Education and Training
Fellowship Program
Pulmonary Disease - Critical Care Fellowship Program
Mission
The mission of the Pulmonary and Critical Care fellowship training program at the University at Buffalo is to produce physicians that 1) have the specialized, currently accepted, and up-to-date knowledge and clinical skills required to function as a consultant in pulmonary- critical care medicine, 2) are capable of working in a variety of settings, and 3) possess habits of life-long learning to build upon their knowledge, skills and professionalism.
Background
The Pulmonary/Critical Care fellowship at the University at Buffalo is a three-year program administered through the University at Buffalo School of Medicine and run by the Division of Pulmonary and Critical Care Medicine. The program is designed to be in accordance with the guidelines set forth by the ACGME and the ABIM to guarantee that all individuals completing the entire three-year program will be eligible for board certification in both pulmonary and critical care medicine.
Goals and Rationale
The goal of the Pulmonary/Critical Care fellowship training program is to prepare fellows for a career in Pulmonary and Critical Care Medicine (CCM) by providing extensive clinical training, basic or clinical research experience, and teaching responsibilities. The fellow will develop these skills in an environment of scholarship and inquiry. The graduating fellow will possess the cognitive knowledge, procedural and interpersonal skills, professional attitudes and practical experience required to become a practicing pulmonologist/intensivist. The successful Pulmonary/Critical Care academician must possess a broad variety of skills that will be provided by the fellowship training program. Trainees will develop experience and expertise in the diagnosis and management of a diverse spectrum of patients with disorders referable to the disciplines of Pulmonary and Critical Care Medicine. This experience and expertise will be acquired by the trainee under the supervision of attending faculty through the management of patients in direct care and consultative roles in diverse inpatient and ambulatory settings. The trainee will acquire skills in basic or clinical investigation by conducting research in a structured and supervised environment. These clinical and research experiences will be supplemented by conferences and didactic lectures.
Eligibility criteria for fellowship
In order to be eligible to apply for the program, you must meet the following qualifications:
- Possess a medical license as an M.D. or D.O.
- Be eligible for a New York state training certificate or permanent medical license
- Have successfully completed three years of U.S. postgraduate training by the time of entry into the fellowship program
- Hold U.S. citizenship, permanent residency or J-1 or H-1B Visa
Our application process utilizes the ERAS application process.
In terms of the application we require:
- A letter from your residency program director (submitted via ERAS)
- Three reference letters (submitted via ERAS):
- One ideally should be from the Division Chief or Fellowship Director of Pulmonary/Critical Care at your program
- One should be from another pulmonary/critical care faculty member
- A recent photograph of the applicant
Interviews are conducted on Wednesdays in March.
If you have any questions about our program or the application process, please feel free to contact us:
Sandra Gilliam, Fellowship Program Coordinator
Office of Graduate Medical Education
ECMC Room G-1
462 Grider St
Buffalo, NY 14215
Email: gilliam3@buffalo.edu
Phone: 716-961-6955
Fax: 716-961-6960
Fellowship program structure
A strength of our fellowship training program is the balance we provide in terms of clinical training, research opportunities and our educational curriculum.
The Pulmonary/Critical Care fellowship training program consists of 21 months of clinical training and 15 months of research activity. The majority of clinical inpatient training is done in the first year with time in the second and third years protected for research training. The schedule for the three year fellowship is as follows:
| First Year: | 1 month core curriculum, 11 months clinical service |
| Second year: | 7 months research, 5 months clinical service |
| Third Year: | 7 months research, 5 months clinical service |
In addition to the inpatient experience fellows maintain an outpatient continuity clinic throughout their fellowship training, with additional outpatient clinic experience available in sub-subspecialty programs such as pulmonary hypertension, lung cancer, sleep medicine and cystic fibrosis.
The primary teaching sites for the program are the Buffalo General Medical Center, a large tertiary care academic hospital and the Western New York Veteran Affairs Healthcare System, a VA hospital. The fellows also rotate one month at the Erie County Medical Center working in their level 1 trauma center and two months at the Roswell Park Cancer Institute, a comprehensive cancer institute.
