Overview and Objectives Clinical and Educational Activities Research Current Trainees Faculty Benefits Career Paths of Recent Graduates Contact Information and How to Apply

OVERVIEW AND OBJECTIVES

The pulmonary disease and critical care medicine fellowship program is designed to provide comprehensive training in all clinical and basic aspects of pulmonary and critical care medicine. A primary objective of the program is to instill an appreciation for scientific investigation and to train physicians for future careers in academic pulmonary medicine. To accomplish this goal, the program offers two pathways, one focused on clinical training and research, and the other on clinical training and basic, bench top research. The faculty recognizes that the energy and curiosity of our pulmonary fellows play a central role in the vitality of the division, and our commitment to maintaining the quality of the fellowship is strong.

There are four fellowship tracks available: pulmonary and critical care; pulmonary; Med-Peds pulmonary and critical care; and rare lung disease (third and fourth year fellows only). Fellows receive 36 months of training. A typical schedule includes 12 months in the critical care unit (9 in the MICU and 3 in specialty ICUs such a neuro, SICU or community ICU), 12 months on consult services, and 12 months on elective rotations or research rotations. The research pathway provides for 18 months of clinical training and a minimum of 18 months of scholarly activity. All pulmonary division, laboratories and clinical research projects are available to the fellows for research training, and there are a number of other opportunities in other Departments. For fellows interested in careers in independent clinical or laboratory research, every attempt will be made to obtain funding for additional years of training in a mentored environment.

The close relationship between pulmonary programs at the Cincinnati Children's Hospital Medical Center and the University provide unique opportunities for fellows. Populations of patients with neurofibromatosis, lymphangioleiomyomatosis, lysosomal storage diseases and other uncommon lung diseases are evaluated in a new Rare Lung Disease Clinic, funded through an NIH Cooperative agreement. Fellows with a specific interest in rare lung diseases such as cystic fibrosis or lymphangioleiomyomatosis may elect to pursue these interests in more depth by joining these programs and providing continuity care throughout the course of their training. A combined medicine-pediatrics pulmonary fellowship is available for fellow candidates who have completed residency training in an approved Med-Peds program and who wish to provide pulmonary care to both children and adults. An NIH-funded rare disease fellowship is also available for third- and fourth-year fellows with training in pulmonary disease or other disciplines.

Clinical and research conferences are an integral part of the training program. The division holds several weekly professional seminars, including pulmonary grand rounds, thoracic radiology and pathology conference, the fellow board review course and thoracic tumor board conferences at the VA and The University Hospital.

The division has recently launched the University of Cincinnati Comprehensive Sleep Medicine Center, directed by Dr. Victoria Surdulescu. Sleep laboratories with ten and two bed capacities have been opened at the University Pointe site and Drake Rehabilitation Hospital, respectively, and Dr. Surdulescu is the medical director for the four bed laboratory at McCoullough Hyde Hospital in Oxford. The VA has a two bed sleep laboratory, and in addition has the capacity to perform sleep studies in the General Research Center (GCRC), which is housed there. Fellows receive ample exposure to sleep during their training, and have the opportunity to take sleep electives or to perform sleep research.

All fellows who complete 36 months of training in pulmonary and critical care are eligible to take the Pulmonary Subspecialty Exam and the Critical Care Medicine Certification Exam administered by the American Board of Internal Medicine. Training providing eligibility for the Pulmonary Boards alone can be completed in a period of two years. Eligibility to take the sleep boards requires training beyond the traditional fellowship options above.

All fellows must have valid Ohio licenses. Temporary licenses can be obtained for a one-year period, but fellows are encouraged to obtain permanent Ohio licenses.

CLINICAL AND EDUCATIONAL ACTIVITIES

Most fellowship training takes place at three facilities: The University Hospital, The Cincinnati Veteran's Affairs Hospital and the Drake Rehabilitation Hospital. Fellows also have the opportunity to rotate through a community ICU at Jewish Hospital, and to participate in subspecialty clinics at the Medical Arts Building and University Pointe.

