Clinical Training

The Medical Intensive Care Unit is a tertiary referral center for patients with complex medical critical care problems. Diseases diagnosed and managed on this service include respiratory failure due to ARDS, pneumonia, COPD, asthma, and neuromuscular diseases, shock, major pulmonary embolism, congestive heart failure, acute and chronic renal failure, upper and lower gastrointestinal hemorrhage, severe pancreatitis and liver failure, life-threatening infections, acute cerebral infarction, intracranial hemorrhage, and status epilepticus. The MICU also provides critical care services for the UPMC Toxicology Program.

Patients in the MICU are cared for by two physician teams, each consisting of a PACCM faculty member, a fellow, two residents, and two interns. Fellows closely supervise the management of critically ill patients by the medical house staff and also gain extensive experience in airway management and endotracheal intubation, mechanical ventilation, central venous catheterization, hemodynamic monitoring, pleural catheter and thoracostomy tube insertion, and bronchoscopy.

The MICU conducts numerous ongoing clinical trials in the areas of ARDS, sepsis, and disease outcome.

UPMC Presbyterian Neurovascular Intensive Care Unit

During this rotation, the fellow cares for critically ill patients with neurologic or neurosurgical disorders. Commonly encountered diseases include acute cerebral infarction and hemorrhage, subdural hemorrhage, status epilepticus, CNS malignancies, and intracranial hypertension.

UPMC Presbyterian Cardiothoracic Intensive Care Unit (CTICU)

The CTICU delivers care to adult cardiac, thoracic, and vascular surgery patients, as well as those who have undergone heart/lung transplantation. Experience in the acute post-operative management of cardiothoracic and thoracic surgery patients is the key focus of this rotation.

In addition to traditional critical care procedures, fellows gain experience with the support of patients requiring extracorporeal membrane oxygenation and ventricular assist devices.

UPMC Trauma Intensive Care Unit

The Trauma ICU service consists of critically ill patients who have suffered major trauma including neurological trauma. This Level 1 Trauma Program is a key component of one of the nation's finest emergency and critical care networks. The City of Pittsburgh's Department of Public Safety centers its Medical Command facility at the hospital, from which city paramedics serve injured patients. This system also has one of the largest and most comprehensive air medical transport programs in the United States. During this rotation, the fellow directly cares for these critically ill patients and gains experience in the multidisciplinary care of patients with complex multi-organ trauma.

Pulmonary Medicine Training

UPMC Presbyterian Consultation Service

The Pulmonary Consultation service provides expertise for complex pulmonary disorders to patients in the Oakland UPMC complex, which consists of UPMC Presbyterian, Children's Hospital, Magee Women's Hospital, and the Western Psychiatric Institute and Clinic.

Diseases diagnosed and managed on this service include COPD, asthma, pulmonary embolism, pulmonary hypertension, pulmonary vasculitis, pneumonia, pleural effusion, pneumothorax, interstitial lung disease, occupational lung disease, drug-induced lung disease, pulmonary malignancy, and sleep-disordered breathing.

Fellows supervise the care provided to patients by the University of Pittsburgh house staff and perform all bronchoscopies for the patients seen on this service.

Combined Critical Care and Pulmonary Medicine Training

Oakland VA Medical Center MICU/Consultation Service

The OVAMC MICU service consists of critically ill medical patients who have been admitted through the Emergency Department or from an outside VA or non-VA facility. Patients are cared for in the 42-bed Critical Care Center. Pulmonary consultation services are also provided to patients throughout the VA hospital.

Patients on this service have a wide variety of pulmonary and critical care disorders including ARDS, shock, pneumonia, COPD, asthma, bronchogenic carcinoma, pulmonary embolism, pulmonary hypertension, pleural effusion, pneumothorax, interstitial lung disease, occupational lung disease, drug-induced lung disease, and sleep-disordered breathing.

Fellows supervise the care provided to both MICU and consult patients by the medical house staff. They gain experience with airway management, mechanical ventilation, and hemodynamic monitoring and perform all inpatient and outpatient bronchoscopies.

Pulmonary Transplantation

The Pulmonary Transplantation service consists of patients who are being evaluated for transplantation, those who are on the waiting list, and those who have received lung or heart-lung transplants. Both inpatients and outpatients are cared for by the service.

Prior to transplantation, patients have a wide variety of pulmonary diseases including emphysema, interstitial fibrosis, cystic fibrosis, and primary pulmonary hypertension.

The Pulmonary Transplantation service provides fellows with training in the evaluation of transplant candidates, the inpatient and outpatient management of lung transplant recipients, and the evaluation and management of the complications of transplantation. This service also provides the fellow with exposure to interventional bronchoscopy.

Outpatient Pulmonary Medicine

Oakland VA Medical Center Pulmonary Medicine Clinic

This clinic serves as a referral center not only for the Oakland facility, but also for five other nearby VA Hospitals. The size of the clinic is carefully controlled to provide optimal patient care and teaching. Fellows see patients one-half day every other week throughout the first two years of training

UPMC Comprehensive Lung Center (CLC)

The Comprehensive Lung Center (CLC) is a comprehensive pulmonary diagnostic and treatment center located at the University of Pittsburgh Medical Center. Patient referrals are received from physicians throughout the eastern and mid-western United States, and each year, approximately 10,000 patients are seen in the CLC.

Fellows see patients one-half day every other week during the first two years of training and one-half day every week during their third year. Fellows participate in general pulmonary clinic as well as in subspecialty clinics in asthma and allergy, sleep disorders, interstitial lung disease, cystic fibrosis, and emphysema.

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