Pulmonary and Critical Care Fellowship

Overview

Loyola University Medical Center has a fully accredited and highly competitive three-year combined Pulmonary and Critical Care Fellowship Program with a total complement of 12 clinical fellows. It offers a comprehensive program of quality patient care, research and education. Our program’s strength lies in the large and varied patient base, the variety of clinical experiences offered and a faculty dedicated to teaching.

Our fellows rotate through three institutions during the course of their fellowship:

  • Loyola University Health System provides a broad range of patient experience with approximately 1,000 acute care beds of which 150 are adult intensive care beds. The University hospital is rated as having the highest patient acuity level in Illinois. The lung transplantation program is one of only seven programs to have performed over 500 transplants. We have an active Sleep Center and perform over 1,300 sleep studies. We have a growing Interventional Bronchoscopy program that performs stenting, laser endobronchial ultrasound and brachytherapy.
     
  • Edward Hines VA Hospital is the largest in the Midwest and is a referral base for other VA hospitals. Large patient base with obstructive lung disease and lung cancer. We have a growing interventional bronchoscopy program with navigational bronchoscopy and endobronchial ultrasound available.
     
  •  RML Specialty Hospital is a community-based long-term acute care facility that provides chronic care to patients with complex medical issues and patients needing prolonged mechanical ventilation.

The fellows are trained to be skilled physician-scientists through intense clinical exposure and several months devoted to research. Fellowship strength in critical care medicine lies in its vast resource of critically ill patients, active critical care research by faculty members, and close teaching affiliation with other specialties.

Goals and Program Content

The subspecialty fellowship program in both pulmonary disease and critical care medicine will provide training and supervised experience at a sufficient level to acquire the competency of a specialist in both disciplines. The combined training program is 3 years in duration of which 18 to 24 months are devoted to clinical training.

  • The clinical experience in pulmonary disease will include opportunities to observe and manage inpatients and outpatients with a wide variety of pulmonary disorders. Fellows will have the opportunity to assume continuing responsibility for acutely and chronically ill patients in order to learn the natural history of pulmonary disease, as well as the effectiveness of therapeutic programs. There will be an educational emphasis on pulmonary physiology and its correlation with clinical disorders.
     
  • The training in critical care medicine will provide at least 12 months of meaningful patient care responsibility in critical care units. At least six of these months will be devoted specifically to the care of critically ill medical patients. Trainees will obtain additional clinical training with experiences in neurosurgical, cardiac, cardiothoracic, high-risk pregnancy and transplantation intensive units. The trainee will have opportunities to assume responsibility under appropriate supervision for the care of patients throughout their stay in critical care units and to monitor the subsequent course of patients throughout the remainder of their hospital stay. The fellow will acquire skills required to organize, administer, and direct a critical care unit and work effectively as a member of a multidisciplinary team.
     
  • The combined fellowship provides trainees with exposure to quality improvement measures in each special care area and enables each fellow to become familiar with billing and coding issues and practice management.

Clinical Overview

Critical Care Services

The medical ICU at Loyola and at the Edward Hines, Jr. VA Hospital comprises the two critical care services. The Fellow oversees the care of these patients and is responsible for the teaching and guidance of residents and students on the critical care service. There are two MICU services at LUMC : MICU A and MICU B.  An intensivist is present on some nights with the fellows taking call from home on the other nights. On weekends the 2 MICU fellows rotate call and the Hines MICU fellow rotates call with the Hines pulmonary consult Fellow. 

Pulmonary Consultation Services

The Fellow is responsible for consultations and procedures. This service will have 1-2 residents and 1-2 students. The Fellow is responsible for interpreting pulmonary function tests. Supervision is provided by the consultation attending for the month. The Fellow also attends the Tuesday morning Thoracic Oncology Clinic at the Cardinal Bernadine Cancer Center and the Thoracic Oncology clinic and conference held at the VA on alternate Tuesday afternoons.

Sleep Medicine

There are very busy sleep labs in both hospitals. Loyola has 8 beds and the VA has 4 beds. Training will include reading sleep studies, attending sleep clinics and conferences. 