Outpatient Experience

The division operates general outpatient pulmonary clinics as well as specialty clinics focused on specific pulmonary diseases. All pulmonary fellows see clinic patients for at least one half-day each week, alternating between The University Hospital's pulmonary clinic and the Veterans Affairs Medical Center's pulmonary clinic. Typical diseases that are seen in the University clinic include chronic obstructive pulmonary disease, asthma, sleep disordered breathing, sarcoidosis, idiopathic pulmonary fibrosis and other interstitial lung diseases and occupational lung diseases. The range of pathology seen in the VAMC pulmonary clinic is similar, but is more heavily weighted toward lung cancer, chronic obstructive lung disease and sleep disorders. Pulmonary faculty members are present to supervise patient care and provide instruction for students, residents and fellows.

The clinic experience is designed to instruct fellows in the approach to the pulmonary patient, including the integration of the history, physical examination, imaging, laboratory and pulmonary function data and synthesis of a coherent plan. Fellows also have the opportunity to attend any of the specialty clinics below, on a continuous or rotating basis.

Specialty Clinics and Pulmonary Attendings
Adult Cystic Fibrosis
Patricia Joseph, MD
Bruce Trapnell, MD

Lung Cancer
James Knepler, MD
Elsie Pina, DO

Pulmonary Rehabilitation
Marta Render, MD
Amaresh Nath, MD

Rare Lung Disease
Frank McCormack, MD
Bruce Trapnell, MD
Lisa Young, MD
Ralph Panos, MD

Interstitial Lung Disease
Frank McCormack, MD
Ralph Panos, MD
Lisa Young, MD
Brent Kinder, MD

Sleep
Victoria Surdulescu, MD
James Knepler, MD

Occupational Medicine
James Lockey, MD
Amy Rohs, MD

Pulmonary Hypertension
Jean Elwing, MD

Inpatient Experience

Pulmonary inpatient consult services are provided at The University Hospital and the Veteran's Hospital. These experiences are designed to teach fellows the diagnostic, management and procedural skills that are necessary to care for hospitalized patients with pulmonary disease. Additional objectives are to provide the fellows with broad exposure to pulmonary pathology and to foster an appreciation for the clinical literature.

The consultation team consists of the attending pulmonary faculty, the pulmonary fellow and one or more medical residents and medical students. The fellows will become proficient in fiberoptic bronchoscopy and lung lavage, transbronchial biopsy and pleural biopsy. Opportunities to gain experience in interventional bronchoscopy, including stent placement, medical pleuroscopy, cryotherapy and laser bronchoscopy, are available through the pulmonary service (Drs. Knepler and Pina) and cooperative efforts with thoracic surgery. Review of pathology specimens in conjunction with faculty of the Department of Pathology is an integral part of the training.

The University Hospital consultation service provides care to patients at all acuity levels and on a variety of services. For example, on a typical day, the fellow may perform a bronchoscopy on a patient with unexplained infiltrates, and see a pregnant patient with dyspnea, a cystic fibrosis patient in exacerbation, and a congestive heart failure patient on a ventilator in the CCU. The number of new consults per day averages about four. Discussions of the patient care and pertinent literature are held during daily rounds, which routinely include both impromptu and prepared didactic sessions.

On the VAMC consultation service, the fellow gains enhanced experience in diagnosis and management of disorders such as carcinoma of the lung, tuberculosis, fungal infections and chronic obstructive lung disease. The fellow sees patients and advises housestaff in conjunction with the attending pulmonary physician in a manner similar to that at The University Hospital.

