Clinical Training

Our Clinical Sites

We have four training sites that provide a rigorous, diverse, and rewarding clinical training experience for our fellows.

1. Ronald Reagan UCLA Medical Center (RRUMC):

Ronald Reagan UCLA Medical Center is a 520-bed hospital with five specialized 24-bed ICUs. It is a quaternary care hospital that is consistently ranked in the top 10 in the US News and World Report rankings. At RRMC, our fellows benefit from specialized training and routinely see cases that some pulmonary physicians only see once in a lifetime. Some of the subspecialized pulmonary care provided at RRUMC includes: interstitial and rare lung diseases, lung transplant, pulmonary hypertension, ECMO, and interventional pulmonary.

• Core clinical rotations
  • Medical ICU, general pulmonary consult service, advanced lung disease (e.g. lung transplant) consult service, pulmonary vascular disease consult service, liver ICU (e.g. pre- and post-liver transplant patients), medical ICU night coverage
• Elective clinical rotations
  • Neuro-ICU, cardiothoracic surgery ICU, surgical/trauma ICU, ECMO management, interventional pulmonary consult service
• Outpatient clinics
  • General pulmonary, pulmonary vascular disease, interstitial lung disease, lung transplant, COPD, lung nodule, sleep medicine, post-ICU clinic
  • *The UCLA main campus provides a continuity clinic experience for many fellows, whether in general pulmonary clinics or subspecialty clinics

2. Santa Monica-UCLA Hospital (SM-UCLA):

Santa Monica-UCLA Hospital is a 281-bed hospital with an 18-bed ICU, which serves as our community hospital. It is staffed by a skilled, tight knit group of full-time UCLA faculty clinician educators. It is the home base for our interventional pulmonary group, offering advanced bronchoscopic, pleural, and airway procedures. At this site, our fellows get to run their own ICU as there are no residents or mid-level providers on the ICU team. Our fellows enjoy both the medicine and the autonomy at Santa Monica and have the opportunity to participate in a truly community intensivist experience.

• Core clinical rotations
  • Medical ICU, general pulmonary consult service
• Elective clinical rotations
  • Interventional pulmonary consult service, cystic fibrosis consult service
• Outpatient elective clinics
  • General pulmonary, cystic fibrosis multidisciplinary clinic, nodules/malignancy/effusion clinic, interventional pulmonary, sleep medicine
  • *SM-UCLA offers a continuity clinic experience for interested 2^nd and 3^rd year fellows, particularly those with an interest in sleep medicine

3. The West LA VA Hospital (WLA VA):

The West LA VA Hospital is a large tertiary care Veterans Affairs hospital with a 36-bed multidisciplinary ICU along with an 18-bed multidisciplinary step-down unit and is part of the largest VA system in the nation. Fellows have the opportunity to serve the veteran population and get particularly in-depth exposure to COPD, lung cancer, pulmonary function testing, cardiopulmonary exercise testing, and sleep medicine.

• Core clinical rotations
  • Medical ICU, general pulmonary consult service, outpatient clinical service, sleep/pulmonary physiology (PFTs, CPETs)
• Outpatient clinics
  • General pulmonary and sleep medicine
  • Robust pulmonary function testing and cardiopulmonary exercise testing exposure
  • *VA provides a continuity clinic experience that most 1^st years participate in, and many 2^nd and 3^rd years choose to continue there as well

4. Olive View-UCLA Hospital (OV-UCLA):

Olive View-UCLA Hospital is a county hospital serving the population of the San Fernando Valley with an 18-bed mixed medical ICU/cardiac care unit. At this site, our fellows get to experience all the benefits of a county hospital – first time presentations, bread and butter cases, an extremely diverse patient population, and the opportunity to take care of underserved patients. The dedicated clinician educator faculty has made OV-UCLA an extremely popular training site for medical students and fellows alike. Additionally, Olive View has also been honored as a pulmonary tuberculosis center of excellence.

