Clinical Curriculum

Overview

Year I

The first year of fellowship focuses heavily on developing clinical expertise in pulmonary and critical care medicine. This year is clinically rigorous, but it is here that fellows discover how to diagnose and manage the vast array of pulmonary diseases that we see at Cleveland Clinic. In this year, fellows also master skills specific to pulmonary/critical care including bronchoscopy, bedside ultrasonography/echo and intubation. The first year is a pivotal time for fellows to explore the multiple academic opportunities available and begin developing mentored relationships (a key aspect of our program) in preparation for their scholarly work.

Year II

The second year of fellowship focuses on two key elements; leadership and scholarship. The early portion of the year is geared towards refining the core skills learned in year one and providing each fellow with clinical leadership experience. Thereafter, fellows begin to set the cornerstone for future scholarship by choosing a personalized clinical focus and academic track. The clinical and academic track with emphasis on the mentorship experience follows each fellow into their third year and is key to our mission of graduating physicians equipped to be leaders in medicine. During the second year, our fellows also participate in our Quality in Leadership (QuiL) curriculum, combining principles of quality improvement and leadership through a longitudinal team-based quality project.

Year III

The third year focuses on continuing scholarship and applying this to a career in pulmonary/critical care medicine. In addition to continued research, education, and individualized clinical training in accordance with each fellow’s academic track plan, fellows should expect to publish, present work at a national meeting, and network with national and international experts. These opportunities form the foundations for what our program strives to achieve: fellows who graduate with a passion for sustained scholarly pursuit who are recognized as emerging thought leaders in their respective area of interest.

Academic Tracks

In the second and third year of fellowship, each fellow will have the opportunity to choose from one of several prespecified academic tracks, and then customize their choice based on their individual interests and career plans. Each track allows a fellow to pursue a deeper focus on a specific area of pulmonary/critical care through academic inquiry and enhanced clinical training. Fellows choose a mentor whom they work alongside to define specific scholarly aims. These aims can vary depending on the long-term career objectives of each fellow, but universally, the academic tracks serve to give fellows advanced training and expertise in a particular aspect of pulmonary and critical care medicine. Any of the clinical areas can be adapted to research career plans, clinical career plans or a combination of the two. Research opportunities include funded biomedical research, clinical research, quality research, and educational research.

• Advanced Lung Disease/Transplant
• Pulmonary Vascular Disease
• Airways Disease (Asthma/COPD)
• Interstitial Lung Disease
• Cystic Fibrosis/Bronchiectasis
• Lung Cancer/Advanced Bronchoscopy
• Neuromuscular Respiratory Disease
• Occupational and Environmental Lung Disease
• Critical Care

Academic Track Example

During their first year, fellows work closely with program directors to carefully select a faculty mentor and scholarship track. The mentor/fellow relationship is the foundation of our track system and starts with the mentor and fellow designing a personalized curriculum to optimize the use of elective blocks for research, education, and focused clinical training.

Ambulatory Clinics

Longitudinal Clinic

The outpatient clinic focuses on teaching evidence-based approaches to outpatient evaluation and management and on delivering world-class care to patients with a wide array of pulmonary diseases. Except during ALD and MICU months, fellows have ½ day of clinic each week, continuing throughout their three years of fellowship. In the first year, fellows have one rotation in outpatient specialty clinics, where they rotate among different subspecialty areas to get a basic understanding of those areas and to recruit a diverse patient panel to their continuity clinics. Fellows assume the role of the patients’ primary pulmonologist and also benefit from supervision by on-site faculty who do not have additional patient care responsibilities during the time they are with the fellows.

Specialty Clinics

During the second and third year of the fellowship, fellows may electively participate in specialty clinics as a rotation or in a longer-term, longitudinal fashion. Specialty clinics offer fellows a unique opportunity to see patients who have been referred to Cleveland Clinic from around the world for specialty care and to work alongside faculty who are leaders in their respective field. Specialty clinic opportunities exist in Interstitial Lung Disease, Sarcoidosis, Lung Cancer, Cystic Fibrosis, Non-CF Bronchiectasis, Interventional Bronchoscopy, COPD, Asthma, Lung Transplantation, Pulmonary Vascular Disease, Occupational and Environmental Lung Disease, Sleep Medicine, and Neuromuscular Disease. 

Simulation Center

Simulation in medical education enables learners to practice necessary skills in an environment that allows for errors and professional growth without risking patients' safety. Cleveland Clinic’s 10,000-square-foot Simulation and Advanced Skills Center (SASC) is at the cutting-edge of simulation training. Simulation-based teaching is built into the educational curriculum of our fellowship program. As part of their orientation, we train incoming fellows in bedside procedures, ICU ultrasound and echo, and basic airway skills, using high-fidelity simulators and clinical grade technology. Additionally, on an annual basis we offer courses on advanced airway management, hemodynamic assessment, ECMO, mechanical ventilation, and tracheostomy care.