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As part of a world-renowned institution, the Pediatric Pulmonary, Allergy, Sleep and Cystic Fibrosis Unit at Massachusetts General Hospital provides sophisticated, evidence-based diagnostic and therapeutic care to a diverse population of patients, and receives referrals from throughout the region and around the country. The division includes a very active cystic fibrosis center, a well-developed pediatric sleep program, a multi-specialty airway, voice and swallowing center, and an allergy and immunology program. These services are supported by a fully-equipped pulmonary function laboratory, bronchoscopy service and pediatric sleep laboratory. The Mass General Pediatric Pulmonary, Allergy, Sleep and Cystic Fibrosis center includes five full-time and two part-time pulmonary faculty members who are actively involved in patient care, basic and clinical research, and teaching. It therefore follows that the Pediatric Pulmonary Fellowship at Mass General offers fellows a rich training environment in which to hone their clinical and research interests and skills.First Year
The primary goal of the first year of the fellowship is to become proficient in the clinical care of pediatric patients with pulmonary conditions in both the inpatient and outpatient setting. During their first year of training, each fellow participates actively in the clinical activities of the Pediatric Pulmonary Unit at Mass General, including the provision of clinical care in both the inpatient and outpatient settings. The year includes a month of transplant medicine and year-long longitudinal clinical experiences in outpatient pediatric pulmonology, sleep medicine, chest radiology, respiratory care and bronchoscopy. Fellows also attend multiple conferences, which are outlined in greater detail in the curriculum tab.Second Year
The goal of the second year of fellowship is to become proficient at reviewing the biomedical literature, developing an appropriate research question, and generating effective research plans and methods. During this time, fellows begin performing research under the close mentorship of an independent investigator. Fellows are also expected to continue to develop and strengthen their clinical skills — especially with respect to outpatient care and inpatient cross-coverage — by continuing to attend outpatient clinics and educational conferences during this time.Third Year
During the third year, fellows continue to build their research skills with the goal of becoming proficient at implementing research methods and techniques, collecting and analyzing data, interpreting results and presenting research findings in oral and written formats. As with the second year, third-year fellows are also expected to continue to develop and strengthen their clinical skills— especially with respect to outpatient care and inpatient cross-coverage — by continuing to attend outpatient clinics and educational conferences during this time.
Applicants to the Program Must Be Graduates of:
USMLE Completion Requirements:
Foreign Nationals/International Medical Graduates Must Have:
Visa Options for Clinical Trainees:
The H-1B application is a two step process involving both the U.S. Department of Labor and the Immigration and Naturalization Service. The Partners Office for International Staff, Scholars and Students (PIO) prepares all visa applications and will work with the applicants and program directors to obtain the necessary documentation.
In addition to the clinical and research components of the program (which are described in detail in their respective sections), the program curriculum includes a comprehensive collection of conferences, individual learning plans and a quality improvement project, each of which is reviewed in detail here.
The program-specific conferences include each of the following:
The core fellows’ conferences span a period of three years in order to ensure that each fellow attends all lectures. The topics include, but are not limited to, the following:
Additional conferences attended by fellows in the Mass General Pediatric Pulmonary Fellowship Program:
Inpatient Pediatric Pulmonary Service:The primary goal of the inpatient component of the program is to prepare fellows to provide high-quality, evidence-based care of patients with pulmonary conditions in the inpatient setting. When he or she is not participating in other required and elective activities, the first year pulmonary fellow spends weekdays and every 4th or 5th weekend on the general pediatric pulmonary service. In this role, the fellow responds to all requests for consultations on patients admitted to the inpatient service, in the pediatric and neonatal intensive care units, and in the emergency department. The fellow also initiates the management of children admitted to the pulmonary service, designs and implements inpatient management plans, follows the daily progress of each patient, and performs outpatient discharge planning. These activities are all performed under the direction of our attending physicians.
Outpatient Pulmonary Clinical Component:The overarching goal of the outpatient component of the fellowship is to prepare fellow to provide high-quality, evidence-based care to pediatric pulmonary patients in the outpatient setting. Throughout all three years of program, fellows see patients in the outpatient setting on a weekly basis. The first-year fellow sees patients on Wednesday mornings under the mentorship of Drs. Shannon Fracchia (general pulmonary and CF), Dr. Allen Lapey (general pulmonary, cystic fibrosis and allergy), and Dr. Shuba Iyengar (allergy, immunology). The second- and third-year fellows see patients on Tuesdays under the mentorship of Dr. Bernard Kinane (general pulmonary), Dr. Jolan Walter (allergy, immunology), and Dr. Craig Canapari (general pulmonary, neuromuscular disorders, sleep disorders). Whenever possible, patients are scheduled in the fellow’s name in order to promote continuity of care. During their first year of training, fellows also provide phone coverage for off-hours calls from outpatients and from referring physicians on weekdays and every 4th or 5th weekend.
