Frequently Asked Questions – Pulmonary Disease and Critical Care Medicine Fellowship St. Elizabeth Youngstown Hospital
1. How long is the fellowship and what is the overall breakdown of clinical time?
The Pulmonary Disease and Critical Care Medicine fellowship is a 36-month program. Out of these three years, 31 months are devoted specifically to clinical experiences.
2. What is the structure of the critical care rotations?
Fellows complete a total of 15 months of intensive care unit experiences throughout the program, with an average daily census of 14 patients per fellow. This critical care time is divided into six months caring for critically ill medical patients (such as in the MICU and CICU) and nine months caring for critically ill non-medical patients (including the Surgical ICU, Burn Unit, and Lung Transplant).
3. What pulmonary disease rotations are required?
The program provides 10 months of dedicated experience in pulmonary disease, distributed among pulmonary consults (4 months), pulmonary physiology and sleep medicine (3 months), and pulmonary subspecialty clinics (3 months).
4. What is the continuity clinic experience like?
Fellows participate in a continuity clinic at the Pulmonary Health & Research Center, attending one half-day session per week for the duration of the program and seeing an average of six patients per session. Outpatient training is highly integrated, offering subspecialty exposure to interstitial lung disease, lung nodules, and a post-ICU recovery clinic that addresses the long-term sequelae of critical illness.
5. Will I have to travel for any rotations, and is support provided?
Yes. There are a few geographically distant rotations designed to provide specialized clinical experiences, including a one-month advanced heart failure and lung transplantation rotation at The Ohio State University Hospital and a burn rotation at the Akron Children's Hospital Burn Unit. To ensure this does not burden fellows, the institution provides housing accommodations at no cost, mileage reimbursement, and excuses fellows from overnight call immediately before travel.
6. What is the call structure for the program?
The program utilizes a night float system rather than traditional 24-hour in-house call. Night float fellows are physically present in the hospital overnight to provide continuous care, ensuring that no fellow works extended consecutive shifts and that adequate rest is maintained. All schedules are strictly designed to comply with ACGME requirements, including the 80-hour maximum work week limit.
7. What are the primary didactic conferences required for fellows?
The program features a robust core curriculum conference series, including a monthly Pulmonary/Critical Care Case Conference, a monthly Journal Club, a multidisciplinary Morbidity and Mortality Conference, and Core Medical Education Lectures. Fellows are also expected to prepare and present at least one formal conference per year of training under the guidance of a faculty mentor.
8. What happens if I miss a required conference due to clinical duties?
The program ensures equitable access to the curriculum by recording or detailing summaries of all educational conferences. Presentation slides and key articles are stored in a secure digital repository. Fellows who miss a session due to clinical duties or approved absences can review the recorded materials later.
9. Are there opportunities for research and scholarly activity?
Yes. Fellows participate in a monthly Research Seminar where they learn study design and data analysis, and present and critique projects. The block schedule incorporates dedicated Research (R) blocks, particularly in the second and third years of the program, to allow focused time for scholarly activity.
10. What simulation training is available?
Incoming fellows receive formal instruction in invasive and bedside procedures at the program's Simulation Lab and Education Center. Before performing procedures on actual patients, fellows practice using simulation and task trainers to master skills including:
- Bronchoscopy
- Robotic-assisted navigation biopsies and ultrasound-guided lymph node assessment for cancer evaluation and staging (EBUS)
- Central and arterial line placement
- Advanced airway management