Clinical Training

Clinical Rotations
Pulmonary & Critical Care Medicine Fellowship Program


University Hospital

Pulmonary Fellows

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.

 


 

Hackensack University Medical Center


Intensive Care Unit
The Critical Care unit at HUMC is a 20 bed unit (combined CCU and ICU) with 24-hour critical care attending presence.  HUMC is home to the highly regarded John Theurer Cancer Center, and fellows will become experienced in oncologic critical care including post-bone marrow and stem cell transplant patients during their time in the ICU. Fellows will also have exposure to a broad range of critical illnesses including septic shock, ARDS, complications of malignancies, obstructive lung disease, pulmonary vascular disease, gastrointestinal, renal and electrolyte disorders. Trainees have ample opportunity to hone their procedural skills in this ICU. In addition, fellows will have the opportunity to care for patients on veno-venous ECMO. Fellows will also supervise and teach Hackensack University Medical Center IM and EM residents during their ICU rotations.

 

Pulmonary Consultation
Trainees will work with highly skilled pulmonologists and gain exposure to the full spectrum of pulmonary diseases including asthma, bronchitis, pneumonia, malignancies, interstitial lung diseases, and pulmonary vascular disease.  Fellows will perform flexible bronchoscopy under the supervision of HUMC faculty.  In addition to routine bronchoscopy, the fellow will become experienced in endobronchial ultrasound, navigational bronchoscopy, robotic-assisted bronchoscopy, and ultrasound-guided pleural procedures in the HUMC Bronchoscopy Suite. In addition to routine pulmonary function testing, the HUMC Pulmonary Lab has a comprehensive Exercise Physiology Lab, and trainees will become skilled in the performance and interpretation of cardiopulmonary exercise tests.

 


 

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


Medical Intensive Care Unit
The ICU is a combined 8-bed 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.

 


 

Saint Barnabas Medical Center


The NJMS PCCM fellowship expanded to Saint 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 St Barnabas Medical Center, leads the pulmonary rotation. See what they have to say about our partnership below.



The pulmonary experience includes inpatient consultation and performance of pulmonary procedures including EBUS and navigational bronchoscopy in a state of the art, fully equipped procedure suite. Fellows will also have a unique opportunity to learn about the care of adult patients with Cystic Fibrosis in an outpatient setting. Other services 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 SBMC pulmonary faculty here: 
https://www.rwjbh.org/saint-barnabas-medical-center/treatment-care/lung/pulmonary-services/meet-our-pulmonary-team/

Over the next two years the PCCM fellowship will begin to transition fellows from HUMC to SBMC. This shift has been planned in detail and with consideration of ongoing mentoring and research relationships between fellows and faculty. The addition of SBMC 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.