Clinical Training and Research

The fellowship program strives to train well-rounded physician utilizing CPMC’s support of research endeavors, state-of-the-art training equipment and dedicated pulmonary continuity clinics.

Clinical Training Overview

Our fellowship program prides itself on the clinical skills training of its fellows. As a tertiary referral center and a high-volume county medical center, CPMC and Highland Hospital, respectively, provide more than adequate experience for fellows in procedural skills necessary to succeed as a pulmonary critical care physician.

Interventional Pulmonology/Advanced Bronchoscopy service: 

A unique strength of our pulmonary fellowship program is a renowned interventional pulmonology consult service. Without a dedicated IP fellowship program at CPMC our fellows become not only well versed in the standard-of-care flexible bronchoscopy and endobronchial ultrasound bronchoscopy but also are exposed to and experienced with rigid bronchoscopy, airway stenting and endobronchial valve placement, thoracoscopy, indwelling tunneled pleural catheter placement, etc. In 2021, the CPMC Van Ness Campus purchased the Ion Robotic Bronchoscopy System and fellows will have numerous opportunities to train with this navigational modality to diagnose, localize peripheral pulmonary nodules.

Fellow Procedure Type Count 7/2019 - 6/2022 

Funded Projects 

Our fellowship program has also benefited from the support of the CPMC graduate medical education office and philanthropic grants to further fellows training. In addition to the benefits and salary listed elsewhere, the following projects have been funded in the past five years:

• Office renovation to accommodate fellowship program expansion.
• Additional workstation on wheels for ICU rounding, dual monitors for desktops, and sit-to stand ergonomic desks.
• Handheld ultrasound equipment for pleural diagnostics and semi-invasive procedures.
• Difficult airway, central line and bronchoscopy training models, mannequins.
• Textbook upgrades for fellows’ office.
• Online ACCP/ATS annual meeting registration and membership coverage.
• UCLA-Harbor CPET course training for first year fellows.

Pulmonary Clinic

First year fellows are paired with a pulmonary attending and mentor at Highland Hospital  for their continuity clinic on Tuesday afternoon. This general pulmonology clinic experience provides exposure to patients with a wide array of advanced pathologies, many of whom have not had access to regular medical care. During their pulmonary medicine rotation at Highland fellows also will have the opportunity to participate in a multi-disciplinary tuberculosis clinic managing complex cases of MDR and XDR tuberculosis on Wednesday afternoons.

For their continuity clinic experience, second year fellows will manage their own weekly general pulmonary patient panel at SF Lung and Sleep medicine (located in the medical office building across the street from the VNC Hospital), under attending supervision.

Third year fellows have the opportunity to choose to continue managing their general pulmonology patient or focus in a particular area of pulmonary medicine with an attending faculty mentor. Subspecialty areas of focus include sleep medicine, pulmonary nodules/lung cancer, pulmonary hypertension, obstructive lung disease, interventional pulmonary, and interstitial lung disease.

CPMC and SF Lung are home to the nationally-accredited CPMC Adult Cystic Fibrosis Center, which holds multidisciplinary clinic twice a month on Tuesday afternoons. Fellows will have the opportunity to learn about the complex care of CF patients alongside clinic staff including pulmonologists, nutritionists, social workers, physical and occupational therapists, and mental health specialists.

Research

Through a dedicated team at Sutter Health’s Institutional Review Board and CPMC Research Institute the pulmonary and critical care division has numerous active research endeavors. Fellows are encouraged to identify a research mentor early in their first year of fellowship and will spend their 6.5 to 9 months (if elective time is used) to further their projects. The graduate medical education office supports fellows by offering to cover the cost of biostatistics courses at UCSF and holding an annual CPMC research award conference, and an annual stipend of $2000 for national or international research conference attendance.

Current Research Projects

• Comfort Care: An analysis of medication utilization an time to death in comfort care extubations
• Interventional Pulmonology: A prospective registry of cryobiopsy
• TREAT-CHF: Tunneled Pleural Catheters in refractory heart failure effusions. 
• SEER-Lung: Prospective protein based biomarkers in patients with pulmonary nodules
• Robotic bronchoscopy: retrospective analysis on safety efficacy and diagnostic yield of Robotic bronchoscopy in a community hospital.
• Carotid ultrasound: utilization of bedside velocity time integral calculation volume responsiveness assessments