Clinical Rotations
Pulmonary & Critical Care Medicine Fellowship Program

University Hospital

Medical Intensive Care Unit
The MICU at University Hospital is a high acuity unit where fellows will gain first-hand experience in managing complex, critically ill patients, with an increasing level of autonomy as they advance in their training.   Fellows are integral to daily multidisciplinary rounds, as well as for medical student and resident education and supervision.  The ICU is busy with rapid turnover, admitting patients with septic shock, ARDS, obstructive lung diseases, acute stroke and other neurologic emergencies, gastrointestinal hemorrhage, acute and chronic liver disease, complications of malignant disease, metabolic crises, as well as endocrine emergencies.  UH is home to a liver transplant program and comprehensive stroke center. Fellows are trained in a variety of critical care procedures, including central venous catheters, arterial lines, thoracentesis, paracentesis, lumbar puncture, endotracheal intubations, chest tubes, and bronchoscopy. All fellows receive extensive training in point-of-care ultrasound, and can choose to pursue training in advanced critical care echocardiography if interested.  A seasoned Palliative Care Team is a key part of the MICU, and fellows will become adept at providing empathetic end-of-life care. Fellows have nighttime ICU rotations at UH, under faculty supervision, during which time they attain additional independence and confidence in their critical care abilities.

Pulmonary Consultation and Pulmonary Physiology
Trainees, in conjunction with Pulmonary and Critical Care faculty, will assess and help manage inpatients with a wide variety of acute and chronic respiratory illnesses. Requests for consultation come from all services within the hospital, including Medicine, Surgery, Surgical subspecialties, Psychiatry and Obstetrics-Gynecology ensuring that fellows become well versed in a wide range of pulmonary conditions.  Fellows will become experts in pulmonary physiology and interpretation of pulmonary function tests. The fellow will learn to perform flexible bronchoscopy, including transbronchial biopsy, endobronchial biopsy, transbronchial needle aspiration, bronchoalveolar lavage, and endobronchial brushing, under conscious sedation as well as general anesthesia and are also trained in endobronchial ultrasound (EBUS) and navigational bronchoscopy. Fellows will also directly supervise and educate medical students and residents who are on their pulmonary elective.

Tuberculosis Consultation
Pulmonary fellows, supervised by faculty from the Global TB Institute, are consulted when Tuberculosis and other pulmonary mycobacterial diseases are either suspected or confirmed. Fellows have the opportunity to gain expertise in diagnosis and management of patients with TB, often in the setting of other complex illnesses.

VA New Jersey Health Care System – East Orange VA Medical Center

Intensive Care Unit
The ICU is a combined MICU/SICU, providing an opportunity in multidisciplinary intensive care. Fellows are active in providing all aspects of ventilator management, as well as supervising and performing procedures, evaluating patients for admission, and educating NJMS residents and medical students who are rotating at the VA. Faculty include both medical and surgical critical care specialists.

Pulmonary Consultation
Fellows provide inpatient pulmonary consultation and gain exposure to a wide variety of respiratory illnesses. Fellows gain experience in a broad range of procedures, including endobronchial ultrasound (EBUS).  A fully equipped Pulmonary Lab provides standard pulmonary function testing, as well as impulse oscillometry, mannitol challenge testing and cardio-pulmonary exercise testing. In addition, fellows become well versed in Sleep Medicine in the VA’s state of the art Sleep Center.

Pulmonary Outpatient Rotation
During this rotation PCCM fellows will have ample opportunity to engage with Veterans in an outpatient setting, and gain a rich understanding of chronic respiratory illnesses, including sleep disorders, lung cancer, pleural diseases, obstructive lung disorders and interstitial lung diseases.

Cooperman Barnabas Medical Center

The NJMS PCCM fellowship expanded to Cooperman Barnabas Medical Center in July 2021. Fellows have experiences in both pulmonary and critical care medicine, taking advantage of several unique opportunities alongside highly skilled and expert faculty. The intensive care unit rotation includes care of complex patients with medical, surgical and neurosurgical conditions. Fellows are an integral part of the multidisiplinary critical care team. The ICU is led by Dr. Fariborz Rezai who has additional expertise in neurocritical care medicine and ICU structure and administration. Dr Kristin Fless, the division director of pulmonary medicine at CBMC and current acting chief of medicine, leads the pulmonary rotation, with Dr. Elena Burke acting as the fellowship site director.

The pulmonary experience includes three distinct experiences to give fellows the chance to experience a wide range of what is offered at CBMC. The fellows are an integral part of the busy inpatient consultation service and have the opportunity to perform varied pulmonary procedures including EBUS, navigational bronchoscopy, robotic bronchoscopy, and pleural procedures in a state of the art, fully equipped procedure suite. Fellows also have the unique opportunity to learn about the care of adult patients with cystic fibrosis in an outpatient setting. Other services that the fellows are involved in include pulmonary rehabilitation, cardiopulmonary stress testing, and a sleep lab. Fellows are guided by faculty with expertise in sleep medicine, pulmonary physiology, lung cancer, interventional pulmonology and much more. Please read more about the CBMC pulmonary faculty here: 
https://www.rwjbh.org/saint-barnabas-medical-center/treatment-care/lung/pulmonary-services/meet-our-pulmonary-team/

The addition of CBMC and its expert faculty to our program further strengthens the fellows' clinical experience. Each clinical site complements the other and together provide a comprehensive and diverse experience.