Pulmonary/Critical Care Fellowship

Overview

The Division of Pulmonary, Critical Care and Sleep Disorders Medicine is part of Internal Medicine Program of the Department of Medicine at the Quillen College of Medicine at East Tennessee State University.

The Fellowship teaching program in pulmonary disease has been ongoing since 1980. There are over 46 graduates of the program located in ten different states. The division was accredited by the ACGME in 1995 as a combined pulmonary/critical care training program. The majority of graduates who have taken the subspecialty board examinations in pulmonary disease and critical care have been certified. The training program is three years, preparing candidates for certification in both subspecialty boards of pulmonary disease and critical care. Two new fellowship positions are offered each year.

Our mission is to deliver excellent, efficient, state-of-the-art and evidence-based medical care to our patients, provide outstanding educational and training opportunities for students, residents and post-graduate trainees, and to promote and foster multi-disciplinary clinical and basic science research programs designed to improve our understanding of human health and disease with the goal of improving quality of life, preserving and restoring respiratory and sleep health.

Applications for fellows accepted through ERAS.
Contact Carla at (423) 439-8048 or email hillc@etsu.edu 

Why ETSU? GME Training Facilities Application Requirements

• Video Transcript: ETSU Quillen College of Medicine Pulmonary/Critical Care Fellowship Program Director

  [Speaker: Dr. Wael El Minaoui]
  Hello. My name is Doctor Wael El Minaoui, and I am the program director for the Pulmonary Critical Care Fellowship at Quillen College of Medicine at East Tennessee State University.

  Our program has been a part of ETSU for over 35 years.

  Our fellowship is a three year combined program of pulmonary and critical care.

  We have two fellows each year for a total of six.

  The program offers training at three different facilities Bristol Regional Medical Center, Johnson City Medical Center, and Holston Valley Medical Center.

  Our fellows gain extensive hands on experience in intensive care units, inpatient pulmonary consultations and outpatient clinics and are exposed to various procedures.

  The faculty includes board certified pulmonologists and intensivists who perform extensive procedures ranging from routine bronchoscopy, EBUS, lasers and stents to robotic and navigation bronchoscopy.

  Our fellows also get excellent training in endotracheal intubation, chest tube placement and management, pleurx catheter placement and management, and bedside percutaneous tracheostomies and our fellows keep up with training.

  After graduation, our fellows have chosen careers in pulmonary, critical care in prestigious places with large healthcare systems and academia nationwide.

  We have fellows who pursue it further training and joint interventional pulmonary fellowships and sleep medicine.

  Finally, I appreciate your interest in our program, I look forward to meeting you soon.

  [Music]

• Video Transcript: ETSU Quillen College of Medicine Pulmonary & Critical Care Fellow Testimonials

  [Speaker: Jack Malone, DO]
  Hi, my name is Jack Malone. I'm a third year pulmonary critical care fellow. I grew up here in Bristol, Tennessee. Fortunate enough to complete the Pulmonary fellowship at the end of the year.

  This is a small program, allows for two fellows per year. We get a total of six fellows.

  The program allows excellent exposure to procedures, which I feel is unmatched in regards to larger programs with pulmonary subspecialties.

  I have done innumerable amount of bronchoscopies, including navigational and endobronchial ultrasound bronchoscopies.

  Procedures also extend to the bedside in the critical care aspects such as intubation, central lines, arterial lines, chest tubes, and bedside percutaneous tracheostomies.

  Mostly do ICU here at Bristol, but at other facilities we have exposure to pulmonary wards and ICU mixtures.

  Our pulmonary clinic is located here at Bristol where we're exposed to COPD, asthma, black lung, pulmonary fibrosis, interstitial lung disease, as well as a myriad of others.

  We do help co-manage our tertiary referral centers with patients who have obtained lung transplant, and we are the local area of expertise in regards to facilitating care with that tertiary center.

  An additional aspect of the program, which is often understated, is the autonomy of the program.

  Overall, the program allows for growth as a pulmonary and critical care, which provides each fellow the confidence to exit the program, feeling as if they are able to manage most, if not all, situations as a community care intensivist and pulmonologist.