Cystic Fibrosis (CF) Care:Throughout their training, fellows care for patients with CF, both in the outpatient setting and the inpatient setting. Throughout the first year, the fellow is the key member of the multidisciplinary cystic fibrosis care team, which includes physicians, physical therapists, nutritionists, social workers, and psychiatrists. During the entirety of the first year, the fellow provides care to patients with cystic fibrosis in both the outpatient and inpatient setting, and meets weekly with the cystic fibrosis care team to review the care provided to all patients with cystic fibrosis seen at Mass General and meets with the inpatient team making management decisions under the direction of the attending. Fellows are also involved in genetic counseling of parents of infants who have positive screens for cystic fibrosis on the state newborn screening of Massachusetts. The fellow is also encouraged to attend the CF national conference and funding is usually available for this.
Pediatric Sleep Disorders Component:The overall goal of the sleep component of the Pediatric Pulmonology Fellowship is to provide fellows with the training required to provide high-quality pulmonary care to patients with sleep-disordered breathing. Each first-year fellow spends one month with the Sleep Disorders Service, participating in the following activities:
Lung Transplantation Component:The transplant rotation is a month-long clinical experience for fellows during their first year of training. The overarching goal of this rotation is to prepare the fellow to be responsible for the evaluation and care of patients requiring lung transplantation. During this time, fellows admit and follow patients both before and after single or double lung transplantation. They are carefully supervised by the Lung Transplantation Medical Director and the transplant surgeons. Trainees also perform consultations on patients who have received heart, liver, bone marrow and other solid organ transplantation.
Pulmonary Function Testing:First-year fellows participate in the interpretation of all pulmonary function tests performed in the pediatric pulmonary function laboratory. The goal of this component of the fellowship is to prepare fellows for independent utilization and interpretation of PFTs. Fellows are also expected to gain a general understanding of how laboratories function, including principles of quality control, validity and reliability of tests. Early in the year, general principles are stressed; later in the year, the focus shifts to more complex issues in PFT interpretation. They are mentored in this process by the program director or a designee.
Bronchoscopy Component:During the first year of the fellowship, trainees perform bronchoscopies on Monday mornings at the Massachusetts Eye and Ear Infirmary. The primary goal of this experience is to provide fellows with the knowledge and skills required to perform and interpret flexible bronchoscopy on pediatric patients. As part of this experience, fellows are expected to learn airway anatomy and recognize common anomalies and disorders.
Pediatric Respiratory Care:During the first year of the fellowship, trainees spend one Thursday afternoon every month with the respiratory therapy service, participating in the care of patients in the Pediatric Intensive Care Unit and the Neonatal Intensive Care Unit. The primary goal of this experience is to provide fellows with the knowledge and skills required to manage patients requiring various methods of respiratory care and support.
Pediatric Radiology:During the first year of the fellowship, trainees spend one Thursday afternoon every month with the pediatric radiology service, reviewing imaging studies and attending all radiology rounds and teaching conferences. The primary goal of this experience is to provide fellows with the knowledge and skills required to select and interpret imaging studies pertinent to pediatric patients with respiratory diseases.
The overarching goal of the research component of the fellowship is to provide trainees with the fundamental skills required to perform original research in fields related to pediatric pulmonology. Fellows are also expected to obtain sufficient experience and skills to become competitive for research grants that will support them in their future careers.
To this end, each fellow performs research in a laboratory of their choosing during the second and third years of training. The process of selecting a research topic begins early in the first year, and the intent is to match each fellow’s interests with those of one of the many accomplished faculty available throughout out Harvard. Collaboration is available with the Adult Pulmonary Unit at Massachusetts General Hospital, the Channing Laboratory, the Harvard School of Public Health and affiliated clinical and research facilities throughout the region.
With the guidance of their research mentors, fellows are expected to generate a research question, develop the appropriate study design, collect and interpret data, and present the data in the form of an original publication. Fellows participate as active members of the research team, attending and participating in laboratory meetings and journal clubs. In order to ensure a successful research experience, each fellow is assigned a Research Oversight Committee which meets with the fellow annually in order to assess the fellow’s progress and provide feedback. The program director also meets with fellows and mentors individually on a biannual basis to monitor and facilitate their progress.
Thank you for your interest in the Pediatric Pulmonology Fellowship at MassGeneral Hospital for Children. We accept applications online electronically through theElectronic Residency Application Service.Applications should include the following documents:
ERAS opens for applications on July 15, 2016. Trainees are encouraged to complete submissions by August 15th, which affords ample time for the program to review all applications and schedule personal interviews for competitive applicants. Interviews are held in September and October.
If you have any questions regarding our program or the application process, please feel free to contact Elena Donovan, Fellowship Coordinator at 617-726-7613 or firstname.lastname@example.org.
MGHfC Pulmonary Fellowship Program
Program Director: Ben A. Nelson, MDAssistant Director: T. Bernard Kinane, MDProgram Coordinator: Elena Donovan
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