Inpatient

  1. What is the structure of inpatient services?
    a) There are 4 inpatient services: General Pulmonary, Consult, Transplant, and Bronchoscopy. For part of the year, one fellow rotates on a Chronic Respiratory Failure rotation. For part of the year, one fellow rotates on a night float rotation. There is one fellow on each service.
     
  2. How many bronchoscopies do fellows perform a year?
    a) We perform about 200 bronchoscopies during our fellowship, with >100 in the first year.
     
  3. What kind of autonomy do you have on rounds as a fellow?
    a) It is expected that fellows lead rounds and that the residents present to fellows. Attendings are always there in person during rounds for back-up when needed and are always available with questions. Fellows and attendings generally touch base at the beginning of the rotation to discuss goals and expectations.
     
  4. What is the structure of the inpatient teams?
    a) Inpatient: There is one attending, one fellow, and an NP (Keri Sullivan) on service at a time. During the day, there are generally 2 medical students, one intern, and one supervising resident on Pulmonary. Overnight, there is one pediatric intern who is supervised by a supervising pediatric resident, covering Pulmonary, Hematology, and Rheumatology.
    b) Transplant/ Bronchopulmonary Dysplasia: Patients who have had lung transplant are cared for by the same resident team (unless in the ICU), the Transplant fellow, and by a transplant-specific interdisciplinary team. There is a dedicated BPD service with an attending and NP and rounds occue with the interdisciplinary team.
    c) Consult: There is one fellow and one attending (and occasionally a resident or medical student). The schedule is based on consult flow and varies greatly throughout the day.
    d) Bronchoscopy/Pulmonary Function Tests: The fellow on this rotation performs bronchoscopy and reads PFTs
  5. What types of patients are admitted to the pulmonary service? 
    a) Patients with a wide variety of diagnoses are admitted to the general pulmonary service. Common diagnoses we admit include: Cystic Fibrosis, Asthma, Interstitial Lung Disease, Bronchopulmonary Dysplasia, Complicated Pneumonia, Pneumothorax, and Sleep Disordered Breathing.
     
  6. What is the census of each service? 
    a) The census varies greatly depending on the time of year. The inpatient service generally has 4-15 patients, consult service 7-25, and transplant 2-5. 
     
  7. What is your relationship like with other departments? 
    a)The different departments collaborate very well together. Departments we tend to work with more include: GI, ENT, NICU, MICU, Rheumatology, Allergy/Immunology, and ID.
     
  8. What is the night call schedule like? 
    a) Weekday night-call is divided between two fellows (Inpatient and Transplant). Generally, one fellow takes call Monday and Wednesday and another takes call Tuesday and Thursday. The weekend fellow takes call Friday night – Monday morning. We will be piloting a night float roation for part of the year (which will also be call from home)

 

Outpatient

  1. How is fellow clinic structured? 
    a) Fellows have continuity clinic one afternoon per week (either Wednesday or Friday) – in person. There are generally 2 preceptors per day. For all fellows, new patients are booked in 1 hour slots. Return visit time slot length varies based on year of fellowship. Pending clinic space availability, we are also able to book patients outside of our assigned afternoon. There is great attention to continuity and fellows generally see patients they follow longitudinally or patients new to Pulmonary.
     
  2. Do you feel supported by support staff (e.g. nursing, front desk staff) in clinic?
    a) Everyone in pulmonary clinic – front desk staff, PFT techs, clinical assistants, nurses, dieticians, and social workers are great, and we work well as a team. They are always there to support and guide us – both in clinic and outside of clinic time.
     