First Year
The fellows rotate through the Western New York Veteran Affairs (VA) Healthcare System ICU, which is a mixed medical-surgical intensive care unit and the Buffalo General Medical Center (BGMC) medical ICU. The fellows also rotate on the pulmonary consultative service at the Buffalo General Medical Center and the Western New York Veteran Affairs Healthcare System. The pulmonary consultative service at BGMC also covers the Roswell Park Cancer Institute, which is geographically contiguous to BGMC, where the fellows will be exposed to unique patient populations like bone marrow transplant patients. The fellow will rotate among the “core” service rotations in an ordered fashion and each fellow will spend approximately the same amount of time on the various rotations. Fellows will also spend two weeks rotating through the anesthesia service where they will brush up on their endotracheal intubation skills. Fellows will also rotate two weeks on thoracic surgery service where they will receive instruction on and perform chest tube insertions.
A unique feature of our fellowship is that we offer a month long orientation program during the first module (July) of their training. First year fellows are not assigned to service rotations or on-call duty during the first module of training.
During the first module the fellows review the basics of pulmonary physiology, learn the basics of pulmonary/critical care medicine, and spend time working with our bronchoscopy simulator. The review sessions are conducted by both faculty members of Pulmonary and Critical Care and other UB faculty members.
During non-class room periods the first year fellows are allotted time to shadow the Pulmonary fellow on each of the four core rotations; learn the specific requirements of each rotation and the logistics of the different hospital systems and ICUs. The goal of this training module is to allow the first year fellows to review the basics of pulmonary/critical care physiology and clinical medicine, begin to learn the essential procedural skills required of a pulmonologist, and to become acclimated to the hospital/program before being placed on service or on call.
Critical Care Training
Patients in the 24 bed MICU at Buffalo General Medical Center are cared for by two teams, staffed by interns, residents, fellows and attendings. The 15 bed combined medical-surgical ICU at Western New York Veteran Affairs Healthcare System is also staffed by interns, residents, fellows and an attending. The responsibilities of the fellow on these ICU rotations generally include overseeing the execution of the ICU patient care management plan, guiding ventilator management, performing and/or supervising critical care procedures, such as intubation, bronchoscopy, central venous line placement, arterial line placement, pulmonary artery catheter placement and interpretation, and ultrasound guided thoracentesis. The BGMC MICU has a dedicated ultrasound machine which is used for line placement and thoracentesis. A similar machine will be available soon at the Western New York Veteran Affairs Healthcare System.
Non-medical ICU training occurs in the following venues: Second year fellows rotate for one month as part of the trauma critical care team at Erie County Medical Center. Fellows also see surgical critical care patients during their rotations in the mixed medical - surgical ICU at the Western New York Veteran Affairs Healthcare System. Fellows also see surgical critical care patients in a consultative manner when on consult rotations at the Buffalo General Medical Center.
Pulmonary Medicine Training
Training in pulmonary medicine occurs via several venues. During the rotation at the Western New York Veteran Affairs Healthcare System the fellow’s main responsibility involves evaluating inpatient and outpatient consults. Approximately 40-50 consults will be seen during the four-week period. Medical residents and fourth year students are assigned to the consultation service. All cases are presented to an attending physician during daily consultation rounds. The fellow also sees new pulmonary patients in consultation in the ambulatory clinic two-three times a week. It is expected that fellows will experience a broad spectrum of different pulmonary diagnosis during these rotations. The fellow, under the supervision of the attending physician, performs all procedures such as bronchoscopy and other diagnostic tests. The fellow interprets all pulmonary function tests in conjunction with an attending physician. During the rotation at the Buffalo General Medical Center the fellow will be involved in the evaluation of 40 to 50 inpatient consults per month. All cases are presented to an attending physician during daily consultation rounds. The fellow supervises medical residents and fourth year medical students rotating on the pulmonary service.