Fellows rotate through the Medical Intensive Care Unit (MICU) at both the University of Cincinnati and at the VAMC. Pulmonary faculty provide instruction on daily rounds, including both bedside teaching and didactic sessions. The fellow functions as a team leader, and with attending input, plays a key role in all management decisions. The level of leadership that fellows provide on these services varies. In The University Hospital ICU, the fellows supervise four to five second- and third-year residents, and are expected to function primarily as consultants and teachers for the housestaff. In the VA ICU, the fellows supervise four to five interns, and provide hands on instruction and careful guidance to junior physicians engaged in their first experience of care for the critically ill. Both ICUs are closed units, and only pulmonary and critical care physicians serve as attendings. In the University ICU, the ranges of pathologies that are seen are typical of an inner city hospital. The University also serves as a referral center for specialty care of critically ill patients with specific needs, such as liver transplantation or acute dialysis. In the VA ICU, respiratory failure, GI bleeding, and sepsis predominate. If they so choose, fellows may also rotate through other ICU's at The University Hospital, including the surgical ICU, the neuro ICU and the burn unit. Elective rotations are available in thoracic surgery, pathology, radiology and other services.

The Drake Rehabilitation Hospital is a 126 bed long term acute facility located approximately 7 miles from The University Hospital. The pulmonary team composed of an attending and a fellow rounds on between 10 and 30 patients with a variety of chronic pulmonary and airway disorders, including up to 20 patients requiring mechanical or non-invasive ventilation. Training in the management of the upper airway, including tracheotomy care and endoscopic evaluation; and in chronic respiratory failure due to obstructive and restrictive disorders, neuromuscular disease and stroke is provided.

RESEARCH

Pulmonary research is a primary focus of the division. Fellows have the opportunity to participate in a variety of projects, for periods ranging from one to 18 months of their fellowship. Research themes in the division include clinical studies in cystic fibrosis and lymphangioleiomyomatosis, basic research in the structure and function of adrenergic receptors in asthma and pathogenesis of sleep disordered breathing. Other areas of strength include pulmonary innate immunity, alveolar macrophage function and differentiation, surfactant protein biology, animal models of pulmonary fibrosis and microbial pathogenesis of pulmonary infection. Fellows may participate in a range of clinical trials that are currently in progress or soon to open, including studies in critical care, COPD, ILD, cystic fibrosis, LAM, alveolar proteinosis and alpha one antitrypsin deficiency. Trainees who present original work at national meetings are funded for travel, lodging and registration by the division.

CURRENT TRAINEES

Stephen Adjei, MB. ChB.
Medical School: University of Ghana
Residency: Griffin Hospital
Interests: Occupational Pulmonary Disease, Sleep, Critical Care, Receptor Biology and Genomics

Grant Breazeale, MD
Medical School: Medical University of South Carolina
Residency: University of Cincinnati
Interests: COPD, Interstitial Lung Disease

Irfan Budhani, MD
Medical School: Aga Khan University
Residency: University of Cincinnati
Interests: Critical care

Lisa Burns, MD
Medical School: Loyola University Chicago - Stritch School of Medicine
Residency: St. Louis University
Interests: Cystic Fibrosis, lung development, COPD

Joshiah Gordon, DO
Medical School: Lake Erie College of Osteopathic Medicine
Residency: University of Louisville
Interests: Critical care and interventional pulmonology

Jared Hagaman, MD
Medical School: University of Cincinnati
Residency: University of Cincinnati
Interests: Interstitial lung disease, pneumonia, and decision analysis

Fuad Hajjar, MD
Medical School: University of Damascus, Syria
Residency: : University of Pittsburgh Medical Center
Interests: Critical care and sleep medicine

Charles Kim, MD
Medical School: Flinders University of South Australia
Residency: UI Champagne
Interests: Pediatric pulmonary medicine, Cystic Fibrosis, and asthma

Daniel Murphy, MD
Medical School: University of Cincinnati
Residency: University of Cincinnati
Interests: COPD, critical care and sleep

Nicolae Oprescu, MD
Medical School: Universitatea de Medicina si Farmacie Carol Davila, Romania
Residency: Morristown Memorial Hospital, New Jersey
Interests: Interstitial Lung Disease and sleep medicine

