— College of Medicine — Department of Pediatrics — Divisions — Pulmonology and Sleep Medicine — Pulmonology Fellowship — Program Overview

Program Overview

Curriculum

Rotations based on 4 week blocks.

Year 1

The first year emphasis is on direct patient care, allowing the fellow to immerse themselves in the hands on practice of pulmonary medicine. The fellow has a weekly pulmonary continuity clinic, that continues throughout the fellowship. Seven months during the first year are spent on the inpatient/consultation service, during which time the fellow leads resident rounds and performs consults under the supervision of the attending. Two months during the first year are spent at a nearby pediatric long-term/transitional care facility. These months provide an opportunity for the fellow to gain confidence in the longitudinal care of children with chronic respiratory failure, including those who are tracheostomy and ventilator dependent. In addition to the teaching that occurs during clinical duties, a month of protected time is allotted to education on procedural skills and the interpretation of diagnostic studies. Lastly, protected time is allotted during the first year for the fellow to begin to develop their research project and connect with faculty who may serve as mentors for their research.

Year 2

The second year’s emphasis is on scholarly activity, with eight months devoted to research. The accessibility of pulmonary faculty, basic science researchers, and statisticians aids the fellow’s ability to pursue their research project. During the second year the fellow continues their weekly pulmonary continuity clinic, and spends four months on the inpatient/consultation service. Ongoing direct patient care ensures that clinical skills developed during the first year are retained while pursuing scholarly activity.

Year 3

The third year’s emphasis is divided between scholarly activity and direct patient care. The goal is to complete a scholarly activity project and ensure the fellow is competent with entrustable professional activities as defined by the American Board of Pediatrics. The year includes two months on the inpatient/consultation service, one month at the long-term/transitional care facility, and nine months on research/electives. Weekly pulmonary continuity clinic continues during the third year as well.

Didactic Hour (weekly)

Topics range from basic physiology to specific forms of pathology. Didactics are heavily driven by the fellows’ questions and areas of interest. Although faculty members may prepare a formal presentation, the didactic hour also serves as an open forum for discussion and questions. This intentional venue allows the fellows to appreciate style differences in the practice of pediatric pulmonology.

Journal Club (monthly)

Journal club is held off campus is a relaxed setting to discuss current literature. All of the fellows in the Department of Pediatrics meet quarterly to learn to critically evaluate research in all disciplines.

Pulmonary department meeting/Cystic fibrosis huddle (weekly)

This multidisciplinary meeting includes all ancillary personnel that participate in pulmonary/cystic fibrosis clinic. Currently admitted patients, interesting clinic patients, and upcoming cystic fibrosis clinic patients are discussed.

Difficult/Chronic Patient Discussion

This meeting occurs every other week and is a time for all providers to get together and discuss chronic (most technologically dependent) children and develop a plan for care going forwards. Fellows are active participants in this conference and are responsible for presenting the patients and their issues.

Airway Conference (monthly)

A collaborative conference with pediatric otolaryngology and pediatric radiology. Brief case summaries are presented by resident/fellow trainees in each department followed by an open forum discussion.

Clinical Research Symposium

All incoming fellows at the University of Nebraska Medical Center participate in a week-long conference that lays the foundation for participating in research. Topics include, but are not limited to: designing studies, grant writing, IRB applications, and statistics. This conference also allows the fellow to make contact with individuals who can provide support services for their research project.

Bronchoscopy Course

During the first year arrangements are made for the fellow to attend the flexible bronchoscopy course taught by Dr. Robert Wood at Cincinnati Children’s Hospital. This long standing course is considered the standard of pediatric bronchoscopy and laryngoscopy.

National Conferences

A national conference is financially supported each year. Fellows are by no means limited to one national conference a year. Other sources of funding for conference attendance may be procured if the fellow wishes to attend additional conferences, especially if presenting their research.

Patient Management Conference (weekly)

All faculty and trainees are invited to this weekly resident led conference. The conference is geared towards the education of the general pediatric residents. Fellows are expected to present once each year. The format typically involves a case presentation followed by a formal review of the pathology identified.

Resident Noon Conference

Informal conference with the general pediatric residents and medical students rotating on pediatrics. The fellow is expected to present once each year.

Resident Rounds (daily)

Time is allotted to daily rounding with the resident team caring for the pulmonary inpatients. This time allows the fellow to develop their teaching skills. During the inpatient clinical months, the fellow is able to work with individual pediatric residents so that he/she can adapt their teaching style to the needs of the resident.

Simulation with M3s

Fellow leads case studies in the simulation lab teaching third year medical students.

Research

The research portion of the fellowship occurs predominantly in the 2nd and 3rd years of training. Fellows will have significant protected time to pursue their scholarly activity. The American Board of Pediatrics defines scholarly activity in broad terms and could include bench research, clinical research, education and quality improvement initiatives. UNMC has many resources to help fellows with their research projects. The division has access to 3 full-time research assistants. There are many ongoing clinical trials that fellows are encouraged to explore. The Learning and Leadership Collaborative (LLC) meets monthly to work on Quality Improvement (QI) initiatives. Faculty within the division are eager to serve as mentors for fellows during their pursuit of scholarly activity. The fellow’s project is overseen by a Scholarly Oversight Committee (SOC)

The Child Health Research Institute is an innovative partnership between UNMC and Children's launched to change - and save - young lives. CHRI is a valuable tool to help fellows coordinate research opportunities.