Procedural Skills

During the inpatient pulmonary rotations at Mary Hitchcock Memorial Hospital (MHMH) and the Veterans Administration Medical Center (VAMC) and the IP rotation, fellows participate in a broad range of procedures, including:

  • Conventional bronchoscopy, including the opportunity to perform endobronchial ultrasound. There is also opportunity to participate in other highly-specialized interventional procedures, including navigational bronchoscopy, airway dilatation, Nd-YAG laser vaporization, argon plasma coagulation, tunneled pleural catheter insertion, percutaneous tracheostomy, and stent placement.
  • Interpretation of pulmonary function tests, including FeNO measurement, bronchoprovocation challenge and cardiopulmonary exercise testing.

Clinical time in the ICU provides opportunities for acquiring and honing skills, including:

  • Insertion of central venous and arterial catheters
  • Endotracheal intubation
  • Chest tube insertion and thoracentesis
  • Paracentesis

Point-of-care ultrasound has become an indispensable tool in the care of critically ill patients. Much of ultrasound/echocardiography learning is a result of “hands-on” experience in the ICU, but there is also a monthly didactic session dedicated to ultrasound, as well as ultrasound sessions during the July boot camp.