All fellows having 18 months of clinical rotations starting in their first year and concluding in the final six months of their third year. All fellows also participate in several practical and didactic courses in their first year of fellowship, including an Airway Cadaver Course, Critical Care Ultrasound Course and a Pulmonary Fellows Orientation Boot Camp led by senior fellows and attendings. A list of all core clinical rotations and simulation training courses are listed below.
Medical Intensive Care Unit
The medical intensive care unit (MICU) at NewYork-Presbyterian/Weill Cornell Medical Center is a 20-bed, closed unit ICU, that treats over 1,200 patients annually. It serves as the tertiary referral center for the Weill Cornell Medicine network, including hospitals in Queens, Lower Manhattan, and Brooklyn. The MICU works closely with other clinical services, including our robust hematology oncology/bone marrow transplant service, liver transplant service, and others to provide the best care possible for our patients.
The unit is divided into two 10-bed groups, each staffed with four residents, led by a fellow, and supervised by an ICU attending. Fellows in the MICU are expected to take an active role in the care of critically ill patients by managing daily rounds, performing or supervising procedures, and providing both formal and bedside teaching to residents and medical students. Fellows rotating in the MICU are also part of the cardiac arrest team.
Procedures commonly performed in the MICU by fellows include endotracheal intubation, bronchoscopy (therapeutic and diagnostic), central venous access, arterial line placement, Swan-Ganz catheter placement, and chest tube placement (surgical and percutaneous). MICU attendings also perform bedside percutaneous tracheostomies.
Pulmonary Consultation Service
The inpatient pulmonary consultation service covers both NewYork-Presbyterian/Weill Cornell Medical Center and the Hospital for Special Surgery. Fellows on the service are exposed to a wide array of pulmonary pathology and procedures. The consult service is typically staffed by two to three fellows and supervised by a dedicated pulmonary attending. Fellows on the service are also members of the multidisciplinary Pulmonary Embolism Response Team and participate in the triage and management of patients with high risk pulmonary emboli. Bedside procedures performed by fellows on the consultation service include thoracentesis, percutaneous chest tube placement, and bronchoscopy. Fellows on the consult service also perform procedures in our bronchoscopy suite (please see below) including tunneled pleural catheter placement, diagnostic bronchoscopy, and advanced bronchoscopy.
ICU Outreach Service
The ICU Outreach Service serves three important roles. First, it provides critical care triage and consultation for patients in the Emergency Department or on the wards. Secondly, it also provides critical care consultation services to other intensive care units, such as the cardiac ICU or Neurological ICU. The ICU Outreach service also provides continuity of care for patients recently transferred from the MICU. The ICU Outreach Service is staffed by two internal medicine residents dedicated to the triage and transfer of critically ill patients from the Emergency Department and wards and is supervised by a fellow and attending. The fellow is expected to assist with ventilator management and other issues for consult patients in other ICUs.
The bronchoscopy suite at NewYork-Presbyterian/Weill Cornell Medical Center offers a wide array of diagnostic and therapeutic procedures for our patients. Fellows participate in all inpatient and outpatient procedures performed by our division. Common airway procedures performed include inspection bronchoscopy, bronchoalveolar lavage, transbronchial biopsies, electromagnetic navigation bronchoscopy, linear endobronchial ultrasound (EBUS), and radial EBUS. Common pleural procedures performed include thoracentesis and tunneled pleural drainage catheter placement. Anesthesia services are available for all cases.
The anesthesia rotation is a four week rotation that provides first year fellows with dedicated teaching in the operating rooms and procedure suites by our staff anesthesiologists. Fellows learn the fundamentals of airway management, endotracheal intubation techniques, and management of procedural sedation. Fellows also observe cases with our thoracic surgeons to learn the basics of common thoracic surgery procedures, such as video-assisted thoracoscopic surgery, mediastinoscopy, rigid bronchoscopy, wedge and lobar resections.
Neurological Intensive Care Unit
Senior fellows rotate through the Neuro ICU at NewYork-Presbyterian/Weill Cornell Medical Center in their third year of fellowship. Our fellows learn from dedicated vascular and neuro-critical care specialists, including neuro-critical care fellows, on the diagnosis, triage, and management of patients with critical neurologic disease.
Cardiothoracic Intensive Care Unit (CT-ICU)
Senior fellows rotate through the CT ICU at NewYork-Presbyterian/Weill Cornell Medical Center in their third year of fellowship. Our fellows learn from critical care and cardiac anesthesiologists, including anesthesia critical care fellows, regarding the management of critically ill patients after cardiothoracic surgery. Fellows also receive exposure to veno-arterial ECMO in the CT-ICU.
- Basic Bronchoscopy
- Bronchoalveolar lavage
- Transbronchial biopsy
- Endobronchial biopsy
- Advanced Bronchoscopy
- Linear and radial EBUS
- EM Navigation
- Argon Plasma and direct thermal ablation therapy
- Endobronchial Stent placement
- Endobronchial Valve placement
- Endotracheal Intubation
- Direct laryngoscopy
- Video laryngoscopy
- Central Venous Access
- Swan Ganz Catheterization
- Chest Tube Placement
- Seldinger pigtail catheters
- Surgical large bore chest tubes
- Tunneled pleural catheters
- Percutaneous Tracheostomy
- Critical Care Ultrasound
Airway Cadaver Course
This course is held annually in late June in conjunction with the Division of Emergency Medicine. Fellows have the opportunity to practice procedural techniques on cadavers under the instruction of faculty from across Weill Cornell Medicine.
- Endotracheal intubation techniques
- Chest tube placement techniques
- Emergent cricothyroidotomy
- Other emergent techniques including open thoracotomy, cardiac massage, aortic clamping.
Critical Care Ultrasound Course
Junior fellows from all institutions in the tri-state area attend an intensive three-day course on critical care ultrasonography. Fellows learn the necessary skills to perform focus bedside ultrasound to assess common pulmonary, cardiac, and abdominal pathologies.
Pulmonary Fellow Orientation Boot Camp
Boot camp is held on the first week of July for all first year pulmonary critical fellows. Senior fellows lead the junior fellows through a structured curriculum of both didactic lectures, as well as practical skills and simulation training. The lecture series focuses on common and emergent clinical scenarios commonly seen on consult and MICU rotations.
- Didactic lectures
- Procedural simulation
- Endotracheal intubation
- Vascular access
- Surgical and percutaneous chest tubes
- Critical Care simulation