The fellow, under the supervision of the attending physician, performs invasive procedures such as bronchoscopy and ultrasound guided thoracentesis. The fellows will gain experience in managing a broad spectrum of different pulmonary diagnoses during these rotations. Consultations and procedures are also performed at Roswell Park Cancer Institute, supervised by the same BGMC pulmonary attending. During the Roswell Park Cancer Institute rotation, the fellow under the supervision of an attending, sees patients in the outpatient clinic and consultations in hospital, participates in cardiopulmonary exercise testing and interpretation, and performs advanced bronchoscopic procedures.
All fellows maintain a weekly pulmonary continuity clinic for the duration of their fellowship either at the VA or at the University Dent Tower outpatient clinic. In order for all fellows to obtain exposure to an adequate sample of female patients, the fellows will spend 18 months at the Western New York Veteran Affairs Healthcare System and then switch to the other ambulatory site (University outpatient clinic) for 18 months. Pulmonary attendings are also present in clinic and review findings and plans. Fellows also attend a sleep/chest clinic on Tuesday afternoons during their research modules at the Western New York Veteran Affairs Healthcare System. Fellows also will attend the pulmonary hypertension clinic during their Roswell and BGH consultative service rotations. An adult cystic fibrosis clinic at the Women and Children’s Hospital is also available. Outpatient clinics at BGMC are being added and will also be available soon for fellow training.
Procedures
Graduating fellows will become proficient in bronchoscopic procedures including transbronchial biopsies, transbronchial needle aspirations, bronchoalveolar lavage; chest tubes insertion; intubations including use of glidescope and intubating bronchoscope; as well as thoracentesis and central venous catheters (with ultrasound guidance).
There is an interventional bronchoscopy program at Roswell Park Cancer Institute and fellows can achieve competency in performance of endobronchial ultrasound guided TBNA and be exposed to stent placement and other advanced procedures. Endobronchial ultrasound is also now available at the VA Hospital.
Second and Third Years
During the second and third years the fellows will start their research training in addition to completing their core rotations. The fellows will rotate for one month in the trauma unit at ECMC during their second year. Fellows will rotate for one month during both their second and third years at Roswell Park Cancer Institute where they will learn advanced bronchoscopic procedures.
Educational conferences
The conference schedule for the Pulmonary fellowship program is tabulated below:
| Conference | Day of week | Time |
| Sleep Case Conference Sleep Didactic Lecture |
1st Wednesday | 8-9 a.m. 9-10 a.m. |
| Case Conference Fellow’s Conference |
2nd Wednesday | 8-9 a.m. 9-10 a.m. |
| Case Conference Pulmonary Medicine Core Curriculum |
3rd Wednesday | 8-9 a.m. 9-10 a.m. |
Case Conference Critical Care core curriculum |
4th Wednesday | 8-9 a.m. 9-10 a.m. |
Case Conference | 5th Wednesday | 8-9 a.m. | Fellow-Faculty Meeting | 9-10 a.m. | Research Conference | 1st Monday | 12-1 p.m. | Journal Club | 3rd Wednesday | 5:00 p.m. | Core Curriculum | Daily first module | 3-4 hrs a day |
Sleep Conferences are coordinated and presented by the sleep medicine fellows.
The Case Conference is coordinated by the fellows assigned to the Consult Service. The fellow will be responsible for contacting other fellows in the program to ensure there are sufficient numbers of cases available for presentation. At least two new cases and preferably three or four are required for each conference. Therefore, the fellows assigned to the Buffalo General Medical Center and Veterans Affairs Medical Center are expected to present at least one case each and fellows are encouraged to present cases from their outpatient clinic. A fellow also presents a 10-15 minute long evidence based review of a pertinent recent clinical article at each case conference. There is a clinical-pathologic conference quarterly where interesting cases are presented and the pathology is reviewed in detail by a pathologist.
The Fellows Conference is coordinated by the 3rd year fellows. Each month one of the fellows lectures on currently important topics in an in depth manner.
Core Lecture Series consists of Critical Care Medicine Review Conference and Pulmonary Medicine Review Conference. The format of the educational component is varied. A wide range of faculty from multiple disciplines is invited to lecture on topics to fulfill the educational requirements of the fellows as outlined by the learning objectives listed by the ACGME.
