Pulmonary Disease and Critical Care Medicine Fellowship

Pulmonary consult services are provided at all of our institutions including Jackson Memorial Hospital, Veterans Affairs Medical Center, and University of Miami Hospital.

The pulmonary consultation service is meticulously designed to refine fellows’ expertise in delivering high-caliber, scientifically grounded consultations for patients with a wide range of respiratory disorders. Each institution has a unique population of patients, providing comprehensive exposure to pulmonary disease for our fellows. Throughout their training, fellows will encounter an extensive array of disease entities, spanning from commonly seen conditions to rare and complex cases. This broad exposure will empower them to excel as consultants in various settings, including private practice, large hospital-based environments, and esteemed academic centers. By the end of the program, fellows will possess the comprehensive skills and knowledge necessary to thrive as distinguished consultants in the field of pulmonary medicine.

Interventional pulmonary services provide fellows with the opportunity to develop their procedural skills and deepen their understanding of pleural physiology. Without an interventional fellowship program, our pulmonary fellows have the unique advantage of performing and assisting with a comprehensive array of procedures, including but not limited to flexible, navigational, rigid, and robotic bronchoscopies, transbronchial biopsies, endobronchial ultrasound, chest tube insertion, tunneled pleural catheters, and percutaneous tracheostomies. This extensive hands-on experience ensures our fellows are exceptionally well-prepared for advanced clinical practice or to pursue application to interventional pulmonary fellowship training.

Continuity Clinics

Continuity clinics are offered at Jackson Memorial Hospital and VA Medical Center for pulmonary fellows.

The Pulmonary Medicine Continuity Clinic at the Ambulatory Care Center at Jackson Memorial Hospital and the VA Medical Center are instrumental in developing and honing the skills necessary for fellows to provide comprehensive outpatient care for patients with pulmonary issues. In this setting, fellows will cultivate expertise in diagnosing and managing common respiratory problems encountered in ambulatory care. They will also gain experience with more complex pulmonary cases, learning to address these challenges under proper supervision.

Fellows will become adept at implementing appropriate preventive health measures and will refine their abilities to serve effectively as outpatient consultants, communicating their findings and solutions to referring physicians with clarity and precision. Collaboration with other healthcare professionals is emphasized, ensuring coordinated patient management involving ancillary services such as home healthcare, durable medical equipment suppliers, social services, and community support services. This holistic approach prepares fellows not only for immediate clinical responsibilities but also for future leadership roles in outpatient pulmonary care, mirroring the comprehensive and patient-centered approach that is a hallmark of your echocardiography laboratory’s strategic initiatives.

Specialty Clinics Rotation

The Specialty Clinics Rotation offers fellows an enriching opportunity to work in a variety of clinics dedicated to the treatment of specific pulmonary diseases. The structure and function of the clinics vary, with some offering short-term consultations for referring physicians, while others provide comprehensive longitudinal care over extended periods. Each clinic brings together a multidisciplinary team of clinicians, basic scientists, nurses, case managers, research coordinators, and other professionals devoted to understanding disease pathogenesis, discovering new treatments, and delivering exceptional patient care.

Fellows are provided with a weekly schedule and rotate through specified clinics throughout the week. The rotation includes clinics focused on cystic fibrosis, non-CF bronchiectasis, nontuberculous mycobacterium, alpha-1 antitrypsin deficiency, sarcoidosis, pulmonary hypertension, interstitial lung diseases, and sleep medicine. This comprehensive and immersive experience ensures that fellows develop a deep understanding of these specialized areas, preparing them to become leaders in the field of pulmonary medicine.

Inpatient Tuberculosis Service

Our program offers a distinctive training advantage with the presence of an inpatient tuberculosis ward, a rarity among fellowship programs nationwide. This unique facility provides our pulmonary fellows with unparalleled exposure to the diagnosis, treatment, and management of tuberculosis in a real-world, inpatient setting. Trainees gain invaluable hands-on experience with complex TB cases, including multidrug-resistant and extensively drug-resistant forms, which significantly enhances their clinical acumen and expertise in infectious disease management.

Inpatient Cystic Fibrosis, Bronchiectasis and Nontuberculous Mycobacterial Service

Our program uniquely features an inpatient cystic fibrosis (CF), bronchiectasis and nontuberculous mycobacterial (NTM) service, again setting us apart from other fellowship programs nationwide. This specialized service provides our pulmonary fellows with invaluable hands-on experience in managing complex and advanced cases of CF, bronchiectasis and NTM infections. Trainees benefit from direct interaction with a diverse patient population, allowing them to develop a deep understanding of the clinical nuances, multidisciplinary care approaches, and cutting-edge treatments for these challenging conditions. The opportunity to work closely with leading experts in CF and NTM further enhances their learning experience, equipping them with the skills and knowledge necessary to excel in both clinical practice and research.

