Today is Monday, Apr. 24, 2017

Department of Internal Medicine

Pulmonary, Critical Care and Sleep Medicine

Clinical Training & Education

Most fellowship training takes place at three facilities: UC Health University Hospital, Cincinnati Department of Veterans Affairs (VA) Medical Center and Drake Center.

Outpatient Experience

The division operates general outpatient pulmonary clinics as well as specialty clinics focused on specific pulmonary diseases.

All pulmonary fellows see clinic patients for at least one half-day each week, at University Hospital's pulmonary clinic or VA Medical Center's pulmonary clinic.

Typical diseases that are seen in the University Hospital clinic include chronic obstructive pulmonary disease, asthma, sleep disordered breathing, sarcoidosis, idiopathic pulmonary fibrosis and other interstitial lung diseases and occupational lung diseases.

The range of pathology seen in VA Medical Center pulmonary clinic is similar, but is more heavily weighted toward lung cancer, chronic obstructive lung disease and sleep disorders. Pulmonary faculty members are present to supervise patient care and provide instruction for students, residents and fellows.

The clinic experience is designed to instruct fellows in the approach to the pulmonary patient, including the integration of the history, physical examination, imaging, laboratory and pulmonary function data and synthesis of a coherent plan. Fellows also have the opportunity to attend any of the specialty clinics below on a continuous or rotating basis.

Specialty Clinics & Pulmonary Attendings

Asthma

Peter Lenz, MD

Adult Cystic Fibrosis

Patricia Joseph, MD
Bruce Trapnell, MD
Lisa Burns, MD

Interventional Pulmonology / Lung Cancer

Sadia Benzaquen, MD
Elsie Pina, DO

Pulmonary Rehabilitation

Ralph Panos, MD

Rare Lung Disease

Frank McCormack, MD
Bruce Trapnell, MD
Ralph Panos, MD

Interstitial Lung Disease

Frank McCormack, MD
Ralph Panos, MD
Markus Gutsche, MD

Sleep

Victoria Surdulescu, MD
Kenneth Casey, MD
Virgil Wooten, MD

Pulmonary Hypertension

Jean Elwing, MD

Inpatient Experience

Pulmonary inpatient consult services are provided at University Hospital and the VA Medical Center. These experiences are designed to teach fellows the diagnostic, management and procedural skills that are necessary to care for hospitalized patients with pulmonary disease.

Additional objectives are to provide the fellows with broad exposure to pulmonary pathology and to foster an appreciation for the clinical literature.

The consultation team consists of the attending pulmonary faculty, the pulmonary fellow and one or more medical residents and medical students. Consult fellows perform routine fiberoptic bronchoscopy including, brushing, lung lavage endobronchial biopsy and transbronchial biopsy.

Opportunities to gain experience in interventional bronchoscopy, including stent placement, medical pleuroscopy, cryotherapy and laser bronchoscopy, are available through the pulmonary service and cooperative efforts with thoracic surgery. Review of pathology specimens in conjunction with faculty of the Department of Pathology is an integral part of the training.

The University Hospital consultation service provides care to patients at all acuity levels and on a variety of services. For example, on a typical day, the fellow may perform a bronchoscopy on a patient with unexplained infiltrates and see a pregnant patient with dyspnea, a cystic fibrosis patient in exacerbation and a congestive heart failure patient on a ventilator in the CCU.

Discussions of the patient care and pertinent literature are held during daily rounds, which routinely include both impromptu and prepared didactic sessions.

On the VA Medical Center consultation service, the fellow gains enhanced experience in diagnosis and management of disorders such as carcinoma of the lung, tuberculosis, fungal infections and chronic obstructive lung disease. The fellow sees patients and advises house staff in conjunction with the attending pulmonary physician in a manner similar to that at University Hospital.

Fellows rotate through the Medical Intensive Care Unit (MICU) at both University Hospital and the VA Medical Center. Pulmonary faculty provide instruction on daily rounds, including both bedside teaching and didactic sessions. The fellow functions as a team leader, and with attending input, plays a key role in all management decisions.

In the University Hospital ICU, the fellows supervise four to five second- and third-year residents, and are expected to function primarily as consultants and teachers for the house staff. In the VA Medical Center ICU, the fellows supervise four to five interns and provide hands-on instruction and careful guidance to junior physicians engaged in their first experience of care for the critically ill. Both ICUs are closed units, and only pulmonary and critical care physicians serve as attendings.

In the University Hospital ICU, the ranges of pathologies that are seen are typical of an inner-city hospital. University Hospital also serves as a referral center for specialty care of critically ill patients with specific needs, such as liver transplantation or acute dialysis. In the VA Medical Center ICU, respiratory failure, GI bleeding and sepsis predominate. If they so choose, fellows may also rotate through other ICUs at University Hospital, including the surgical ICU, the neuro ICU and the burn unit.

Elective rotations are available in thoracic surgery, pathology, radiology and other services.

Drake Center is a 126-bed long-term acute facility located approximately seven miles from University Hospital. The pulmonary team, composed of an attending and a fellow, rounds on between 10 and 30 patients with a variety of chronic pulmonary and airway disorders, including up to 20 patients requiring mechanical or non-invasive ventilation.

Training in the management of the upper airway, including tracheotomy care and endoscopic evaluation, and in chronic respiratory failure due to obstructive and restrictive disorders, neuromuscular disease and stroke is provided.

CARE/Crawley Building

More Information

Academic Office:
University of Cincinnati | Division of Pulmonary, Critical Care & Sleep Medicine
231 Albert Sabin Way, ML 0564
Cincinnati, OH 45267-0564
Phone: 513-558-4831
Fax: 513-558-4858
Email: pulmonary@uc.edu

Pulmonary Fellowship Director:
Peter Lenz, MD,

Program Coordinator:
Bonnie Cartaya
513-558-3916
Email: bonnie.cartaya@uc.edu