Pulmonary and Critical Care Fellowship

New for 2019, Bridgeport Hospital is now sponsoring an ACGME-accredited 3-year pulmonary and critical care fellowship. The vast majority of training will be at Bridgeport Hospital and will consist primarily of both outpatient and inpatient pulmonary consultation services and medical and surgical critical care. Additional rotations at Yale New Haven Hospital for inpatient pulmonary medicine, medical critical care and neuro-critical care will be part of the program in order to provide training experience in a university hospital setting. Elective and research blocks will also be available to trainees with the goal of fellows attending regional and national meetings to present their work.

Key clinical faculty for this program will continue to be based at Bridgeport Hospital. Conferences will cover areas of both clinical pulmonary and critical care medicine, physiology, and research.  Point of care ultrasound training and bronchoscopy simulation have been added and will continue to be developed as part of the training experience.

Application to our program is through the Electronic Resident Application Service (ERAS). The Bridgeport Hospital Pulmonary and Critical Care Fellowship will participate in the National Resident Matching Program (NRMP) Medical Specialties Matching Service (MSMP). 

Please note that we will no longer be recruiting for the 2-year pulmonary fellowship. 

The Pulmonary Diseases fellowship is an ACGME accredited two-year training program leading to eligibility for the American Board of Medical Specialties certification in Pulmonary Diseases.

Fellows spend a total of 12 months on inpatient Pulmonary Medicine consultative services and 6 months in the medical intensive care unit spread throughout their 24 month fellowship. The majority of the intensive care unit time is done during the first year of fellowship, with the focus of the second year on Pulmonary Medicine. The remaining 6 months is devoted to clinical research activity with some time spent in the Pulmonary Function lab. Fellows are permitted 4 weeks of vacation each year and are also given time to attend national conferences if they are presenting their original research.

There are weekly continuity clinics for general Pulmonary Medicine and for the Center for Sleep Medicine. Other outpatient experience can be had through the office of the community-based faculty.

Essentially all of our fellows have gone on to receive further training in Critical Care Medicine. A number of them have also done further training in Sleep Medicine and Interventional Pulmonology. Our prior fellows have ultimately practiced in community or hospital based settings and a number of them have gone on to practice in an academic enviroment.

The Section of Pulmonary, Critical Care, and Sleep Medicine has a robust conference schedule. Weekly sessions include a journal club and a clincal topic conference that may be case-based or drawn from board review type questions. Weekly attendance at the Yale Pulmonary Conference and Medical Grand Rounds is also expected. Monthy sessions include a multi-disciplinary thoracic oncology conference and a CPC conference with input from Pathology and Radiology. Every other month wit sit with our pulmonary pathologist at the microscope to review slides with a focus on histopathology.

At the beginning of each academic year, the Attending facutly members deliver a core lecture series focusing on the basics of Pulmonary Medicine. Other conferences are prepared and presented by the fellows with input from the faculty. Faculty members are routinely present at the conferences.
PGY-3
Fadi Aldaas
Inga Forde
The Section of Pulmonary, Crtical Care, and Sleep Medicine maintains a full spectrum of related facilities.

There is a Pulmonary Physiology lab for pulmonary function testing. This includes the ability to perform advanced cardiopulmonary exercise testing as well as the standard testing of spirometry, lung volumes, and diffusion analysis.

Our bronchoscopy suite provides for standard bronchoscopic evaluation. We have fluoroscopy for performing transbronchial biopsies. Endobronchial ulstrasound (EBUS) is also performed. Bronchoscopic procedures are assisted by nursing and respiratory therapy staff and anesthesiolgy services are available if needed.

The medical intensive care unit is a 16-bed unit capable of the full support of the critically ill patient. There is also an 8-bed intermediate care area that functions as a step-down unit for our ICU patients as they improve. We have bedside ultrasonography for line placement, pleural procedures, and critical care echocardiograpy. We have a Glide Scope for airway management. The fellows have ample opportunity for perfroming the standard ICU related procedures including the insertion of central venous catheters, arterial lines, thoracostomy tubes, and endotracheal tubes.

