Pediatric Pulmonary Consultation Hospital Service
Pediatric Pulmonary Consultation Service coverage
1 Pediatric Pulmonary Fellow to cover each month
Weekends: The Fellow on service covers 2 weekends a month. Pulmonary fellows not on service cover 1 weekend a month.
The Fellow on service coordinates with the residents to cover the service days
Pulmonary Service Duties
The Fellow on service is responsible for managing patient care and leading the resident/student team. Pre-rounding with the resident team is recommended prior to attending rounds. Fellows are encouraged to formulate preliminary recommendations for the consulted patients. During rounds, the Fellow is encouraged to insert their knowledge and teach the resident/student when appropriate. As always, the teaching faculty is always available and provides clinical insight and education regarding patient care, pathophysiology, and discussion of assessment and recommendations during rounds.
Fellows covering the hospital service that day have At-Home pager call regarding medical issues for outpatient and inpatient pulmonary patients. The Fellow is encouraged to formulate an assessment and plan for the patient and call the back-up attending to discuss their concerns as needed. If there are no fellows on call, the attending physician is first call.
Consultation and procedures notes are documented in the Memorial Hermann Care4 EMR.
Fellow continuity clinic is TUESDAY or FRIDAY AFTERNOONS regardless of assigned rotation.
Fellows are excused from their continuity clinic on the 2nd Tuesday/Friday of every month to attend one of our unique pulmonary subspecialty clinics to expand their exposure to special subsets of respiratory disorders:
Aerodigestive clinic
Bronchopulmonary dysplasia clinic
Congenital Diaphragmatic Hernia (CDH) clinic
MD Anderson Pulmonary clinic
Pediatric Complex Care clinic
Pediatric Sleep clinic
Rare Lung Disease clinic
Primary Ciliary Dyskinesia (PCD) clinic
Pulmonary Hypertension clinic
Sickle Cell-Pediatric Pulmonary clinic
UT-Houston utilizes Epic EMR for clinic notes and correspondence letters to the referring physician.
Nationally Recognized Programs
Primary Ciliary Dyskinesia (PCD) center
· One of the largest centers in the PCD registry
· Global health program in Latin America
· Nasal biopsy, nasal nitric oxide, video microscopy, electron microscopy imaging
· Medical home for over 600 children with special health care needs
· More than 100 patients requiring chronic mechanical ventilation
· Advanced telemedicine with Tyto Care
Bronchopulmonary Dysplasia (BPD) Program
· Nationally recognized by NICHD Neonatal Research Network
· One of the largest centers for premature infants born <27 weeks
· Over 300 patients in our BPD NICU follow-up program
Congenital Diaphragmatic Hernia (CDH) center
· Over 100 patients with CDH and pulmonary involvement
· Multispecialty care, including PFTs, iOS, Bayley neurocognitive testing
Pediatric Pulmonary Lecture Series
The fellow lecture series is custom designed to focus on pulmonary physiology and clinical topics that improve the Fellow’s knowledge and skills. Over the three years, we cover important topics listed in the ABP Pediatric Pulmonology Content outline which can be found at www.abp.org.
Major topics include:
Lung development
Ventilation
Pulmonary circulation
Pulmonary lymphatics and Nervous system
Respiratory muscles
Gas exchange
Exercise
Asthma and Pulmonary function testing
Cystic fibrosis
Ventilatory management
Pulmonary hypertension
Bronchopulmonary dysplasia
Congenital upper and lower airway malformations
Lung defenses
Aspiration lung injury
Sickle cell and the lung
Sleep disordered breathing
Journal club
Radiology / Pathology conference
Division and clinic meetings
Additional Educational Opportunities
We offer a robust list of additional educational opportunities to expand the Fellow’s understanding of medicine beyond Pediatric Pulmonology. The various educational conferences provided to the Fellows enrich the clinical experience and further develop the fellows’ skills in the six core competencies and scholarly requirements for fellowship training.
Fellow Core Curriculum
Grants 101
Collaborative Institutional Training Initiative (CITI) course
Training course for Integrated Research Information Software (iRIS) system
Bronchoscopy training in the sim lab
The Fellows learn the principles, utilization and interpretation of MANY special diagnostic tools that help in the assessment and management of various respiratory disorders:
complete pulmonary function tests
exercise bronchoprovocation studies
cardiopulmonary exercise testing
impulse oscillometry
lung clearance index device
nasal nitric oxide testing
ciliary biopsy for high-speed video microscope analysis (HSVMA)
laryngoscopy and bronchoscopy in clinic and hospital setting.
Our robust scholarship program provides research training and experience that exposes fellows to the concepts of hypothesis driven research; encourages active participation and presentations at national societies; and inspires career development as a physician-scientist. Fellows are guided through the process with mentorship and the Scholarly Oversight Committee (SOC). All Fellows are required to complete assigned components of Clinical Research Curriculum which improve their understanding of research concepts and topics as they develop their own scholarly product.
Clinical Research Curriculum (CRC) website
Research Rotation
The University of Texas Health Science Center at Houston Pulmonary Fellowship provides a minimum of 17 months of “research” rotations throughout the three year fellowship. The fellow is expected to identify, participate and complete a scholarly activity as described by the American Board of Pediatrics. Of note, an ELECTIVE may be chosen in place of the Research rotation, if there is significant overlap between the research topic and training in that elective. The change must be pre-approved by the program director.
The ABP has expanded the options for projects but did not dilute the rigor expected. Scholarly activity can include, but is not limited to, clinical research, basic science research, meta-analysis, quality improvement project, educational curriculum design, and Master’s level program with a thesis.
Rotations are provided in monthly time periods with increasing numbers of months as the fellow advances in training. Oversight of all scholarly activity is provided by the Fellow’s individualized Scholarship Oversight Committee (SOC).
