Ohio State Navbar

Education

Training and Procedures


Critical Care Training

Critical Care Training, 9.5 months total: 6 months MICU, 3.5 months non Medical ICU
Our Critical Care Training program offers the unique ability for the fellows to experience caring for critically ill patients within various models of ICU structure."University Hospital 11th Floor MICUs

  • Two 12-bed MICUs
  • Staffed in the traditional academic model:
    • One faculty,
    • One fellow,
    • Two residents,
    • Two interns, and
    • The occasional fourth-year medical student.

University Hospital 8th Floor MICU

  • 12-bed MICU
  • Staffing model of:
    • One faculty,
    • One fellow, and
    • Three nurse practioners.
    • No housestaff.

Ohio State University East Mixed ICU (medical, cardiac, surgical)

  • 18-bed mixed ICU
  • Primarily staffed by:
    • Hospitalists,
    • One pulmonary/critical care faculty, and
    • One fellow consulting on all MICU and CCU patients.

The fellow gets to experience a wide range of critical care models which require different levels of involvement and team dynamics.

Fellow Responsibilities on all ICU Rotations

  • Overseeing the execution of the ICU patient care management plan,
  • Guiding ventilator management,
  • Performing and/or supervising critical care procedures
    (such as intubation, bronchoscopy, venous central line placement, arterial line placement, pulmonary artery catheter placement and interpretation, tube thoracostomy and chest tube management.)

We also have monthly critical care ultrasound sessions in the ICU staffed by ER and Pulmonary/Critical Care faculty which are intended to allow interested fellows to become proficient in all aspects of critical care ultrasound.


Non-medical ICU Training

Non-medical ICU training occurs via the following rotations:

1. F2s spend one month as part of the SICU CC team, caring for all surgical patients including trauma patients.

2. F3s spend one half month caring for all post-operative cardiac patients in the ICU

3. F3s spend one half month caring for all post-operative thoracic surgical patients in the ICU.

4. F3s spend one half month caring for all critically ill neurologic patients in the Neurologic ICU.

5. Fellows also see surgical critical care patients in a consultative manner when on consult rotations at University Hospital and OSU East Hospital.

6. The Surgical CC fellows also rotate in the 11th floor MICU as part of our cross-disciplinary training in critical care.


Pulmonary Medicine Training

Training in pulmonary medicine occurs via several venues:

Inpatient Pulmonary Consult Services

  • See approximately 800-900 consults per year
  • Includes all aspects of pulmonary consultative medicine.
  • Two consult teams (one based in the James Cancer Hospital, one based in the Ross Heart Hospital) each with a faculty, fellow and 0-2 residents/students.

The two consult teams alternate days of accepting new admissions from the University Hospital. The majority of the patients are pulmonary in nature, but there are critical care consults for and ventilator management for patients requiring mechanical ventilation on cardiology services in the Ross Heart Hospital, in the James Bone Marrow Transplant Unit and in the University Hospital Surgical Intensive Care Unit; we only provide consultative service for these ICUs and are not responsible for the primary care of these patients.

Through these experiences the fellow will be exposed to the entire spectrum of pulmonary procedures including:

  • Chest tube placement and management,
  • Pleural catheter placement,
  • Pleurodesis and bronchoscopic procedures
    (such as bronchoalveolar lavage, transbronchial and needle biopsies, cryotherapy, stent placement and brachytherapy.)

Pulmonary/CC Consult Service

The pulmonary/cc consult service at OSU East provides exposure to a wide spectrum of pulmonary patients. OSU East is a secondary hospital with a combination of private practice services and traditional academic services, this experience exposes the fellow to a different patient population and health care system than OSU University Hospital.

Additionally, the consult fellow is responsible for interpreting inpatient and outpatient pulmonary function tests, bronchoprovocation studies and pulmonary exercise tests performed during the consult months.

Outpatient Pulmonary Medicine Training

Training in outpatient pulmonary medicine occurs via fellow clinics which are located in the Martha Morehouse Medical Plaza. Fellows maintain a outpatient clinic one half day per week throughout their fellowship. Clinics are only cancelled during the non-medical ICU rotations in SICU, Cardiac and Thoracic surgery.

Fellows will have a continuity clinic in general pulmonary medicine for 23 months. The final 12 months of clinic will be done in six month blocks in a variety of the sub-subspecialty clinics.

Fellows will choose which three (3) sub-subspecialty clinics they wish to rotate through from the following programs:

  • Pulmonary hypertension,
  • Pulmonary transplantation,
  • Cystic fibrosis,
  • TB,
  • ILD,
  • Lung cancer,
  • COPD,
  • Asthma,
  • Sarcoid,
  • Interventional pulmonary, and
  • Other programs that can be modified to the fellow’s interest.

Procedures

Over the last several years, graduating fellows have performed approximately 250-300 bronchoscopic procedures including transbronchial biopsies, transbronchial needle aspirations, bronchoalveolar lavage; 10-20 chest tubes; 50+ intubations including use of glidescope and intubating bronchoscope; as well as thoracentesis and central venous catheters (both with and without ultrasound guidance).

We also have a growing Interventional Pulmonology program and fellows can achieve competency in performance of endobronchial ultrasound guided TBNA, argon plasma coagulation (APC), cryotherapy, flexible stent placement, medical thoracoscopy, rigid bronchoscopy, and indwelling pleural catheter placement.

Fellows assist and have the opportunity to become proficient in placement of percutaneous tracheotomies in the MICU. Fellows have the opportunity to achieve competency in critical care ultrasound imaging.