Lung Transplantation

Loyola University Chicago Medical Center has one of the most active lung transplantation programs in the country. The Pulmonary Division directs all pre- and post- operative care of these patients. The Fellow has an opportunity to care for these patients and familiarize themselves with the challenges of immunosuppression and lung rejection.

Ventilator Service

The Division provides a ventilator management service to patients at RML Specialty Hospital located in Hinsdale, Illinois (10 miles from the main medical center). Fellows will have a 2-4 week rotation during which they will learn about chronic respiratory failure and weaning. Fellow will round daily with a Pulmonary and Critical Care faculty member. 

Trauma Surgery

Each Fellow spends 1-2 months as part of a trauma surgery team. The Fellow participates in daily rounds and in the management of trauma patients. There is extensive exposure to surgical critical care in this rotation.

Thoracic Surgery ICU

Fellows assigned to the cardiothoracic ICU work with the anesthesia residents and are responsible for the immediate postoperative care for patients undergoing CABG, thoracic resection and lung transplant.

Night Float

Fellows are assigned to an in-house 12 hour shift to cover the MICU at Loyola from 7 PM to 7 AM for 6 shifts a year. In the first year these shifts are with the nocturnal intensivist. In the second and third year fellows are on call independently.  They are responsible for guiding and assisting the residents regarding new admissions and managing ongoing problems with the existing ICU patients if needed. They also assist residents in procedures such as central line placement.

Anesthesiology

The Fellow is trained in airway management skills by an anesthesiologist. Proficiency in mask ventilation, orotracheal intubation and the use of the other advanced airway devices such as laryngeal mask airway is expected by the end of training.

Simulation Training

Fellows get trained in procedures through simulation training provided through the state of the art simulation center at the Stritch School of Medicine: A bronchoscopy simulator was added in 2012 that further assists in training in routine bronchoscopy as well as EBUS.

By the end of their training, fellows will get certified in doing the following procedures:

  • Flexible bronchoscopy
  • Transbronchial and endobronchial biopsy
  • Transbronchial needle aspiration (TBNA)
  • Central line placement
  • Arterial line placement
  • Thoracentesis
  • Paracentesis
  • Tube thoracostomy
  • Thoracic ultrasound

In addition, fellows will get exposure to advanced  interventional procedures including endobronchial ultrasound (EBUS) guided TBNA, navigational bronchoscopy, indwelling pleural catheter and endobronchial stent placements.

Simulation training
Simulation training

How to Apply

To apply for the Pulmonary & Critical Care Fellowship Program, you need to submit the following through ERAS:

  • Application
  • Official medical school transcripts. If originals are not in English, please provide a certified English translation.
  • A Dean's letter (medical school)
  • An official record of board scores (NBME, FLEX, USMLE, LMCC, VQE, or FMGEMS)
  • Three letters of recommendation from individuals familiar with your professional qualifications, including one from your internal medicine residency program director.
  • A curriculum vitae
  • A personal statement
  • A valid ECFMG certificate (if you graduated from a medical school outside of the U.S. or Canada)
  • Applicants must possess a valid permanent Visa or U.S. citizenship. No H1B Visas will be accepted.
  • All Fellowship candidates must possess a valid permanent Illinois medical license when they start the program.

Only completed files will be considered. Link to Electronic Residency Application Service (ERAS)

Applicants must have three years of accredited postgraduate education in internal medicine and must be eligible for or have passed the ABIM examination.

FREIDA Online

Obtain additional information about the training program through the American Medical Association and the Association of American Medical Colleges. Freida Online (Fellowship and Residency Electronic Interactive Database)

Contacts

Sunita Kumar, MD, DABSM, FCCP
Associate Professor of Medicine
Fellowship Program Director, Pulmonary & Critical Care

Dr. Sean Forsythe

Sean Forsythe, MD
Associate Professor of Medicine
Division Director, Pulmonary & Critical Care  

For additional information, please contact:

Kathy Kania
Fellowship Program Coordinator
Loyola University Medical Center
2160 South First Avenue
Building 102, Office 7608
Maywood, IL 60153
Phone: 708-216-6497
Fax: 708-216-6890
kathleen.kania@luhs.org