Core Curriculum

Objectives

All fellows are expected to maintain certification in basic and advanced cardiopulmonary resuscitation. Arrangements are made every 2-3 years for group BCLS/ACLS refresher training.

Pulmonary Diseases

After completing training, fellows are expected to: 

• Diagnose and manage obstructive lung disease.
• Diagnose and manage pulmonary malignancies, including primary and metastatic cancers.
• Diagnose and manage pulmonary infections due to all causes.
• Diagnose and manage pulmonary infections that occur in the immunocompromised host.
• Diagnose and manage diffuse interstitial diseases.
• Diagnose and manage pulmonary vascular diseases such as pulmonary vasculitis, pulmonary hemorrhage, pulmonary embolism, and pulmonary hypertension.
• Diagnose and manage occupational disorders.
• Diagnose and manage diseases due to drugs and radiation therapy.
• Diagnose and manage pulmonary diseases associated with connective tissue disorders.
• Diagnose and manage pleural space problems due to infection, neoplasms, and pneumothorax.
• Diagnose and manage inherited pulmonary diseases such as a1 antitrypsin deficiency and cystic fibrosis.
• Know the indications for and management of lung transplantation.
• Interpret chest x-rays, chest computed tomography, ventilation perfusion scans, and pulmonary angiograms.
• Assess pre-operative risk.
• Assess disability related to pulmonary diseases.
• Understand the pharmacology of drugs commonly used in patients with pulmonary diseases.
• Manage chest wall deformities.
• Manage neurological and muscular disorders affecting ventilation.

Critical Care Medicine

After completing training, fellows are expected to: 

• Diagnose and manage acute respiratory failure due to all causes.
• Manage ventilators and know the proper use of different ventilator modalities.
• Know the indication for and proper use of non-invasive ventilator modalities.
• Wean patients from mechanical ventilation.
• Diagnose and manage sepsis.
• Know the proper management of airway in intubated and non-intubated patients.
• Intubate with a laryngoscope and with a bronchoscope.
• Manage enteral and parenteral nutrition.
• Measure and interpret arterial blood gases and central venous pressures.
• Measure and interpret hemodynamics studies.
• Know the proper sedation of awake and intubated patients.
• Know the proper use of paralytic agents.
• Measure and interpret outcomes in the medical intensive care unit.
• Manage renal and electrolyte problems in critically ill patients.
• Know the proper management of blood transfusions and transfusion reactions.
• Know the proper management of hemostatic disorders.
• Manage anaphylaxis and acute allergic reactions.
• Manage postoperative patients and complications.
• Diagnose and manage nosocomial pneumonia.
• Assess and manage psychosocial and emotional issues of critically ill individuals and their families.
• Understand clinical, economic and legal aspects of the care of critically ill patients.
• Understand obstetric and gynecologic disorders.
• Understand the pharmacology of drugs commonly used in critically ill patients.
• Manage chest trauma.
• Manage drug overdose.
• Diagnose and manage gastrointestinal hemorrhage.
• Diagnose and manage acute and life-threatening endocrine and metabolic derangements.

Sleep disease

After completing training, fellows are expected to: 

• Diagnose and manage sleep disorders, particularly obstructive sleep apnea.
• Preliminary interpretation and polysomnographic and nap studies.
• Diagnose and manage problems related to CPAP and BiPAP therapy.
• Diagnose and manage sleep diseases other than obstructive sleep apnea.
  

Procedures

After completing training, fellows are expected to: 

• Perform bronchoscopy with endobronchial biopsy, transbronchial biopsy, bronchoalveolar lavage, bronchial washing, and transbronchial needle aspiration.
• Intubate with a laryngoscope and with a bronchoscope.
• Ventilate patients with a bag or mask.
• Know the proper administration of oxygen.
• Be capable of performing pericardiocentesis.
• Be capable of performing and interpreting pleural fluid drainage and pleural biopsy.
• Insert chest tubes and perform pleurodesis of the pleural space.
• Insert Swan-Ganz catheters, central venous catheters, and arterial catheters and know how to properly calibrate hemodynamic monitoring equipment.
• Insert transvenous pacemakers.
• Be capable of performing arterial puncture and interpreting blood sampling.
• Be capable of performing cardioversion.
• Be capable of performing emergent tracheostomy.
• Understand the indications for hemodialysis and peritoneal dialysis.
• Understand the indications for peritoneal lavage.
  

Pulmonary Physiology and Immunology

After completing training, fellows are expected to: 

• Interpret spirometry, bronchodilator studies, diffusing capacity, lung volumes, flow volume loops, and bronchial provocation tests.
• Perform and interpret exercise studies.
• Interpret bronchoalveolar lavage studies.
• Know the indications for immunization against pulmonary diseases.
• Calculate and interpret oxygen content, delivery, and consumption.
• Have knowledge of pulmonary pathology and interpretation of lung and pleural biopsy material.

Basic Science and Clinical Research

After completing training, fellows are expected to: 

• Identify a clinical or a basic science research problem.
• Develop experimental methods.
• Understand simple concepts of protein analysis and purification.
• Understand simple molecular biological principles and techniques.
• Design clinical or basic science research studies.
• Interpret data and statistical problems related to research studies.
• Prepare and submit grants to seek funding.
• Prepare manuscripts for publication.