1. Pulmonary/Critical Care Fellowship Program
Phoenix VA/BGSMC

2. History Fellowship started in 1980 Three Year Fellowship Program
Leads to certification in :
Pulmonary Disease
Critical Care

3. History As of June 2008, ALL graduated fellows: Board Certified
Graduated Fellows: primarily in Private Practice

4. Staff Members VAMC Richard A. Robbins Owen Austrheim Lillibeth Pineda
Program Director, Chief Pulmonary/Critical Care VAMC
Owen Austrheim
Associate Section Chief & Director, Sleep Medicine VAMC
Lillibeth Pineda
Patricia Rocha
John Roehrs
Clement Singarajah
Director Critical Care VAMC
Allen Thomas
Director Pulmonary VAMC

5. Staff Members (BGSMC) Pulmonary Associates
David Baratz (Director Pulmonary BGSMC)
Mark Gottfried
Manny Mathew
Da-Wei Liao
SAFA (Critical Care BGSMC)
Robert Rashke (Director Critical Care BGSMC)
Huw Owen-Reece
Thomas Bajo
Arizona Center Chest Diseases
Arcot Premkuar
Cameron Dick

6. Other Affiliated Hospitals
Mayo Clinic
Pulmonary Pathology
St. Josephs Medical Center
Pulmonary transplant
SICU/Trauma
Scottsdale Shea
Pulmonary radiology
JC Lincoln
Trauma
Maricopa Medical Center
Pulmonary
MICU

7. Current Fellows Kevin Park (Third Year Fellow)
Evan Schmitz (Third Year Fellow)
Roxanne Garcia-Orr (Second Year Fellow)
Jessica Hurley (Second Year Fellow)
Christian Jivcu (First Year Fellow)
Henry Leudy (First Year Fellow)
Emad Wissa (First Year Fellow)

8. Pulmonary Fellows (2011) Tonya Whiting (Good Samaritan)
Joshua Jewell (University of Nevada)

9. Current Fellow Demographics (includes 2011 fellows)
4 /9 are from the Good Samaritan residency program
Other institutions include University of Massachusetts, Rutgers, St. Joseph’s in Phoenix, Maricopa in Phoenix.
3 / 9 are international graduates.

10. VA Staff Fellowship coordinator (Nancy Brown) 1 research PhD
1 physician assistant
1 research coordinator
Multiple respiratory therapists including
Bronchoscopy
Oxygen/CPAP
2 section secretaries

11. VA Pulmonary Critical Care Section
Endoscopy suite (flouro, Super Dimension)
Sleep Lab (3 beds)
MICU (10 beds)
3 pulmonary function labs (>1000 PFTs per year)

12. Fellowship Program Structure
3 year Program (Clinical)
6 months research
30 months clinical (below is approximate and can be varied)
10 months VA
Half pulmonary/half ICU
10 months BGSMC
10 months electives

13. Fellowship Program Structure - VA
Consultations (in-patients)
Pulmonary Clinic (1/2 day once a week at VAMC and 1/2 day once a week at private office).
MICU (closed unit with primary care responsibility).

14. Fellowship Program Structure - BGSMC
Pulmonary
Consultation and primary care
ICU
Primary care

15. Fellowship Program Structure Most Popular Electives
Pathology Mayo Clinic
Sleep (both VA and BGSMC)
Infectious disease (BGSMC)
Toxicology (BGSMC)
Pulmonary transplant (St. Josephs)
Pulmonary radiology (Shea)

16. Clinical and Basic Research
Biostatitics/Epidemiology (Dr Gerkin BGSMC)
Areas of interest:
COPD
Pulmonary inflammation
Nitric oxide and oxidants
Clinical research

17. Fellowship Program Structure
Most fellows present at national meetings (ATS or ACCP).
Case presentations at both Arizona ATS and National ATS

18. Pulmonary/Critical Care Conferences
Wednesdays (2-4 hours)
Journal Club
Pulmonary presentation
Critical care presentations
Monthly-Arizona ATS multidisciplinary conference
Every 2 weeks-tumor board

19. Fellowship Weekend Call
2 fellows BGSMC
One in ICU
One in Pulmonary
1 fellow at VA (AM only)
BGSMC pulmonary fellow covers nights at VA.

20. Fellowship Governance
Fellowship Committee
5 faculty
Robbins, Baratz, Rashke, Singarajah, Thomas
3 fellows
one from each year
Meets monthly

21. VA Pulmonary Fellowship Consults & Procedures
Consultations: >3000
Bronchoscopies: >200
Sleep studies: >500
Other frequent procedures
Needle biopsies ─ Chest tubes
Thoracentesis ─ Central lines
Pleural biopsies ─ Pleurex cathers

22. VA Critical Care Fellowship Census & Procedures
Average ICU census ~ 7
Critical Care Consults: ~50
Procedures in ICU per year
Percutaneous tracheostomies: ~50
Bronchoscopies: ~120
Intubations: ~120
Variety of other ICU procedures (lines, thoracentesis, paracentesis, etc) done mostly by residents with fellow supervision

23. Banner GSMC Pulmonary Rotation
Average Daily Census - 25
7 ICU patients
18 ward patients
Average Consults / Day – 5
Supervision of Residents / Medical Students that are on service

24. Banner GSMC Pulmonary Rotation
Procedures per year
Percutaneous tracheostomies: ~50
Bronchoscopies: ~200
Intubations: ~ 100
Variety of other ICU procedures (lines, thoracentesis, paracentesis, etc)

25. Pulmonary Associates Continuity Clinic
Each fellow works a half day per week in the Pulmonary Associates office seeing private practice patients with a wide variety of pulmonary diseases.
Fellows will have direct responsibility for patients on an ongoing basis over 3 years.
An opportunity to interact with private practice pulmonary medicine

26. GOALS Board Certification Consultant in Pulmonary and Critical Care
Clinical Research
Provide direct patient care especially in ICU
Competence in bronchoscopy and other procedures
Teaching

27. Ultimate Goal
LEADER IN PULMONARY and CRITICAL CARE !!!