Interventional Pulm?

[coogmed]

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I am a current 4th year in IM, thinking about Pulm/CC for fellowship. I've been working with a doc that does interventional at my hospital, and I'm trying to get as much info about it as possible. Does anyone out there know which programs have a dedicated fellowship in interventional pulm? Is the prevailing attitude in the field that this will become a formal fellowship, or will it remain something that is learned via other means?

Any input would be greatly appreciated!!! 😀

 

[bigtuna]

There is one interventional pulmonologist at my program. I did an elective with him. Procedures include Pleurx catheters, thoracentesis, chest tube, thoracoscopy, percutaneous tracheostomy, bronchial stents, pleurodesis.

I only know of a few programs with formal fellowships: tulane, lahey clinic in boston.

I think it remains to be seen how this field will develop. Most of these procedures are traditionally done by a thoracic surgeon and there can be problems with turf battles. However, similar to the situation with cardiologist/cardiac surgeon, the pulmonologist is often the one who sees the patient first.

 

[phllystyl]

I've heard that both the BID and Penn offer fellowship training in interventional pulm after finishing your regular pulm/cc fellowship... much akin to iCards.

Anyone *nudge AJM nudge* care to elaborate?

 

[AJM]

There are currently 4 formal IP fellowship programs in the country -- there used to be 5, but after Katrina the Tulane IP program effectively shut down. I hear that they're trying to get restarted, but since most of their facilities and equipment was at one of the hospitals that has no plans to reopen, they're going to have a long road to get their program going again....

The other programs are BID, Lahey, Penn, and one other that I'm forgetting (somewhere in the midwest maybe???). UCSD will have an IP fellowship up and running within the next couple of years, and a number of other programs are looking into starting their own fellowship programs.

IP is a field that is becoming increasingly subspecialized, and the prevailing attitude is that people who want to do IP should do a formal fellowship. This fellowship is a one-year fellowship done after completing a pulm/cc fellowship. The interventional pulmonologists that I know have a goal of making this into a formal board-certified specialty, although I think they'll have to have a few more fellowship programs than what there are currently in order to accomplish that.

It doesn't seem to me that there is a huge turf war between thoracic surgeons and interventional pulmonologists. In fact, the BID IP program, which is the top IP program in the country, is actually under the thoracic surgery department, and all of the interventional pulmonologists and fellows get their salaries, etc, from thoracics. At some other hospitals looking into starting their own IP programs, it's the thoracic surgeons who are the ones wanting to start this up. Sure, there are always turf wars in every specialty, but I get the feeling that thoracic surgeons for the most part see interventional pulmonologists as an asset to their practice. I can elaborate as to why I think this is the case later on if you want... I'm just too tired to do that now. 🙂

As far as the procedures that trained interventional pulmonologists are doing, in addition to what bigtuna mentioned, they do things such as bronchial stent removals (much trickier than stent placements), endoscopic bronchial thermoplasty, superdimensional bronchoscopy, endobronchial ultrasound, and endobronchial one-way valve placements for endoscopic lung volume reduction therapy.