  3. What type of sub-specialty clinics are available and can fellows attend them?
    a) Second and third years attend subspecialty clinics that replace their continuity clinic. Fellows are always welcome to attend more subspecialty clinics if they want more exposure to specific areas.
    1. Bronchopulmonary Dysplasia
    2. Sleep
    3. Chronic Ventilator
    4. Adult CF
    5. Aerodigestive
    6. Congenital Diaphragmatic Hernia
    7. Esophageal Atresia
    8. Exercise
    9. Neuromuscular Disease
    10. Primary Ciliary Dyskenesia
    11. Pulmonary Hypertension
    12. Severe Asthma
    13. Transplant
    14. Trach Clinic
    15. Interstitial Lung Disease
    16. Vaping
       
  4. What electives can fellows participate in? 
    a) Electives that fellows have participated in include the following:
    1. Respiratory Therapy
    2. Rehabilitation Medicine (meeting with RTs/pulmonologists at our local rehab hospital)
    3. Radiology
    4. ORL Observation
    5. ICU
    6. Allergy
    7. Vent Program Home Visits
    8. Interventional Pulmonology
    9. Sleep Medicine
    10. Many Others
      * Fellows are also able to create new electives that they are interested in

Research

  1. Do you get to plan your own research project or do you pick from pre-selected projects?
    a) Fellows are encouraged to meet with many faculty members across different departments and can either create their own projects or join an ongoing project of interest.
     
  2. Are you expected to do research during your first year?
    a) Over the course of the first year, each fellow gets exposure to potential research projects and mentors.  By the end of the first year, the fellow has chosen their academic mentor and planned their academic project.
     
  3. How do you choose your research mentor? 
    a) We are encouraged to meet with many faculty members both in pulmonary and outside of the department to discuss our research interests. Fellows generally choose their mentors based on overall interests after these discussions. There is a research curriculum in the first year to help fellows meet potential mentors.
     
  4. Do fellows work with individuals outside of the pulmonary department?
    a) Yes, fellows will frequently be mentored by individuals outside of the pulmonary department, and many fellows have a team of mentors to best support their research goals and interests.

Education

  1. Are fellows involved in resident teaching? 
    a) There are many opportunities for fellows to teach residents, both informally (on rounds, when discussing consult patients, during pulmonary clinic), and more formally (including morning lecture for the residents rotating with pulmonary and noon conferences for the residency program). Many fellows are very involved in resident education and are part of hospital committees to enhance resident education.
     
  2. Which conferences do fellows generally attend?
    a) The two most commonly attended conferences are North American Cystic Fibrosis Conference in the Fall and the American Thoracic Society Conference in the Spring. Generally, second and third year fellows attend these conferences while first year fellows are covering the inpatient services. There are a variety of other national and international conferences that fellows attend – pulmonary specific (e.g. ILD, sleep) and other specialty related to specific research interests (e.g. adolescent medicine).
     
  3. Do first year fellows get time off to study for boards?
    a) Yes – first year fellows who are taking boards are given time off of service (generally 2-3 weeks) prior to boards.
     
  4. Are the attendings approachable? 
    a) Yes, attendings are extremely nice and approachable. Even when not on service, they are always available to discuss patients and teach. They often reach out to fellows with interesting patients and are invested in fellow education and learning. Overnight, on call attendings are always happy to speak to fellows with any questions that arise – either about floor patients or outside calls, there is never a concern about waking up an attending overnight.

General/Life Outside the Hospital

  1. What is your favorite part of the fellowship program? 
    a) The fellows and attendings are amazing, it is a great environment to work and learn in and fun to come into work.
     
  2. How is the work-life balance? 
    a) Given the large size of the fellowship program, we have a lot of weekends off (first years work 6 weekends, second years work 3 weekends, and third years work 2 weekends), which enables us to spend a lot of time exploring the city with family and friends. We do work very hard when we are in the hospital, but it is really nice to be in a big program, both because we are able to get to know so many people, and because we do have a lot of time when we are not in the hospital that we are able to enjoy.
     
  3. What do you like most about Boston? 
    a) Boston is an amazing and beautiful city with so many things to do and explore. Locally, there is no shortage of activities: beautiful walks, hikes, museums, concerts, and great shopping. It is also a short drive to Vermont, New Hampshire, Rhode Island, and Maine and nice to be able to explore these neighboring states.
     
  4. How much vacation and elective time do you have? 
    a) As a first year, we have about 10-12 weeks off of service – 4 of those weeks are used as vacation and the remainder is used as elective/research planning.