The goal of our pediatric pulmonology fellowship program is to provide didactic training for pediatric physicians to prepare them for a career in academic pulmonary medicine. Our core curriculum is structured such that the majority of clinical training will occur during the first year, allowing fellows to focus on research training during the second and third years.
Fellows will engage in specific training experiences according to the career path selected during their first year. The three career paths offered by our program include a clinician educator track, a clinical research track, and a bench research track.
Core Curriculum
While the specific career path will differ between fellows, all fellows will complete a core curriculum. This curriculum is designed to foster the clinical skills and knowledge needed to prepare fellows for subspecialty certification and the care of their future patients. The core curriculum also introduces the foundations of research.
Year One
During their first year of fellowship, trainees primarily focus on clinical training. This includes inpatient care rotations at CHOA at Egleston. During this time, fellows will care for patients admitted to the pulmonary medicine service, as well as perform consultations and bronchoscopies. Fellows will be expected to cover the service during the daytime and be first call at night when they are on service. They also take weekend call. Other clinical rotations during the first year include sleep medicine, pulmonary physiology (including pulmonary function testing), and pulmonary practice with our colleagues at CHOA’s Scottish Rite campus (including both inpatient and outpatient experience). Fellows will also have opportunities for selective rotations during their first year, including allergy immunology (required 4 weeks during fellowship), ENT, PICU (strongly encouraged), anesthesia (encouraged), NICU, and interventional bronchoscopy. Other elective options may be chosen with approval from the program director. Additionally, fellows will be required to spend time in a variety of ambulatory clinics, including general pulmonology, adult and pediatric cystic fibrosis, apnea/sleep, pulmonary/sickle cell, aerodigestive, lung transplant, interstitial lung disease, technology dependent, and high risk asthma clinics. Near the middle of their first year, fellows will have one research rotation where they will visit various labs/mentors and, in collaboration with the program director and division chief, choose a fellowship track. This decision will help tailor subsequent training to meet the fellow’s individualized goals.
Years Two and Three
During the second and third years of fellowship, fellows devote more time to research activities. 75% of their time (9.5-10 modules) is reserved for focused research training. At the start of their second year, each fellow will be expected to prepare a project proposal to present to their scholarship oversight committee (SOC), which is identified at the end of their first year and includes their research mentor, division chief/program director, and 2 other faculty members, at least one of whom is outside the division and one of whom must have a PhD. Based on the recommendations of the committee, fellows will prepare and submit a competitive grant application to an appropriate institution, the funding of which will not impact their position within the fellowship. In addition, fellows will be scheduled for some clinical experiences, including the inpatient pulmonary medicine service at Egleston, CHOA at Scottish Rite, sleep medicine/pulmonary function, ambulatory, and selectives. The primary expectation during the second year is to begin to accumulate data so that, during the third year of fellowship, trainees will be able to analyze their data and share their research through conference presentation and manuscript preparation/submission. Throughout their fellowship, fellows will involve themselves with journal clubs, research seminars, fellows’ conferences, and pediatric chest rounds.
Continuity Clinic
Notably, during all rotations throughout their three years of training, fellows will attend their own general pulmonology continuity clinic, which will be scheduled for 1 clinic session per week. Approximately once monthly, they will be assigned a cystic fibrosis clinic, as well as a technology dependent, sleep, or other pulmonary sub-specialty clinic.
Lectures
The didactic curriculum includes department fellow courses, such as introductory research, ethics, and teaching courses, as well as division journal clubs and research seminars. Clinical lectures will be provided in fellows’ conferences and pediatric chest rounds on a weekly basis. Attendance at these courses and lectures is expected of all fellows. Additionally, fellow attendance at resident lectures, pediatric ground rounds, and conferences within other divisions (particularly critical care medicine and infectious diseases) are encouraged. Fellows are also expected to provide clinical lectures to residents. During research rotations, fellow attendance at PACS research seminars, as well as those of their lab mentor, is expected. Additionally, fellows will present their on-going project results and future proposals to their committee bi-annually.
Mentoring
Fellows will meet regularly with the fellowship director. A career path will be selected during the first year of training. Each fellow will have a scholarship oversight committee according to the career path identified for that fellow. This mentoring committee consists of the fellow’s primary mentor (selected by the fellow and agreed upon by the program director), the program director or division chief, and two additional faculty members. One member of the mentoring committee will come from a different division. Committee meetings will be held at regular intervals to ensure the continued success of the fellow.
Specialty Paths
The following paths are designed to ensure that we prepare fellows in training for a career in academic pulmonary medicine and the parallel faculty career paths many universities offer. We recognize that not all fellows will know which career path they want to pursue, particularly during their first year. These paths are designed to be easily tailored to an individual fellow’s needs and are not binding. Clinical Educator Path
The clinical educator path is designed for physicians who want to focus their careers on clinical patient care and the education and mentoring of trainees (medical students, residents, and fellows). In addition to the core curriculum requirements, elective coursework on effective teaching strategies and presentation skills will be encouraged. In addition, fellows pursuing this path are expected to engage in activities which promote child advocacy and enhance the overall quality of patient care. Research projects may include clinical outcome studies related to selected medical therapies or patient care deliver.
Clinical Researcher Path
The clinical research path is designed for physicians who want to focus their careers on clinical research. Given the complex nature of human research, particularly with regard to research ethics, study design and analyses, fellows pursuing this track will be encouraged to complete a fourth year of fellowship training. In addition to the core curriculum requirements, fellows will complete coursework in clinical research ethics, biostatistics, and clinical research design and analysis. Fellows will also be encouraged to attend seminars on research grant writing skills. Research projects may include epidemiological studies of disease, clinical outcomes-based research, characterization studies, and clinical trials (recommended for fourth-year fellows only).
Bench Researcher Path
The bench research path is designed for physicians who want to focus their careers on basic or translational science. Like the clinical research path, the bench research path requires additional coursework beyond what is offered in the core curriculum and may entail a fourth year of fellowship training. Elective coursework in the basic sciences (e.g., cell biology, biochemistry, molecular physiology) is encouraged. Fellows will be encouraged to attend seminars on research grant writing skills. Fellows pursuing this track will have the opportunity to visit several laboratories and learn a variety of bench laboratory techniques. Research projects may include animal or translational research related to airway physiology, cellular structure and function, and molecular mechanisms of redox signaling and lung inflammation.