• Core clinical rotations
  • Medical ICU, general pulmonary consult service, outpatient clinical service
• Outpatient clinics
  • General pulmonary clinic
  • *Olive View offers a continuity clinic experience for interested 2^nd and 3^rd year fellows

Procedural Training

Also unique to our training program is the abundance of procedural training we offer. Fellows will graduate from our program proficient in the following:

• Bronchoscopy: general bronchoscopy, transbronchial biopsies, linear endobronchial ultrasound with transbronchial needle aspiration
• Pleural procedures: thoracentesis, chest tubes, tunneled pleural catheters
• Airway management: direct laryngoscopic intubations, video laryngoscopic intubations, fiberoptic intubations
• Percutaneous tracheostomy
• Right heart catheterizations
• Central venous catheterization including subclavian catheters and hemodialysis catheters
• Arterial lines
• Advanced ultrasound training with a formal training curriculum in ultrasound

Fellows will get elective exposure to:

• Rigid bronchoscopy, robotic bronchoscopy, navigational bronchoscopy, and radial endobronchial ultrasound
• Medical pleuroscopy
• Invasive Cardiopulmonary Exercise Tests

Clinical Rotation Structure

• 1^st year: 48 weeks of clinical rotations + 4 weeks of vacation
  • Clinical rotations are a mix of ICU + inpatient consults + outpatient procedure/clinic coverage
• 2^nd and 3^rd year:
  • Clinician educator track: ~26 weeks of clinical rotations + ~22 weeks of elective (divided between research, ICU electives, and backup/jeopardy coverage) + 4 weeks of vacation
  • Research/STAR track: ~14 weeks of clinical rotations + 34 weeks of research + 4 weeks of vacation
• Continuity clinic: every fellow is assigned to a continuity clinic, which they attend one half-day per week. This experience allows fellows to provide longitudinal care to patients, forming relationships that last throughout fellowship.
  • Available clinical sites for continuity clinics: UCLA, VA, Olive View (2^nd and 3^rd year only), Santa Monica (2^nd and 3^rd year only)
  • Additional outpatient clinic experience is provided during the VA and Olive View outpatient rotations, which includes clinic coverage and participation in outpatient pulmonary procedures
  • A UCLA-based “outpatient rotation” is provided for 2^nd year fellows to foster interest in and ensure exposure to subspecialty outpatient pulmonary medicine
• Available clinical “tracks”: during the 2^nd and 3^rd year, we have the flexibility and resources to allow interested fellows on our clinician educator track to gain additional sub-specialty training in a number of fields, preparing fellows to exit fellowship after 3 years with an area of subspecialized expertise that often otherwise takes an additional year of fellowship training. These areas include:
  • Interstitial lung disease
  • Pulmonary vascular disease
  • Sleep medicine (through the pilot AIRE program)

Didactics and Education

Throughout the entire fellowship, fellows will be exposed to both informal and formal didactic lectures at every site with certain conferences available to all sites via tele-conferencing, as well as a staggered hands-on workshop series. In addition, fellows also play a large role as educators, preparing teaching conferences to be delivered to residents and the fellowship program.

Didactic lecture curriculum

• 2 hours of weekly protected time on Tuesday mornings for our core didactic lectures series
• Bimonthly “journal watch” and “journal club” conferences to discuss the latest research published in the field of pulmonary/critical care
• Weekly Grand Rounds delivered by both internal and visiting faculty

Case-based curriculum

• Weekly case-based conference in which fellows presents a case for discussion with invited faculty experts and multidisciplinary input from radiology, pathology, and others.,
  • Our most popular conference!
• Each site has dedicated patient-related conferences that fellows attend on an optional basis – e.g. tumor board, transplant selection committee, multidisciplinary ILD conference, etc…

Simulation-based curriculum

• Quarterly simulation or hands on courses split by training year
  • 1^st year receive a targeted curriculum in procedural training, ultrasound, and teaching skills
  • 2^nd and 3^rd years participate in a rotating series of workshops throughout their senior years of fellowship, including difficult airway, endobronchial ultrasound, cardiopulmonary exercise, and career development