Upon joining the Fellowship Program, each Fellow is assigned to an outpatient General Pulmonary Continuity Clinic at one of the three hospitals and continues in that assigned clinic for the duration of her/his training. Each clinic meets one half day per week and is staffed by Pulmonary Attendings who are always available and who review each case. At SFGH the fellow on the Consultation Service also sees patients in the Tuberculosis Clinic one half day each week.
A number of disease-specific pulmonary clinics are available, including those devoted to Asthma, Cystic Fibrosis, Interstitial Lung Disease, HIV, TB, Pulmonary Hypertension, Lung Cancer, and Lung Transplant.
The ICU patient population at MLH includes patients that have undergone major vascular and cardiac surgery, as well as heart, lung, liver, bone marrow, and kidney transplantation. In addition, there are patients from the general medical and surgical services with the usual spectrum of pulmonary and non-pulmonary problems resulting in respiratory, cardiac, and other organ systems failure. A number of these patients require arterial venous hemofiltration, intra-aortic balloon pump management, and ECMO.
At SFGH, trauma is the major reason for ICU admission. The fellows have an opportunity to increase their skills in the diagnosis and management of these complex patients with an emphasis on skills related to mechanical ventilation, hemodynamic monitoring, management of simple and complex cardiac arrhythmias, and procedures such as chronic arterial venous hemofiltration and intra-aortic balloon pump management.