Pulmonary Medicine Training

Pulmonary Medicine training at Columbia is spread across the first two clinical years with rotations spent on Pulmonary Consult Service and the Lung Transplant Service. Fellows have a continuity clinic throughout the three years of training and have opportunities to rotate through sub-specialty clinics (see Ambulatory Training Page). Columbia University has active clinical and research programs in sub-subspecialties of lung disease including cystic fibrosis, interstitial lung disease, COPD (LVRS), alpha-1 antitrypsin deficiency, sleep medicine, lung cancer, interventional bronchoscopy, LAM, and lung transplant providing a rich clinical experience in pulmonary medicine with diverse pulmonary pathology.

Pulmonary Consult at NewYork-Presbyterian/Columbia

During the six months of inpatient pulmonary consult at Milstein Hospital, fellows diagnose and manage common and rare pulmonary diseases, and supervise medical student(s) and medical residents on the consult service. The diverse pulmonary pathology encountered stems from our tertiary care referrals, the varied interests of the faculty, and the surrounding neighborhoods with recent immigrants and indigent patients. Columbia University has a large Bone Marrow Transplant program, active lung cancer program providing fellows the opportunity to gain expertise with management of lung disease in the immunosuppressed patient, especially non-infectious pulmonary complications of malignancy, as well as pulmonary toxicities of medications. There is no dedicated pulmonary in-patient service for the Department of Medicine, thus the fellow manages the majority of inpatient pulmonary cases on this service. The fellow is responsible for inpatient bronchoscopies, thoracentesis and placement of pigtail catheters and tunneled pleural tubes (PleurX) while on this service.

Lung Transplantation

Our lung transplantation program is one of the oldest in the United States and is the major center for lung transplantation in the New York Tri-state Area. In the three months that fellows spend during their first two clinical years on the lung transplant service, fellows are exposed to a wide variety of advanced lung disease including rare interstitial lung diseases, pulmonary hypertension, and cystic fibrosis and they learn about post-transplant management, diagnosis and management of lung transplant complications. In this rotation, fellows gain proficiency in bronchoscopy and transbronchial biopsies with attention to the role of bronchoscopy in post-transplant management and assessment of histologic findings in post-lung transplant patients. Please visit our Lung Transplant Program.

Interventional Bronchoscopy

Fellows are trained in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under direct supervision by one of our interventional bronchocsopists. Fellows perform EBUS in varied rotations including the pulmonary consult service, interventional rotation, and when at all possible, fellows are encouraged to perform outpatient bronchoscopies on their own patients. We have an active interventional bronchoscopy service at Columbia University which exposes our fellows to a variety of diagnostic, therapeutic and investigational interventional bronchoscopy procedures such as bronchial thermoplasty for severe asthma, navigational bronchoscopy to biopsy peripheral lesions and bronchoscopic treatment for advanced emphysema. Please visit our Interventional Bronchoscopy Program.

Pulmonary Physiology Training

Pulmonary physiology training is integrated into the six months of inpatient pulmonary consult service. During this time, fellows will learn the diagnosis and management of sleep disorders, the interpretation of sleep studies and the interpretations of PFTs and CPETs.

Pulmonary Function Testing (PFT)

Our pulmonary diagnostic unit provides comprehensive pulmonary function testing to patients throughout the medical center as well as to patients before and after lung transplantation and thoracic surgery. Under the direction of Dr. Robert C. Basner, fellows learn the physiology of pulmonary function testing as well as pulmonary pathophysiology. Please visit our Pulmonary Function Testing (PFT).

Cardiopulmonary Exercise Testing (CPET)

The CPET lab performs exercise testing on patients with advanced lung disease, many of them perioperative for lung volume reduction surgery or lung transplantation, pulmonary hypertension or unclear etiology for dyspnea. This affords a rich educational experience for our fellows who are learning about exercise physiology in the healthy and diseased state, and determine the impact of co-morbid medical conditions on exercise capacity.

Optoelectronic Plethysmography (OEP)

Unique to most pulmonary diagnostic centers is our Optoelectronic Plethysmography System, currently primarily used for scientific research and innovative clinical study. It is a new non-invasive method to evaluate ventilation through an external measurement of the chest wall surface motion. Fellows have the opportunity to generate research projects investigating the role of this technology in the evaluation of ventilatory disorders in a myriad of clinical conditions.

Sleep Medicine

Our Cardiopulmonary Sleep & Ventilatory Disorders Center under the direction of Dr. Robert Basner provides expert education in sleep medicine and physiology to our fellows who receive instruction in the interpretation of polysomnography, diagnosis and treatment of sleep disorders and the techniques of measurement and interpretation of the physiology of sleep and breathing. Please visit our Sleep & Ventilatory Disorders Center.