Our fellows complete at least 18 months of clinical training during their fellowship. The first year of fellowship is all clinical and the remaining 6 months of clinical training are scattered through the second and third year. Throughout the 36 months of PCCM fellowship, fellows participate in a continuity clinic.
Five hospitals participate in the clinical training of PCCM fellows including: Yale New Haven Hospital (Y-NHH), a tertiary care hospital, The West Haven Veteran's Administration Hospital (WHVAMC), Hospital of St. Raphael a private community hospital, Bridgeport Hospital, a community hospital with specialty burn unit, and the Hospital for Special Care, a comprehensive rehabilitation hospital specializing in ventilator dependence, weaning and respiratory rehabilitation.
Senior fellows rotate for 2 weeks through the Coronary Care Unit (CCU) at Yale New Haven Hospital. This rotation allows PCCM fellows to gain experience and competence in managing critically ill patients in the unique environment of the CCU. The CCU at Yale New Haven Hospital is a 14-bed adult ICU which provides care to patients with life-threatening cardiovascular illness such as acute myocardial infarction, heart failure, cardiomyopathies, and arrhythmias. As a regional referral center, the unit supports patients as they undergo advanced diagnostic procedures such as cardiac catheterization and electrophysiology studies, as well as invasive procedures such as pacemakers, intra-aortic balloon pumps and left ventricular assist devices, coronary stents and brachytherapy. The PCCM fellows have a comprehensive and unique opportunity to experience and participate in state of the art intensive coronary care. As a heart transplant center, fellows will additionally be exposed to the complex and multidisciplinary care of the patient pre and post-transplant.
During this rotation, PCCM fellows are expected to gain experience and knowledge in procedures such as Swan Ganz catheter placement, temporary venous pacemaker placement, and pericardiocentesis. They additionally spend time in the interventional catheterization laboratory to understand the technical aspects of catheter-based advanced therapies (e.g. stenting, valvuloplasty, intra-aortic balloon placement) and to understand how this relates to the care of the critically ill patient.
Hospital for Special Care
Hospital for Special Care has 200 beds and is licensed as a Long-Term Acute Care Hospital (LTAC). The Hospital services patients with chronic respiratory diseases from spinal cord/neuromuscular disorders, COPD, chronic ventilator dependency and long term weaning from mechanical ventilation. Acute rehabilitation is also provided. Our fellows have the option to spend time at HSC as an elective during their training.
Bridgeport Shriner's Burn unit/SICU
The burn unit is a unique and highly specialized care environment and is the only burn center in the state of Connecticut The burn center is an outstanding model of interdisciplinary care including occupational & physical therapy, dietary, respiratory & pulmonary services, social work and chaplain services. Thermal injuries with inhalation injuries, electrical, chemical and exfoliative skin disorders are what is typically seen here.
Chest and Critical Care Radiology
As radiographic studies are a critical part of our pulmonary and critical care medicine, learning how to interpret radiographic studies of the thorax is critical. Fellows meet on a daily basis in the thoracic radiology suite and read films with the thoracic radiology service.
Fellows can rotate through the operating room with anesthesiology either at Yale-New Haven Hospital or the West Haven VA and learn the technical skills of intubation, vascular access and difficult airway management.
Our fellows have the opportunity to spend a month doing an away elective in a field of their choosing Our previous fellows have spent time learning lung transplant at specialized centers, learning about bronchiectasis and MAI, spending time in an underserved location as part of the Johnson and Johnson Global Health program.
All of our first year fellows have weekly continuity clinic at the West Haven VA under the guidance of our faculty (Hilary Cain, Carly Rochester, Kathleen Akgun, Charles Dela Cruz, Christine Won, Klar Yaggi and Meir Kryger). The VA clinic population includes a large amount of COPD, asthma, lung nodules and obstructive sleep apnea.
During their second and third years the fellows alternate their weekly clinic between the West Haven VA and Winchester Chest Clinic at Yale-New Haven Hospital. Winchester Chest Clinic serves the local community as well as a wide referral population. The addition of Winchester Chest Clinic in the second and third year of fellowship not only gives the fellows exposure to a wider range of pulmonary disease but also teaches them the art of outpatient consultative medicine. The faculty who supervise in Winchester include Jennifer Possick, Richard Matthay, Jonathan Puchalski and Patty Lee.
Our fellows have a wide variety of subspecialty clinics to choose from including TB, cystic fibrosis, ILD, asthma, thoracic oncology, pulmonary hypertension and sleep. Our fellows spend 6 months doing ½ day/week in subspecialty clinics during the course of their fellowship.
- Yale Center for Asthma and Airways Disease
- The Yale Center for Sleep Medicine
- Adult Cystic Fibrosis Clinic
- The Yale Interstitial Lung Disease Center
- Occupational and Environmental Lung Diseases
- The Yale COPD Center
- The Yale Thoracic Oncology Program
- Winchester Chest Clinic
- Pulmonary Vascular Disease Program