Pulmonary/Critical Care Fellowship Rotations
Boston Medical Center - Brighton
Our three-year Pulmonary and Critical Care Fellowship provides a comprehensive balance of clinical training, procedural expertise, and research experience. Fellows rotate through a wide range of inpatient and outpatient settings, gaining exposure to diverse disease processes while developing the skills to become expert clinicians, educators, and scholars.
Year One: Foundations in Pulmonary and Critical Care
The first year is divided equally between two core experiences:
- Inpatient Pulmonary Consult Service
- Medical Intensive Care Unit (MICU)
Fellows rotate in two-week blocks and complete additional rotations in Sleep Medicine and Long Term Acute Care Facility in the ventilator weaning unit.
Clinical Exposure Includes:
- Obstructive lung diseases (asthma, COPD, bronchiectasis, cystic fibrosis)
- Pulmonary infections (tuberculosis, fungal, immunocompromised hosts)
- Interstitial lung disease and sarcoidosis
- Pulmonary hypertension and occupational lung disease
- Pleural and mediastinal disorders
- Acute respiratory failure and ventilator management
- Sleep disorders and neuromuscular respiratory failure
- Multisystem critical illness including sepsis, metabolic, and hematologic emergencies
Procedural Training:
- Airway management and endotracheal intubation
- Mechanical and noninvasive ventilation
- Arterial and central venous catheter placement
- Pleural drainage via thoracentesis, chest tube, and tunnel pleural catheter placement
- Diagnostic bronchoscopy
- Pulmonary function testing and interpretation
- Cardiopulmonary resuscitation and cardioversion
Fellows also attend a half-day continuity clinic each week throughout all three years under dedicated faculty supervision.
Year Two: Advanced Procedures and Critical Care
In the second year, fellows expand their procedural expertise and broaden their critical care experience.
Clinical Rotations:
- Pulmonary Procedure Service – Develop mastery in advanced bronchoscopy (including EBUS and navigational bronchoscopy), thoracentesis, chest tube placement, and cardiopulmonary exercise testing.
- Surgical Intensive Care Unit – Manage complex postoperative patients, including cardiothoracic, neurosurgical, and general surgical cases.
Year Three: Leadership and Clinical Mastery
The final year focuses on consolidating clinical skills and cultivating leadership and teaching abilities.
Key Experiences:
- Advanced clinical rotations in:
- Pulmonary Hypertension (including right heart catheterization)
- Lung Transplantation (one-month rotation)
- Electives tailored to fellow interests (e.g. additional outpatient rotations, sleep medicine, procedural training)
- Pre-Attending MICU rotation: Senior fellows lead rounds under faculty supervision, developing autonomy, teaching, and leadership skills.