Pulmonary Journal Club. A fellow presents a journal article every month on a rotating basis. They choose an article which has recently been published in a primary pulmonary or critical care journal and distribute it to all members of the Division. They are responsible for leading a discussion of the article. Journal Club runs for 40 minutes with an additional 20 minutes for questions and comments.
Pulmonary Research Conferences are presented to increase the fellows' knowledge and interest in the basic sciences, to assist junior faculty to develop research projects, to provide an informal forum for researchers outside the Division who have potential collaborative interests and to obtain feedback from clinically oriented faculty. Second and third year fellows are expected to present their research data at conference.
The pulmonary fellows subsume greater responsibility for the educational process as they progress during their fellowship. These include problem-based learning, case discussions with literature reviews, and case presentations with bedside teaching and formal lectures.
Call
There is no in house call on any rotations. Fellows on consult and ICU rotations take at home call. At the BGMC MICU, attendings take primary at home call every other night and all day Sunday. Fellows on consult and ICU service at that particular hospital alternate weekend call.
Vacation
There are four weeks of vacation each year for fellows.
Research opportunities
Research experience is regarded as an essential part of the fellowship training. Fellows are provided ample protected time in the second and third years of training for research experience. Fellows have several opportunities for basic, translational, and clinical research with the divisional faculty. These include:
| Faculty | Topic |
|---|---|
| Sanjay Sethi, M.D. | COPD, Respiratory Infection |
| M. Jeffery Mador, M.D. | Respiratory Muscles, Sleep Medicine |
| Ali El Solh, M.D. | Sleep Medicine, Pneumonia |
| Karin Provost, D.O. | COPD, Macrophage function |
| Manoj Mammen, M.D. | Proteomics, Nanomedicine |
Beyond the research opportunities offered within the Division, several opportunities exist within the University and affiliated institutions. The Program Director will assist the fellow with arranging research opportunities outside of the Division.
Fellows
Third Year Fellows (Academic Year 2009-2012)
| Ilya Berim, M.D. | iberim@buffalo.edu |
| Mohammed Mogri, M.D. | mmogri@buffalo.edu |
| Anand Varma Gottumukkala, M.D. | vav2@buffalo.edu |
Second Year Fellows (Academic Year 2010-2013)
| Mohammed Abo Khamis, M.D. | m73a@buffalo.edu |
| Namrata Nag, M.D. | nnag@buffalo.edu |
| Anil Patel, M.D. | apatel9@buffalo.edu |
First Year Fellows (Academic Year 2011-2014)
| Talha Khan | tekhan@buffalo.edu |
| Kamen Rangelov | kamenran@buffalo.edu |
Contact Us
Fellowship Program General Inquiries
Sandra V Gilliam
Program Coordinator
Office of Graduate Medical Education
ECMC Room G-1
462 Grider St
Buffalo, NY 14215
(716) 961-6955
(716) 961-6960 fax
gilliam3@buffalo.edu
Academic/Administrative General Inquiries
Donna M. Donahue
Division Administrative Assistant
VA Western New York
Medical Research Building- 151
Room 146
3495 Bailey Ave.
Buffalo, NY 14215
(716) 862-8634
(716) 862-6526
Sleep Fellowship Program
Information regarding the Sleep Fellowship program is available under the Sleep Section tab of the Divisional webpage.
Other Educational Opportunities
Residents and third and fourth year medical students may chose an elective in Pulmonary at either Buffalo General Medical Center or the Western New York Veterans Administration Hospital. During the elective, they will participate in in-patient consultations, outpatient clinics, and have the opportunity to observe bronchoscopy and other pulmonary procedures. They will attend the weekly divisional teaching conferences, Pulmonary case conferences, research seminars, and journal clubs. Priority is given to SUNY-Buffalo students, but visiting students from other medical schools are welcome. The Department of Medicine student office will schedule these rotations.
Residency Program
Residency programs for all divisions are administered through the Department of Medicine. For details, visit the department’s Residency Program.
Medical Student Clerkship
For details regarding the Medical Student Clerkship, visit the department’s Medical Student Clerkship pages.