Training & Curriculum

Fellows in the Cedars-Sinai Pulmonary and Critical Care Fellowship supervise medical house staff members and students assigned to the units. Emphasis is placed on learning evidence-based principles of management and on highlighting the pathophysiologic aspects of conditions or treatment modalities.

Fellows will learn both the theoretical and practical aspects of all procedures relevant to the care of critically ill patients (including ICU ultrasounds) and will gain strong experience in neurological, trauma and general surgical ICU care. Participants can also rotate through a variety of other critical care units—including the Cardiac ICU, Cardiac-Surgical ICU, Anesthesiology, Pediatric ICU, Dialysis Unit, etc. 

Fiberoptic bronchoscopy is performed by the fellow under the supervision of one of the staff. Fellows perform more than 200 bronchoscopies during their fellowship. These procedures, as well as needle aspiration biopsies, are performed in the pulmonary/critical care division procedure rooms. In addition, Cedars-Sinai is a major center for yag laser resection therapy, insertion of stents, use of brachytherapy and other state-of-the-art devices, such as navigational bronchoscopy, EBUS and percutaneous tracheostomy. 

This is an intense, 1-month rotation intended for second- and third-year fellows. During this rotation, fellows will be part of a multidisciplinary team consisting of faculty from anesthesia critical care, pulmonary and critical care, and cardiothoracic surgery. In addition to actively managing patients undergoing traditional cardiac surgery, fellows will gain exposure and experience in ECMO, heart/lung transplant, ventricular assist devices, total artificial heart, TAVR, Impella and intra-aortic balloon pumps.

Our fellows work in a variety of outpatient clinical settings. These include a meaningful weekly continuity clinic held at the Southern California Kaiser Permanente location and through various Cedars-Sinai ambulatory facilities. Specialty clinics include lung transplant, cystic fibrosis, pulmonary hypertension, interstitial lung disease and sleep clinics.

Fellows provide pulmonary consultation for the Cedars-Sinai medical and surgical teaching services, as well as other participating hospitals when rotations are held there. During this period, our fellows will supervise medical house staff and students in the pulmonary elective.

Working in the Pulmonary Laboratory at participating institutions under the supervision of the full-time lab director, fellows learn performance, calculation and interpretation of pulmonary function tests. The physiologic evaluation of patients includes spirometry, lung volumes by dilution and plethysmographic techniques, diffusion, mechanics and blood-gas analysis. In addition, the lab is equipped for sophisticated exercise and other special studies.

Fellows will see patients during the biweekly lung transplant clinic. Patients are evaluated as possible candidates for lung transplantation or treated for care following a lung transplant. Fellows are primarily responsible for transplant patients admitted to the medical center, and each fellow is trained in all aspects of pre-transplant, perioperative transplant and transplant management. They'll also be able to participate in procurement procedures.

As of June 2014, we have rolled our critical care program into our combined pulmonary and critical care program.