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The goal of the Pulmonary and Critical Care Medicine Fellowship is to provide exceptional training for the next generation of pulmonary/critical care physicians, and to provide an experience that will allow graduates to be successful in a career path of their choosing.
The Division of Pulmonary, Allergy and Critical Care Medicine aims to provide optimal patient care while achieving the institutional goals of respect, integrity, teamwork and excellence. The team of expert pulmonologists promotes best practices among trainees by providing them with mentorship and support in a collaborative, inclusive environment where trainees have the opportunity to develop skills in clinical care, medical education and research.
Through effective communication and understanding individual needs, the program allows each trainee the ability to create a customized track for themselves, utilizing all of the resources Penn State has to offer. By catering to the interests of each fellow and maintaining a broad range of skills within the core faculty, the program ensures each trainee has a thorough foundation in all areas of pulmonary and critical care medicine, as well as opportunities to explore a variety of career interests.
Graduates from the program have successfully pursued careers in academic medicine and private practice.
Learn More about the Fellowship
All Pulmonary and Critical Care Medicine Fellowship applications must be processed through ERAS.
Please refer to the official AAMC ERAS fellowship website for more details.
Due to the high number of applicants, the program is unable to notify or respond to each candidate. Contact the Program Coordinator with questions.
Penn State Health Milton S. Hershey Medical Center
P.O. Box 850, Mail Code H039
500 University Dr.
Hershey, PA 17033-0850
Orientation occurs during the first month of fellowship, with a one-week pulmonary/critical care boot camp that includes small-group sessions on relevant topics and hands-on training in the Clinical Simulation Center for procedures, ultrasound and bronchoscopy.
Fellows spend the next three weeks rotating through the three core clinical rotations with a second-year fellow.
Following orientation, first-year fellows spend 13 blocks, four weeks each, on each of the core clinical services: the medical ICU service, the general pulmonary consult service and the interventional pulmonary service. Additionally, first-year fellows have a four-week elective they may use to gain additional exposure to a specific interest outside the core clinical rotations, with the goal of helping to set them up for their scholarly work during the second and third years.
At a Glance
Second- and third-year fellows each spend a total of six months on required clinical rotations, including a minimum of three months on non-medical ICU rotations, an additional two months on the medical ICU service, two weeks of respiratory care and ventilator block and one month of optional airway training.
At a Glance
Inpatient Pulmonary Consult and Cystic Fibrosis Service
This rotation provides fellows with opportunities to learn about the diagnosis and management of a broad range of pulmonary diseases including obstructive, vascular and interstitial lung diseases.
Pulmonary issues of the immunocompromised patient are regularly encountered due to the busy transplant and hematology/oncology services at the Medical Center. This service also provides direct care of all patients with cystic fibrosis patients admitted to the Medical Center.
Additionally, fellows on the consult service are responsible for interpreting pulmonary function tests and cardiopulmonary exercise tests under the direction of the consult attending.
Interventional Pulmonary Consult Service
The interventional pulmonary consult service is responsible for evaluating new interventional pulmonary consults and performing interventional pulmonary, general bronchoscopic, percutaneous tracheotomies and pleural procedures on both inpatients and outpatients.
On this service, fellows receive extensive training in basic and advanced bronchoscopy, including exposure to endobronchial ultrasound, endobronchial valve placement, navigational bronchoscopy, airway stenting and bronchial thermoplasty.
Pleural procedures are an evolving part of this rotation, and fellows will gain experience in small and large-bore chest tube placement, pleurodesis and pleural biopsy.
While on the rotation, fellows spend one half-day a week in the multidisciplinary thoracic clinic, where fellows evaluate and manage various aspects of thoracic malignancies in concert with thoracic surgery.
Trainees in the Pulmonary and Critical Care Medicine Fellowship each have their own general pulmonary continuity clinic where they provide longitudinal care for patients with a broad range of pulmonary pathology.
Because of the outstanding outpatient referral base from central Pennsylvania, a fellow will typically see patients with both common and rare diseases including asthma, COPD, interstitial lung diseases, neuromuscular diseases, sarcoidosis, rheumatologic diseases and pulmonary hypertension.
During the second and third years, fellows have regular rotations through the interstitial lung disease, sarcoidosis and pulmonary hypertension clinics. In these clinics, fellows are responsible for evaluating and providing both initial and follow up care for patients with these complex diseases. As part of the pulmonary hypertension clinic, fellows also perform right heart catheterizations in the cardiac catheterization lab and gain experience in interpreting pressure waveforms and performing acute vasodilator testing.
Medical Intensive Care Unit
Penn State Health Milton S. Hershey Medical Center’s Intensive Care Unit, a 16+8 bed service, provides the foundation for the critical care training program. As the quaternary referral center for the region, the medical ICU is responsible for the care of patients with a diverse array of complex pathology.