  [Speaker: Sagar Bhula, MD]
  Hey, my name is Sagar Bhula. I'm one of the first year pulmonary critical care fellows here at ETSU. The program is located in the Tri-Cities within the Appalachian Mountains.

  We are a community-based program and we rotate through three main sites. Our primary site is here in Bristol. We also rotate at Johnson City Medical Center and Holston Valley Medical Center.

  Each location provides a wide variety of pulmonary and critical care pathologies. We have board-certified sleep, interventional pulmonary, and pulmonary hypertension specialists as part of the teaching staff.

  Our attendings are incredibly supportive, always providing guidance and encouragement with a positive attitude. Their expertise and positive demeanor make learning from them a truly enriching experience.

  The pulmonary fellowship gives you the opportunity to be very hands-on from the beginning. Within my first couple months, I was able to perform many bronchoscopies, including EBUS, navigational, bronchoscopy, and robotics.

  I chose ETSU because of its supportive environment and collaborative spirit, which makes an ideal setting to further my training. We hope ETSU is also a great fit for you.

  [Music]

Board-Certified Faculty in Pulmonary Disease, Critical Care, and Sleep Medicine.

Our faculty provide the latest evidence-based treatments for a number of disorders including: asthma, chronic obstructive pulmonary disease,emphysema, occupational lung disease, pulmonary vascular diseases, interstitial lung diseases, critical care/intensive care medicine, cystic fibrosis, pulmonary infections, tuberculosis, lung cancer and common and more complex sleep disorders like sleep apnea, insomnia, restless legs syndrome and narcolepsy.

Areas of particular interest to the faculty include, but are not limited to, idiopathic pulmonary fibrosis, asthma/COPD, complex sleep disorders, lung cancer and management of adult respiratory distress syndrome and septic shock. Diagnostics, treatment and management, and educational programs are focused on the needs of patients and their families.

Our Faculty and Fellows publish scholarly activity that involves basic research as well as clinical research aimed at improving respiratory clinical care and sleep health.

Hospitals

Several teaching hospitals are utilized. These are the Bristol Regional Medical Center (BRMC), Holston Valley Medical Center (HVMC), and Johnson City Medical Center (JCMC).

At BRMC and VAMC, the Fellows provide first line care in the medical intensive care units as part of a comprehensive multidisciplinary team. Fellows, in conjunction with faculty preceptors, perform pulmonary consultations on hospitalized patients at each facility. Two of our training facilities are Level 1 trauma centers.  BRMC also provides our Fellows the opportunity for long term ventilator care and rehabilitation medicine.  Fellows participate in ambulatory care clinics in which continuity of care for patients with pulmonary disease is stressed.  The Division is responsible for special diagnostic procedures such as pleural biopsy, lung biopsy and fiberoptic bronchoscopy. Specialty procedures include the use of ultrasound bronchoscopy, navigational bronchoscopy, percutaneous tracheostomy placement, chest tube insertion and pleurodesis.

Modern, well-equipped pulmonary function and exercise laboratories are available for both in-patients and out-patients at each teaching hospital. These include spirometry, body plethysmography and blood gas analysis - including facilities for direct measurement of P50 as well as 2,3 DPG, blood lactate and pyruvate. Flow volume loops, closing volumes, carbon monoxide diffusion, and studies for exercise induced asthma are available. 

Scholarly Activity

All fellows are expected to accomplish scholarly activity during their Fellowship. Fellows will participate in research for at least 3-6 months of their 36 month training period. Time in an area of research will depend upon interests and goals of the individual candidates. Active areas of research in this Division are sleep disordered breathing, sleep and cardiovascular disease, acute and chronic lung conditions such as asthma, chronic obstructive pulmonary disease, lung cancers and fibrosing lung diseases. The Division collaborates closely with the Department of Physiology and the Division of Allergy and Immunology and joint research projects are possible and encouraged.

Teaching

All fellows are active in teaching. Teaching responsibilities are assumed in the course in physical diagnosis as well as the teaching of applied clinical pulmonary and pulmonary physiology for the house staff and medical students rotating on the service. The fellows are responsible for the day-to-day instruction of interns and residents in the diagnosis and care of patients with critical illness.