, exercise and sleep laboratories. Fellows are assigned on a rotating basis to interpret these studies with faculty oversight.
- Fiberoptic flexible bronchoscopy, including bronchoalveolar lavage and transbronchial biopsies in infants, children and adolescents. The division performs approximately 200 procedures per year. Fellows receive training in the Johns Hopkins School of Medicine Simulation Center in a mock OR setting and with virtual bronchoscopy. Fellows are expected to complete 100 bronchoscopies during their fellowship.
- Electives are available through the departments of Anesthesia and Critical Care, Otolaryngology, and with other consultation services.
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