Training Programs

1) Combined Pulmonary Diseases and Critical Care Medicine (Three Years) -A training program in Pulmonary Diseases has existed at Tulane University Medical Center for more than forty years. The combined Pulmonary and Critical Care Fellowship was established and initially received ACGME accreditation in 1993 (most recent re-accreditation was in 2006). Three fellows are accepted each year. The goal of this three-year program is to prepare fellows for a successful clinical or academic career, depending on their vocation and choice. The first year of fellowship is usually devoted almost entirely to acquire a sound clinical experience. During second and third year fellows expand their knowledge and refine their skills to eventually become competent sub-specialists, able to function independently. A formal written curriculum guides fellows in acquiring knowledge through the framework of the six core competencies and foster personal growth. The typical rotations include:

First year: 4 months of MICU and 8 months of pulmonary consultation. This is a busy clinical year focusing on acquiring basic knowledge, a solid clinical experience and basic procedural skills. During this year fellows work under closer faculty supervision and – among other things - learn PFT interpretation, manage their own patients in their weekly continuity clinic.

Second and third year: at least 2 months of SICU, 1 month of Trauma, 4 months of MICU, 2 months of LTAC/pulmonary rehabilitation, 2 months of Sleep Medicine, 1 month of Pulmonary Transplant, 2 months of elective rotations and up to 12 months of research. The rotation schedule during second and third year is adjusted to individual preference, when possible. Fellows consolidate and expand their diagnostic and clinical skills, refine their interpersonal and educational skills, expand their procedural skills, and they gradually enjoy more autonomy in their leadership role while rotating in the ICU, while supervising the resident teams or their junior colleagues. The number of protected research months will be commensurate to interest in an academic career, productivity and scholarly achievements.

Fellows rotate in a variety of settings that include Tulane University Health Sciences Center, Southeast Louisiana Veterans Health Care System, Medical Center of Louisiana New Orleans and Kindred Hospital (all located in New Orleans). A MICU elective is available at West Jefferson Medical Center and Pulmonary Transplant at Ochsner Clinic. These different institutions provide opportunities to manage a diverse patient population.

First year fellows are expected to present and discuss a case at the Annual Tristate Thoracic Society Case Conference, usually in January. All fellows are expected to participate in scholarly activities and demonstrate productivity (at a minimum, an abstract presented at national specialty meeting). Tulane, in collaboration with Louisiana State University, has a General Clinical Research Center where fellows take a course on “Methods in Clinical Research”.

Conferences offered include weekly core curriculum lectures on pulmonary and critical care topics; weekly chest conference (focusing on chest radiology); weekly Department of Medicine grand round; weekly multidisciplinary tumor board conference; every other week pulmonary/critical care journal club; every other week sleep medicine conference or sleep journal club; weekly research conference (mandatory attendance once/month); monthly clinico-pathological conference. Quality assurance (M&M) conference is also given periodically.

Fellows are required to take a pulmonary/critical care in-service exam during their first/second year and a critical care in-service exam during their third year, in preparation for the board exams.

Outpatient training activities include a weekly continuity clinic at Medical Center of Louisiana New Orleans and at Southeast Louisiana Veterans Health Care System. Fellows also participate in the various subspecialty clinics that include Tuberculosis Clinic, Adult Cystic Fibrosis Clinic, Interstitial Lung Disease Clinic, Asthma Disease Management Clinic and the Comprehensive Sleep Medicine Clinic. While rotating through these specialized clinics, fellows enjoy 1:1 teaching from their faculty.

Some experience in interventional pulmonology is available for interested fellows through our interventional program. In the past, one extra year of training in Interventional pulmonology was offered, this is no longer the case.

The opportunity of one more year of training in sleep medicine is available, after completion of pulmonary/critical care training, for interested fellows.

Applications are accepted via ERAS every year from December to February. The fellowship program participates in the NRMP.

2) T-32 Training in Lung Molecular and Cell Pathobiology

A solid base of biomedical and basic molecular research in lung diseases has evolved at Tulane University. In 1992, as part of a campus wide strategic plan by Tulane to improve and modernize the lung research activities into the areas of cell and molecular pathobiology, Drs. Mitchell Friedman (Principal Investigator) and Arnold Brody (Co-Principal Investigator) were recruited to Tulane University Medical Center. Dr. Friedman as Professor of Medicine and Chief of the Section of Pulmonary Diseases, Critical Care and Environmental Medicine at Tulane University Medical Center. Dr. Brody as Professor of Pathology, Vice Chairman of the Department of Pathology at Tulane and Director of the Tulane Lung Biology Program. With the recruitment of Drs. Friedman and Brody a solid and highly competitive lung disease research program evolved into the highly collaborative Lung Biology Program at Tulane University. The individual faculty members of the Lung Biology Program represent two departments in the Medical School (Medicine and Pathology). Furthermore, critical interactive research programs have been developed between the Tulane Lung Biology Program and other research centers at Tulane including the Center for Gene Therapy, Department of Biomedical Engineering, Department of Pharmacology, and the Tulane Cancer Center.

The main research areas are in mechanisms of lung fibrosis, lung cancer, pulmonary circulation, asthma, COPD, gene therapy, and effects of inhaled toxicants on the lung and airway inflammation mechanisms. The rapid growth of research faculty and research projects in lung cell and molecular pathobiology at Tulane since 1992 has also been associated with the development of pre-doctoral and post-doctoral training activities. The wide range of research activities at the cell and molecular level in lung disease, the track record of achievement and training by the faculty, the development of excellent research experience for our trainees, the productivity of the faculty and trainees as evidenced by their publication record and grant funding and the fact that a number of trainees have obtained faculty positions serve as the basis for the T-32 training grant to offer funded formalized research training in lung cell and molecular pathobiology.