Fellows lead rounds under the guidance of the faculty, supervise procedures and provide didactic instruction to residents and students on service.
Weekly ventilator rounds, focused on the physiology of the respiratory system and how it is affected by mechanical ventilation, are led by faculty and attended by fellows and residents. As the year progresses, fellows are expected to take a leading role in ventilator rounds.
Additionally, proficiency with critical care ultrasound is emphasized through weekly bedside ultrasound rounds.
Heart and Vascular Intensive Care Unit
Fellows can spend one month during their second or third years on the Heart and Vascular Intensive Care Unit service, where patients with complex cardiac disease receive care.
Penn State Heart and Vascular Institute has 30 beds and is a center for advanced heart failure. While on this service, fellows gain experience with extracorporeal membrane oxygenation (ECMO), left ventricular assist devices (LVAD) and heart transplant.
Surgical Anesthesia Intensive Care Unit
Fellows can spend one month during the second or third years on the Surgical Anesthesia Intensive Care Unit service, where, under the guidance of critical care certified staff, they manage complex post-operative surgical patients, including orthopedics, obstetrics and gynecology, otolaryngology and others.
Trauma Intensive Care Unit
Penn State Health Milton S. Hershey Medical Center is a level 1 trauma center, and fellows on this service are responsible for providing care to this group of critically ill patients.
Fellows are required to spend one month during the second or third year on service in the Surgical Trauma Intensive Care Unit. Fellows are invited to attend trauma arrivals in the trauma bay in the emergency department for hands-on experience. ATLS is a program-supported certification that is mandatory prior to this rotation.
Neuroscience Critical Care Unit
Fellows can spend one month during their second or third years on the Neuroscience Critical Care Unit service.
This busy neurology and neurosurgery service has a 16-bed capacity that provides fellows with ample opportunities to manage patients with severe neurological diseases, including stroke, intracranial hemorrhage, status epilepticus, central nervous system tumors and infections and others.
Fellows can spend one month during their second or third years on the anesthesiology rotation. During this rotation, fellows learn about pre-operative evaluation of patients, conscious sedation and general anesthesia and airway evaluation. Fellows learn how to manage both elective and emergent airways and gain proficiency in the use of single and double-lumen endotracheal tubes, laryngeal mask airways and other airway adjuncts.
Second and third-year fellows can choose to spend time on various electives, including thoracic radiology, pulmonary rehab, anesthesiology, sleep medicine, thoracic surgery, critical care ultrasound, pathology, allergy and immunology, cardiology, echocardiography, PFTs, nutrition and simulation education training, with options for others.
The program also works with fellows to develop new electives to cater to specific career interests when needed.
Penn State College of Medicine and Penn State Health promote an environment of inquiry, and all fellows are expected to participate in scholarly activity during their fellowship training.
Given the diverse interests of the faculty, the program has the ability to support scholarly interest in many areas, including basic science, clinical trials, outcomes research or medical education.
To ensure the fellows’ success, each fellow is required to delineate a particular scholarly project with an appropriate faculty mentor by the beginning of their second year. The scholarship committee meets with each fellow on a semi-annual basis to ensure they are meeting appropriate milestones and to help address any issues that may have arisen.
By the end of their third year, fellows are expected to have a product related to their scholarly work.
Areas of active research by the faculty include:
- Acute lung injury/ARDS
- Chronic obstructive pulmonary disease
- Communication in the intensive care unit
- Critical care ultrasound
- Cyanide intoxication
- Cystic fibrosis
- End-of-life discussions
- Interstitial lung disease
- Pulmonary hypertension
- Thoracic malignancies
More information can be viewed in the faculty profiles.
A robust and wide range of conferences supplements these educational opportunities for the fellows. These conferences provide a foundation in the pathophysiology, diagnosis and clinical management of patients with complex lung diseases and the critically ill. The majority of educational activity takes place at Tuesday weekly conferences, scheduled from 3 to 5 p.m.; a schedule is included here.
Fellow Honors and Recognitions
Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center accept ongoing nominations for the Exceptional Moments in Teaching award.
The award, given monthly by the Office for a Respectful Learning Environment, accepts nominations from College of Medicine students who are invited to submit narratives about faculty members, residents, fellows, nurses or any other educators who challenge them and provide an exceptional learning experience. See more about the award here.
Previous nominees from the Pulmonary and Critical Care Medicine Fellowship are listed here. Click the + next to a nominee name to read their nominator’s comments.
The annual Resident/Fellow Research Day is held each summer on and around the Penn State Health Milton S. Medical Center campus in Hershey, PA.
The intent of the event is to provide an opportunity for residents and fellows to showcase their research accomplishments to their peers in other clinical departments, as well as their colleagues in the basic sciences.
Previous presentations from the Pulmonary and Critical Care Medicine Fellowship are listed here.