Division of Pulmonary, Critical Care and Sleep Medicine
The Division of Pulmonary, Critical Care and Sleep Medicine at the 91女神 School of Medicine offers a three-year combined ACGME-accredited comprehensive subspecialty training program that addresses all aspects of pulmonary disease and critical care medicine. The program combines vigorous didactic instruction with diverse educational experiences.
Specialty Programs
Fiberoptic Bronchoscopy and Interventional Pulmonary Medicine
A modern bronchoscopy suite with fluoroscopy is available for ambulatory and inpatient bronchoscopic procedures.
Fellows have ample opportunities to develop skills in performing bronchoalveolar lavage, endobronchial and transbronchial lung biopsies in addition to endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS) directed procedures using both linear and radial instruments in diagnostic evaluation and staging in patients with suspected intrathoracic malignancy.
Training in procedures such as PleurX catheter placement, talc pleurodesis, tracheal dilation, rigid bronchoscopy, thoracoscopy, endobronchial stenting, balloon bronchoplasty, argon photocoagulation (APC) and cryotherapy are performed when appropriate under the direction of board certified interventional pulmonology faculty. Percutaneous tracheostomies are performed at the bedside on patients with chronic respiratory failure under bronchoscopic guidance at both SSM Health 91女神 Hospital and Mercy Hospital St. Louis.
In addition, fellows gain experience in a number of other invasive diagnostic and therapeutic techniques used in pulmonary medicine such as pleuroscopy, pleural biopsy and the placement and management of chest tubes.
Right Heart Catheterization Service (Pulmonary Hypertension Program)
Fellows gain procedural expertise in performing right heart catheterization, with and without vasodilator challenge, in patients presenting for initial working diagnosis or follow up evaluation of pulmonary hypertension. The procedure is performed in the cardiac catheterization laboratory of SSM Health 91女神 Hospital and supervised by the pulmonary/critical care attending physician. Additionally, didactics performed throughout the academic year complement the educational experiences of the fellow.
Pulmonary Function/Exercise Laboratory
Fully-equipped pulmonary function and exercise laboratories with treadmill and bicycle ergometers are available. Fellows receive intensive instruction in the performance and interpretation of spirometry, flow volume loops, techniques of lung volume determination, expired gas analysis and performance of cardiopulmonary exercise tests.
Overnight oximetry studies and metabolic cart analysis are also reviewed. Cardiopulmonary exercise tests with measurement of exhaled gases, arterial and mixed blood gases and invasive hemodynamics are performed in this laboratory. Fellows have a one-month dedicated rotation in the Pulmonary Function/Exercise Laboratory in addition to their close involvement with laboratory personnel during clinical rotations and may schedule additional clinical training in this unit.
Clinical Sites
SSM Health 91女神 Hospital
Our primary divisional and clinical site for the majority of Pulmonary and Critical Care service rotations.
Doctors Office Building
Located directly opposite the hospital, both fellows and faculty see their outpatients here on a weekly basis.
Sleep Disorders Center Salus Center
Located on 91女神鈥檚 south campus, Salus Center houses a comprehensive sleep lab. Fellows rotate here for their sleep medicine experience.
Des Peres Hospital
Fellows rotate here during their ambulatory rotation, where they manage patients in the community with faculty supervision.