The core faculty in the Division of Pulmonary, Critical Care and Sleep medicine includes 11 full-time, internationally-recognized faculty who possess a broad array of clinical and research interests covering the major fields of pulmonary and critical care medicine. The Program Director is Dr. Paru Patrawalla, an accomplished teacher and widely invited lecturer with an extensive background in using Medical Simulation Training techniques as well as a national expert in the growing field of Critical Care Ultrasonography. Fellows interact with core faculty on a daily basis through bedside rounds, daily clinical conferences, journal clubs, and didactic sessions. Formal didactic sessions are built around a core lecture series given year-round by our faculty and include respiratory physiology, hemodynamic monitoring, mechanical ventilation, and respiratory infections.
The Mount Sinai Beth Israel Pulmonary and Critical Care Medicine Fellowship Program is a 3 year combined program committed to providing outstanding clinical training in all aspects of pulmonary and critical care medicine. The first-year is dedicated to developing the foundations of clinical training in pulmonary and critical care medicine, as well as giving fellows the building blocks to subspecialty critical care medicine. This includes training in the management of patients in trauma, surgical intensive care, neuro critical care, cardiac critical care and palliative care medicine. The second year of fellowship is designed to further build clinical expertise in pulmonary with rotations on pulmonary subspecialty services, including pulmonary vascular disease, cystic fibrosis and sleep. Fellows in their second year also focus on scholarly activities and an individualized pathway to meet their career goals. The goal of their third year fellowship is to develop clinical expertise in a specific area of their choosing, complete scholarly activity and build on their educational and leadership skills.
Mount Sinai Beth Israel is a 600 bed tertiary care referral center that serves the lower east side of Manhattan and the surrounding boroughs and is the Lower Manhattan campus for the Icahn School of Medicine at Mount Sinai. Mount Sinai Beth Israel’s unique combination of referral and primary care patient populations provides a well-balanced mix for the training and clinical research programs of the Pulmonary and critical care medicine Fellowship Program.
The clinical training emphasizes the diagnosis and management of acute and chronic respiratory diseases, with emphasis on the practical application of pulmonary physiological and biologic principles and all aspects of critical care, consultative chest medicine, rehabilitation, pulmonary hypertension, lung cancer, and sleep medicine. An equally important aspect of our program is training in a vast array of pulmonary and critical care procedures. Our training program includes in-depth preparation in:
- Critical Care Ultrasonography/Point-of-care ultrasonography
- Percutaneous Tracheostomies
- Intubation with video and direct laryngoscopy
- Management of the difficult airway
- Flexible bronchoscopy
- Endobronchial ultrasound (EBUS)
- Short and long-term chest thoracostomy tube insertion and maintenance
- Pleurodesis
- Treatment of primary and secondary pulmonary hypertension
- Interpretation of pulmonary function tests, airway responsiveness testing and cardiopulmonary exercise testing
- Pulmonary rehabilitation
A unique aspect of this program is that we are able to pair a robust and comprehensive foundation of clinical training with an individualized pathway for career development. Fellows are deeply engaged in learning research, quality improvement, teaching and leadership skills. We have an expectation that our fellows will participate in scholarly projects and fellows routinely present their research at national meetings and publish in peer-reviewed journals. Our goal is to help our fellows succeed and become leaders in Pulmonary and Critical Care Medicine. Many of our graduates have gone on to become innovative clinician-educators and leaders in medical education and hospital administration.
The Alice and Richard Netter Simulation Center: Mount Sinai Beth Israel boasts a state-of-the-art simulation center directed by Dr. Paru Patrawalla. The center utilizes the most modern, life-sized, computerized patient simulator (SimMan™ 3G) to emulate a vast array of clinical scenarios to facilitate critical skills acquisition in areas such as basic and advanced airway management, resuscitation from cardiac arrest & shock, medical crisis leadership tactics and task based procedures such as insertion of central lines under ultrasound guidance. Dr. Patrawalla trains both residents and fellows in simulation training skills in order to serve as simulation center faculty and to promote and practice these skills during their careers.
Critical Care Ultrasonography/Point-of-care Ultrasonography: The Division has become a national leader in this relatively young field, having applied the use of ultrasonography to the care of ICU patients since the early 1990’s. Critically ill patients are routinely scanned using this safe, non-invasive imaging modality to determine the causes of shock, respiratory failure, intravascular volume status and procedural guidance. Dr. Patrawalla has achieved national recognition as a leader of critical care ultrasound training with a focus on competency-based educational methods. She serves as Co-chair of one of the largest national courses for critical care ultrasound and reviewer for the only national assessment-based certificate for critical care ultrasound. Fellows receive extensive training in point-of care ultrasound, beginning with a 3 day regional introductory course during their 1st month of fellowship. This is followed by an intensive, mastery learning approach to training using a web-based image archiving application to deliver immediate and instructive feedback to fellows. Train-the-trainer sessions are used to enhance the teaching skills of fellows, many of whom have become faculty at the national level. Training in advanced echo and transesophageal echocardiography is also available.