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Patient Care

The physician fellow will demonstrate increasing, graduated expertise and competence in the following areas:

  • The ability to communicate effectively with patients and their families, demonstrating caring, compassionate, and respectful behaviors leading to trust, credibility, and excellent rapport with patients and families.
  • The ability to take a good patient history, i.e., to establish an essential, accurate and, to the extent possible, comprehensive information base about the patient; furthermore, in the critical care setting, it is essential that the physician fellow develop the ability to recognize and respond promptly and appropriately to the following clinical presentations:
    • Acute renal failure
    • Acute respiratory distress syndrome
    • Arrhythmia
    • Brain ischemia
    • Chest pain
    • Coma
    • Gastrointestinal hemorrhage
    • Hypotension
    • Multi-system trauma
    • Post-operative care in an unstable patient
    • Respiratory failure
    • Severe abdominal pain
    • Severe infection
    • Shock
  • The ability to perform an appropriate and relevant physical examination, one that is accurate, directed toward the patient's problems, properly sequenced and uses branching examination techniques when appropriate: the physician fellow must correctly detect subtle findings when present.
  • The ability to make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment. The physician fellow must be able to relate abnormal findings with altered physiology and establish sensible and prioritized differential diagnoses.
  • The ability to develop and to carry out effective patient management plans: the physician fellow must be able to develop an orderly succession of testing and therapeutic recommendations leading to high quality, appropriate, cost-effective and comprehensive care.
  • The ability to counsel and educate patients and their families through consistently thorough and effective educational interventions.
  • The ability to use information technology effectively to support patient care decisions and patient education.
  • The ability to competently and proficiently perform all medical and invasive procedures considered essential for the practice of pulmonary and critical care medicine: the physician fellow must develop an understanding of the indications, contraindications, equipment, methods, specimen handling, and patient follow-up and must consistently act to minimize risk and discomfort to patients in the following procedures:
    • Arterial blood gas measurement
    • Arterial catheter placement
    • Flexible bronchoscopy
      • Bronchoalveolar lavage
      • Transbronchial needle aspiration biopsy ("Wang" needle biopsy)
      • Transbronchial lung biopsy
    • Central venous catheter placement
    • Endotracheal tube insertion
    • Lumbar puncture
    • Paracentesis
    • Pulmonary artery catheter placement
    • Thoracostomy tube placement
    • Thoracentesis

The ability to work effectively and consistently with health care professionals, including those from other disciplines, to provide patient-focused care.

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