Joseph Seaman, MD
Medical School: Wright State University, Boonshoft School of Medicine
Residency: University of Cincinnati
Interests: Interventional pulmonology, COPD and critical care

Christian Tencza, MD
Medical School: University of Cincinnati
Residency: University of Cincinnati
Interests: Rheumatologic lung disease and mechanical ventilation

Erich Walder, MD
Medical School: University of Cincinnati
Residency: University of Cincinnati
Interests: Lung Cancer, critical care

PAST TRAINEES

Name	Completion Date	City and State
Don Nelson, MD	1971	Tulsa, OK
Thomas Bunnell, MD	1971	Covington, KY
Roger Mengel, MD	1972	West Reading, PA
Martin Brueggemann, MD	1973	Cincinnati, OH
Y. Ploysongsang, MD	1973	Bangkok, Thailand
Rolando Brual, MD	1974	Celina, OH
Peter Enyeart, MD	1974	Cincinnati, OH
Michael Belman, MD	1974	Woodland Hills, CA
Philip Schworer, MD	1974	Florence, KY
Andrew Loewy, MD	1974	Cincinnati, OH
Terence Reuland, MD	1976
David Dortin	1975	Cincinnati, OH
Julie Ricking, MD	1976	Toppenish, WA
Ranjit Weerakoon, MD	1976	Dallas, NC
Harris Musafer, MD	1975	Norwalk, CA
Renata Schiffer, MD	1975	Cincinnati, OH
Grady Campbell, MD	1976	Cincinnati, OH
Girish Bhaskar, MD	1976	Lake City, FL
Sam Bansal, MD	1977	Ottowa, OH
Mark Robinson, MD	1977	San Bernardino, CA
Mark Hopping, MD	1978
Ralph Huller, MD	1978	Covington, KY
Brian Kanter, MD	1978	Minneapolis, MN
James Kennealy, MD	1979	Cincinnati, OH
William Krall, MD	1978	Fairfield, OH
Steven Schonfeld, MD	1979	Baltimore, MD
Arthur Bentsen, MD	1979	Evansville, IN
Ronald Roberts, MD	1979
David Wiltse, MD	1980	Cincinnati, OH
Otis Pinkard, MD	1980
Nicholas Tapyrik, MD	1980	Beaver, PA
Charlotte Kent, MD	1981	Oxford, England
Ralph DiLisio, MD	1982	Saint Claire Shores, MI
Charles Gensmer, MD	1981	Princetown, MN
Robert Baughman, MD	1982	Cincinnati, OH
Mitchell Rashkin, MD	1982	Cincinnati, OH
Chaturbhai Patel, MD	1981	Mansfield, OH
Alfonso Lopez, MD	1983	Cincinnati, OH
Nancy Munn, MD	1983	Huntington, WV
Patrick Sturm, MD	1983	Beaver, PA
Lee Jackson, MD	1984	Lexington, KY
Michael Dohn, MD	1984	Cincinnati, OH
Nelson Greene, MD	1985	Salem, VA
John T. Smith, MD	1985	British Columbia, Canada
Marshall McHenry, MD	1984	Cincinnati, OH
Bruce Corser, MD	1987	Cincinnati, OH
David Denholm, MD	1986	Beechwood, OH
Joseph Thorpe, MD	1986	Cincinnati, OH
Michael Halvonik, MD	1987	Cincinnati, OH
Craig Eisentrout, MD	1987	Cincinnati, OH
George Boatwright, MD	1988	Louisville, KY
Luis Guerra, MD	1986	Arlington, TX
Edward Fara, MD	1988	Chicago, IL
Patricia Miles, MD	1989	Covington, KY
William Dowdell, MD	1989	Marietta, GA
Jesse Doers, MD	1990	Knoxville, TN
Gregory Colangelo, MD	1990	Fairfield, OH
Michael Connolly, MD	1991	Birmingham, AL
William Lacy, MD	1991	Louisville, KY
Massoud Ansari-Leesar, MD	1990	Detroit, MI
Richard Sternberg, DO	1993	Hamilton, OH
Thomas Parker, MD	1993	Cincinnati, OH
Christopher Hayner, MD	1994	Cincinnati, OH
Glen Turner, MD	1994	Cincinnati, OH
James Lott, MD	1995	Birmingham, AL
Baher Elhalwagi, MD	1996	Longview, TX
Elsira Pina, DO	1996	Cincinnati, OH
Jamal Turki, MD	1996	Amman, Jordan
Stuart Green, MD	1994	Nevada
Maqbool Ahmed, MD	1997	Bullhead City, AZ
Chiara Conrado, MD	1997	California
John Liming, MD	1997	Cincinnati, OH
Amaresh Nath, MD	1998	Cincinnati, OH
Eakachai Sathianpitayakul, MD	1999	Bangkok, Thailand
Shahla Mallick, MD	1999	Cincinnati, OH
Sever Surdulescu, MD	2000	Mooresville, NC
Khaled Saleh, MD	2001	Minneapolis, MN
Victoria Surdulescu, MD	2000	Cincinnati, OH
Fortune Alabi, MD	2002	Detroit, MI
Khalid Almoosa, MD	2002	Cincinnati, OH
Sally Seymour, MD	2003	Washington, DC
Steve Strausbaugh, MD	2003	Cincinnati, OH
Junaid Malik, MD	2004	Detroit, MI
Amy Rohs, MD	2004	Cincinnati, OH
Kevin Fogel, MD	2005	Cincinnati, OH
Lisa Young, MD	2005	Cincinnati, OH
Syed Quadri, MD	2005	Detroit, MI
Samir Ataya, MD	2006	Cincinnati, OH
Ray Santucci, MD	2006	Cincinnati, OH
Jean Elwing, MD	2006	Cincinnati, OH
Prabhet Sinha, DO	2007	Cincinnati, OH
David Beck	2007	Cincinnati, OH
Chadi Loutfi, MD	2008	Boca Raton, FL
W. Clay Willmott, MD	2008	Florence, KY

