PCCM Program Details

Clinical Rotations

UF Health Shands:

  • MICU
  • Pulmonary Consult Service
  • Lung Transplantation and Advanced Lung Disease

Regional VA Medical Center :

  • MICU
  • Consult Service

Training Program Summary

22 clinical months

  • 1 month each: cardiothoracic, neurology and surgical ICUs
  • 2-3 months at Orlando Regional Medical Center multisystem ICU
  • 1-2 months of lung transplantation and advanced lung disease
  • 3-4 months each of ICU and pulmonary consult service at VA medical center
  • 3-4 months each of MICU and pulmonary consult service at Shands Hospital at University of Florida
  • 14 months of research and elective time

First year of training includes eleven clinical months. Fellows receive orientation and procedure simulation training at the start of fellowship. Education by our dedicated chest radiologist also occurs in the first year.

MICU and Inpatient Pulmonary Consultation Services

An active consultation service is present at each hospital. The fellow will spend 4 months on the Shands Hospital consult service and 4 months combined VA Medical Center consult and MICU service over the course of the fellowship. While at the VA, the fellow will also participate in the Lung Mass Clinic. Pulmonary function tests are reviewed and interpreted by the fellow and faculty on the consult service. Bronchoscopic and pleural procedures to further evaluate in-patient consults are performed by the fellow and faculty on the consult service. The fellow will have the opportunity to teach residents and students doing a pulmonary medicine elective while on the consult service.

During the fellowship, the fellow will rotate through the MICU service at Shands Hospital for 4 months and the VA Medical Center MICU for 4 months. The fellow is responsible for performing or supervising procedures such as intubation, central line placement, Swan-Ganz catheter placement, arterial line placement, and chest tube placement. The fellow supervises and teaches the housestaff on the MICU rotation. In the third year of fellowship, the fellow will spend time in SICU, Neuro ICU, and advanced lung ICU.

For 3 months during the fellowship, the fellow will rotate on the lung transplant and advanced lung disease service. While on this service, the fellow will have the opportunity to evaluate patients for lung transplantation and to provide care for those patients who have undergone lung transplant. The fellow will also have exposure to management of the patient with advanced lung disease.

Fellows will rotate on the sleep medicine and pulmonary diagnostics rotation for 3 months during their fellowship. While on this rotation, the fellows will interpret polysomnograms. In addition, fellows will supervise and interpret methacholine challenge tests and cardiopulmonary exercise tests under the guidance of the faculty on the consult service.

Shands Pulmonary Consultation

The inpatient pulmonary Shands consult rotation includes the workup, evaluation, and management of patients with pulmonary disorders while hospitalized.

VA Pulmonary Consultation

The inpatient pulmonary VA consult rotation includes the workup, evaluation, and management of patients with pulmonary disorders while hospitalized.

UF Health Shands MICU

The UF Health Shands MICU rotation includes the workup, evaluation, and management of critically ill patients with predominantly medical conditions. Patients seen during this rotation have a wide variety of common and uncommon medical critical care disorders involving one or more organ systems.

Advanced Lung Disease & Lung Transplantation

The advanced lung disease and lung transplantation rotation includes the workup, evaluation, and management of patients who have advanced lung disease and who have undergone lung transplantation.

VA MICU

The VA MICU rotation includes the workup, evaluation, and management of critically ill patients with predominantly medical conditions. Patients seen during this rotation have a wide variety of common medical critical care disorders involving one or more organ systems. Patients may have acute critical illness or more chronic critical illness.

Outpatient Services

Afternoon clinics at Shands Hospital at the University of Florida and Gainesville VA medical center are staffed by the faculty and fellows of the Pulmonary, Critical Care, and Sleep Medicine Division. Fellows have one-half day clinic a week at Shands throughout the fellowship. This permits exposure to a variety of subspecialty clinics, including cystic fibrosis, pulmonary hypertension, lung mass and interstitial lung disease, Alpha-1 antitrypsin, and rare lung diseases. First and third year fellows also attend the VA Medical Center Clinic one-half day per week, which serves as a general pulmonary continuity experience. During the second year of fellowship, the fellows spend one-half day a week in the sleep medicine clinics, six months at Shands and six months at the VA. When on the Pulmonary Consult Service at Shands Hospital, fellows assist the attending in seeing urgent outpatient consults.

Shands Pulmonary Outpatient Clinics

The Shands pulmonary outpatient rotation includes the workup, evaluation, and management of patients with pulmonary disorders in the outpatient setting. Patients seen during this rotation have a wide variety of common and uncommon pulmonary diseases.

VA Pulmonary Outpatient Clinics

The VA pulmonary outpatient rotation includes the workup, evaluation, and management of patients with pulmonary disorders in the outpatient setting. Patients seen during this rotation have a number of common pulmonary diseases, particularly obstructive lung disease, interstitial lung disease, and neoplastic lung disease.

Special Rotations

Each fellow spends 2 months during the third year of fellowship in the Shands Hospital Surgical Intensive Care Unit/Burn Unit under the supervision of the Anesthesia/Critical Care Medicine Service. On this rotation, the fellow is exposed to care of the critically ill post-operative, neurologic injury and trauma patients in the Surgical ICU. Cardiothoracic surgery and ICU exposure is also provided including the opportunity to harvest donor organs and assist with lung transplantation and lung resection surgeries. Fellows experience multisystem ICU patient management on rotations at Orlando Health, a tertiary referral center in downtown Orlando, FL. Housing is provided and fellows participate in patient care and educational activities with medical critical care faculty members and fellows.

Elective rotations are also available in diagnostic radiology with a chest radiologist and cardiac catheterization.

Each fellow is provided block time for research and is required to investigate an area of pulmonary or critical care medicine. Both clinical and basic science research experiences are available. Preparation and presentation of a research project is a required aspect of this training program and the preparation and submission of a manuscript is highly encouraged. The program provides training in the areas of study design, performance, statistical analysis, writing, and editing. Each fellow will select and be supervised by a faculty mentor in the conduct of their project after their first year.

All of our Pulmonary/Critical Care Medicine fellows rotate through the state of the art Neuro ICU run by board-certified Neuro-intensivist. The Neuro-intensivist also offers a one and two year training program accredited by the UCNS (United Council of Neurological specialties). To find more information about their fellowship, please visit: http://neurology.ufl.edu/divisions-2/neurocritical-care/neurocritical-care-fellowship-at-the-university-of-florida/

Research

All fellows are expected to provide evidence of scholarly activity per ACGME and Program requirements as part of completion of their fellowship training. This rotation provides for relative protected time to assist in accomplishing these goals.

UF Health Shands SICU

The UF Health Shands SICU rotation includes the workup, evaluation, and management of critically ill patients following surgery and trauma. Patients seen during this rotation have a wide variety of common and uncommon surgical critical care disorders involving one or more organ systems.

Anesthesia

The Anesthesia rotation is fifteen days in duration and is intended to provide the fellow with necessary cognitive and technical skills to manage the airway of patients in need of assisted ventilation. In addition,fellows are expected to gain familiarity with issues arising from use of induction agents, paralytics, andairway devices.

Cardiothoracic Intensive Care Unit (CTICU)

The UF Health Shands CTICU rotation includes the workup, evaluation, and management of critically ill patients with cardiothoracic disorders of predominantly a surgical nature and critically ill postoperative cardiothoracic patients.

Orlando Regional Medical Center MICU

The Orlando Regional Medical Center MICU rotation includes the workup, evaluation, and management of critically ill patients with predominantly medical conditions. Patients seen during this rotation have a wide variety of common medical critical care disorders involving one or more organ systems.