The main objective of this project is to train highly-qualified post-doctoral students in basic mechanisms of lung disease focusing on lung cell and molecular biology. Trainees in the Program, utilizing emerging technologies and new approaches, will acquire the necessary skills to design and conduct basic research studies in pathobiology. We have developed a formalized 2-year training program (a mentored laboratory research project and a formalized core curriculum) to prepare the trainees to develop a successful and independent academic career in research in lung biology.

3) Sleep Medicine (1 Year Program Post Residency/or PUD/CCM Training)

One fellow each year is accepted in this one-year training program and trained at the AASM-accredited Tulane Comprehensive Sleep Center. The fellow is supervised by faculty members that are board-certified in Sleep Medicine, is trained in polysomnogram interpretation and technical aspects of sleep medicine and sees patients in sleep clinic. Didactic activities include a “Sleep Medicine Lecture Series” that cover core curriculum topics in sleep medicine. There is also a monthly “Sleep Medicine Journal Club”. The sleep medicine fellow participates in teaching pulmonary/critical care fellows from Tulane University and Louisiana State University, who routinely rotate through sleep medicine as part of their training. Currently our sleep medicine fellowship is accredited by AASM and is applying for ACGME accreditation. Applicants must have completed an ACGME accredited fellowship preferably in Pulmonary/Critical Care. For more information regarding the Sleep Medicine Fellowship Program, please contact Supat Thammasitboon, M.D., Fellowship Program Director.

Clinical Programs

Interventional Pulmonology Program

Dr. Edmundo Rubio directs the Interventional Pulmonology Program and focuses on diagnosis and treatment of lung and pleural diseases with minimally invasive techniques.

Rigid bronchoscopy is routinely performed. Airway tumors are treated with laser therapy and cryotherapy. Airway stents are placed both through rigid and flexible bronchoscopy. A variety of procedures are performed, including thoracoscopy.

Under the umbrella of this program, all pulmonary/critical care fellows are also trained in percutaneous tracheostomy.

The Interventional Pulmonology Fellowship program, one of a handful in the country, begun with Dr. Martin Mayse (Yale) as the inaugural fellow in 2002-2003. Dr. Kathleen Williams ( University of Arizona) was selected as the next Interventional Pulmonology Fellow in 2003-2004. Dr. Maria Cirino (Tulane) finished her training for 2004-2005. Dr. Arthur Sung (Standford) completed his training 2005-2006. Although the interventional program is still active and accepts referrals from the Gulf South area, a specific fellowship training is no longer offered.

Currently the program has an interest in the use of Computerized Navigational Bronchoscopy and Endobronchial Ultrasound.

The program was initiated by Dr. Kevin Kovitz in the early 90s. Currently under the direction of Dr. Rubio, a disciple of Dr. Kovitz, the program continues to accept referrals.

Adult Cystic Fibrosis Program

Dr. Dean Ellithorpe is the Director of the Accredited Adult Cystic Fibrosis Center, that is part of the regional Cystic Fibrosis Program at Tulane and is partially supported by the Cystic Fibrosis Foundation. These clinics are the only separate program for adults in the Gulf South and have over 60 patients on the roster. The CF Team is composed of Dr. Dean Ellithorpe, Cheryle Donoghue, RN (Nurse Coordinator), Edith Gabor, RN (CF Research Nurse Coordinator and PORTCF Administrator), Colleen Sevin, RD (Adult CF Nutritionist), Ashley Belding, GSW (Social Worker), Jimmy Renfroe, CRRT, MBA (Respiratory Care Clinical Coordinator). Clinical research studies as well as collaborative Basic science research are conducted. (link to Adult CF Center).

Interstitial Lung Disease Program

This Program is directed by Dr. Lasky. This is the only clinic of its type in the Gulf South that is the referral source for patients with interstitial lung disease. The clinic will provide diagnostic aid and treatment protocols for patients with these problems. We are currently part of a several multi-center trials for new therapeutic agents in IPF.

Asthma Disease Management Program

Dr. Nereida Parada is the Director of the Asthma Management Clinic at Tulane University Health Sciences Center. Tulane and MCLNO lead a statewide asthma management effort. Dr Parada is board certified in Internal Medicine, Pulmonary Diseases, Critical Care Medicine and Allergy/Immunology.

Pulmonary Rehabilitation Program

Dr. Lasky directs the Pulmonary Rehabilitation Program at Tulane University Health Sciences Center.

Pulmonary Diagnostic Laboratory

Dr. Lasky directs an active Pulmonary Diagnostic Laboratory at TUHC that is equipped with state-of-the-art pulmonary function test equipment.

Adult Sleep Disorders Program

Dr. Houman Dahi is the director for the Adult Program in the only Accredited Comprehensive Sleep Center in Louisiana. Dr. Supat Thammasitboon, who trained in Sleep Medicine at Southwestern University in Dallas, Texas, is the sleep medicine fellowship program director. Tulane has a 6 bed Sleep Laboratory with 4 mobile units. Services have recently been extended to the Southeast Louisiana Veterans Health Care System.

Teaching opportunities

The Section is responsible for teaching students, residents and fellows. Students rotate through the various clinical services staffed by our faculty. In addition, our faculty contributes to the Junior Medical Clerkship Lecture series. Faculty and fellows participate in the Introductory to Clinical Medicine course for second year medical students and teach physical diagnosis. Dr. Simeone coordinates the pulmonary block of the T2 pathophysiology course and fellows have an opportunity to facilitate small group “problem-based learning” discussions. Resident teaching occurs both on the in-patient service, consultation, and critical care services. In addition, faculty and selected fellows give lectures in the Internal Medicine Resident's Lecture series.

GME Resources for House Officers

Sample Fellowship Contract