FACULTY

Name	Position
Elwing, Jean - MD	Assistant Instructor
Joseph, Patricia M. - MD	Associate Professor
Knepler, James - MD	Assistant Professor of Medicine
McCormack, Francis X. - MD	Division Director, Taylor Professor
McGraw, Dennis - MD	Associate Professor
Nath, Amaresh - MD	Assistant Professor
Panos, Ralph - MD	Associate Professor of Medicine, VA Section Chief
Pina, Elsira M. - DO	Professor Associate
Rashkin, Mitchell C. - MD	Fellowship Program Director, Professor
Render, Marta - MD	Professor
Surdulescu, Victoria - MD	Assistant Professor
Trapnell, Bruce - MD	Professor
Young, Lisa - MD	Assistant Professor

BENEFITS

The salary for fellows is determined by university policy and postgraduate year status, according to NIH criteria. Fellows currently receive 20 days of vacation, excluding weekends.

You may find stipend and benefit information on the web site for the Health Alliance Office of Graduate Medical Education at www.med.uc.edu/residency.

CAREER PATHS OF RECENT GRADUATES

Several of our recent graduates hold faculty or directorship positions at a variety of institutions including Case Western Reserve, the University of Cincinnati and the Food and Drug Administration. Many former graduates are in private practice in the Midwest and throughout the United States.

CONTACT INFORMATION AND HOW TO APPLY

Fellowship applicants must apply through ERAS at https://www.erasfellowshipdocuments.org/

Joyce La Clair
Fellowship Coordinator
Division of Pulmonary & Critical Care Medicine
University of Cincinnati College of Medicine
PO Box 670564
Cincinnati, Ohio 45267-0564
joyce.laclair@uc.edu

Link to the map to Medical Center at http://medcenter.uc.edu/directions.cfm