Our Center for Sleep Medicine is a full service sleep center evaluating and treating a broad spectrum of sleep disorders for patients down to the age of three. We provide consultative services and testing including standard polysomnography, multiple sleep latency testing, and actigraphy. Daytime studies can be provided for night shift workers. There is a robust home sleep testing program as well. The Center for Sleep Medicine is staffed by two full-time Clinical Sleep Specialists.
The Section of Pulmonary, Critical Care, and Sleep Medicine maitains an active clinical research effort. Our fellows are expected to participate actively in the ongoing research of the Section and are encouraged to generate their own ideas for research projects. Recent and ongoing areas of investigation include: ARDS, sepsis, and various topics related to Sleep Medicine. There are also a nubmer of quality improvement projects underway.

The fellows are required to produce an abstract that is presented at a national meeting, a manuscript for publication in a peer-reviewed journal, or a review article suitable for publication in a peer-reviewed journal. Within the last two weeks of their fellowship training, each fellow will present their research activity to the Section in the form of a Grand Rounds type presentation.

Recent publications of the Section include:
  1. Fortis S, Kittah J, De Aguirre M, Plataki M, Wolff A, Amoateng-Adjepong Y, Manthous CA. Perseverant, non-indicated treatment of obese patients for obstructive lung disease. BMC Pulm Med. 2013 Nov 22;13:68. doi: 10.1186/1471-2466-13-68. PubMed PMID: 24266961.
  2. Chanda A, Kwon JS, Wolff AJ, Manthous CA. Positive pressure for obesity hypoventilation syndrome. Pulm Med. 2012;2012:568690. doi: 10.1155/2012/568690. Epub 2012 Oct 11. PubMed PMID: 23094151; PubMed Central PMCID: PMC3475306.
  3. Odigie-Okon E, Jordan B, Dijeh S, Wolff A, Dadu R, Lall P, Zarich S, Amoateng-Adjepong Y, Manthous CA. Cardiac injury in patients with COPD presenting with dyspnea: a pilot study. Int J Chron Obstruct Pulmon Dis. 2010 Nov 9;5:395-9. PubMed PMID: 21103406; PubMed Central PMCID: PMC2981154
  4. Bansal A, Chawla M, Cohen PJ, Kwon JS. Pleural epithelioid hemangioendothelioma. Lung. 2012 Aug;190(4):469-70. doi: 10.1007/s00408-012-9377-9. Epub 2012 Mar 6. PubMed PMID: 22392541. 5: Arias SA, Cohen P, Kwon JS. Clozapine-induced lymphocytic alveolitis. Am J Psychiatry. 2011 Feb;168(2):210-1. doi: 10.1176/appi.ajp.2010.10101494. PubMed PMID: 21297049.
  5. Kaufman DA, Ravi S, Dadu R, Horowitz D, Logue MA. Severe hypoxemia and orthodeoxia following right pneumonectomy. Am J Respir Crit Care Med. 2011 Dec 1;184(11):e1-2. doi: 10.1164/rccm.201012-1950IM. PubMed PMID: 22162892.
  6. Vazquez R, Gheorghe C, Kaufman D, Manthous CA. Accuracy of bedside physical examination in distinguishing categories of shock: a pilot study. J Hosp Med. 2010 Oct;5(8):471-4. doi: 10.1002/jhm.695. PubMed PMID: 20945471.
  7. Tian J, Kaufman DA, Zarich S, Chan PS, Ong P, Amoateng-Adjepong Y, Manthous CA; American Heart Association National Registry for Cardiopulmonary Resuscitation Investigators. Outcomes of critically ill patients who received cardiopulmonary resuscitation. Am J Respir Crit Care Med. 2010 Aug 15;182(4):501-6. doi: 10.1164/rccm.200910-1639OC. Epub 2010 Apr 22. PubMed PMID: 20413625.
  8. Feng Y, Amoateng-Adjepong Y, Kaufman D, Gheorghe C, Manthous CA. Age, durationof mechanical ventilation, and outcomes of patients who are critically ill. Chest. 2009 Sep;136(3):759-64. doi: 10.1378/chest.09-0515. PubMed PMID: 19736189.
  9. Fortis S, Florindez J, Balasingham S, Aguirre MD, Amoateng-Adjepong Y, Manthous CA. Ventilator Settings Can Substantially Impact Patients' Comfort. J Intensive Care Med. 2014 Jan 19. [Epub ahead of print] PubMed PMID: 24446238.