Inpatient Bone Marrow Transplant Service

The Bone Marrow Transplant (BMT) rotation offers fellows the opportunity to care for cancer patients with acute pulmonary disease and critical illness. Fellows will manage an array of critical illness often related to immunosuppression or treatment side effects. This rotation provides a comprehensive and intensive training experience in a unique subset of patients.

Our trainees have the privilege of completing their training at three large institutions just blocks from one another including the University of Miami Hospital, Miami VA Medical Center, and Jackson Memorial Hospital in the beautiful city of Miami, Florida. This lends to an exceptional training environment for incoming pulmonary and critical care fellows. As some of the largest and most comprehensive teaching hospitals in the nation, our training sites provide exposure to a diverse patient population, enriching clinical training with a wide range of medical conditions, from common ailments to rare and complex diseases. The training sites are equipped with state-of-the-art facilities, including advanced intensive care units and specialized pulmonary labs, ensuring the highest quality training.

Renowned faculty members, who are leaders in their fields, offer mentorship and innovative approaches to patient care and research. The collaborative environment at our training sites allows fellows to work closely with multidisciplinary teams, enhancing their learning experience and preparing them for complex clinical practice. We provide robust research opportunities, enabling fellows to engage in cutting-edge projects and contribute to advancements in their field. The comprehensive training program combines hands-on clinical experience with a strong didactic curriculum, covering various intensive care units, specialty clinics, and outpatient settings. Committed to fostering a supportive and inclusive learning environment, our fellowship program encourages fellows to pursue their professional goals with ample resources and guidance, ensuring they develop the skills, knowledge, and confidence needed to excel in their careers. Our overarching goal is to produce the next generation of leaders in Pulmonary and Critical Care Medicine. In addition, we strive to:

• Provide comprehensive and cutting-edge evidence-based clinical training in pulmonary and critical care medicine.
• Promote excellence in clinical, translational and basic research, particularly in areas of pulmonary hypertension, acute respiratory distress syndrome, obstructive lung diseases, sleep medicine and other cardiopulmonary diseases.
• Cultivate leaders who will advance global health, influence public policy, and improve healthcare delivery systems.
• Emphasize the importance of patient safety, quality healthcare delivery, and innovative approaches in biomedical and data sciences.
• Foster an environment that supports the growth and development of all trainees.
• Through our commitment to these principles, we aim to make significant contributions to the field of pulmonary and critical care medicine and to the health and well-being of our patients and communities.

Our comprehensive didactic program provides fellows with protected time to advance their education, free from clinical duties. This structured approach enhances their knowledge and skills in pulmonary and critical care medicine through a variety of focused sessions and lectures.

Mondays: Fellows alternate between the mechanical ventilation curriculum and the echocardiography curriculum, including hands-on sessions. These sessions build progressively on knowledge throughout the two-year (CCM) or three-year (PCCM) program.

Tuesdays: Journal Club, where each fellow presents once or twice annually, fostering critical appraisal and discussion of current literature with participation and guidance from faculty.

Wednesdays: The core lecture series featuring board-relevant topics in pulmonary and critical care medicine, delivered by distinguished faculty from various specialties.

Thursdays: Pulmonary, Critical Care, and Sleep Grand Rounds, featuring guest speakers who are experts in their fields, as well as presentations by University of Miami faculty and fellows.

Fridays: Conferences alternate between Morbidity and Mortality (M&M), radiology, and pathology sessions, offering a diverse and in-depth review of clinical cases and related topics.

This didactic schedule is designed to provide a comprehensive and cohesive educational experience, ensuring our fellows are exceptionally well-prepared for board exams and clinical practice.

The clinical program emphasizes extensive perioperative management. Fellows will participate in the preoperative evaluation of transplant candidates. They will also learn to perform comprehensive preoperative examinations for the purposes of transplant candidate selection, optimize perioperative patient care and will be able to discuss risks and benefits.

In addition, fellows will participate in the weekly multidisciplinary selection committee to discuss the candidate suitability for liver transplantation. Fellows should develop an understanding of what resources are required by the larger multidisciplinary team for efficient decision-making.

During the one-month intensive care unit rotation, fellows will follow and manage patients who underwent abdominal organ transplantation. Furthermore, up to a one-month rotation with Life Alliance Organ Recovery Agency, a division of the Daughtry Family Department of Surgery at the UM Miller School of Medicine, will broaden the fellows’ training relative to the organ procurement process.

Throughout the one-year fellowship, fellows are expected to cover at least 50 major, non-transplant cases, including biliary reconstructions, esophagectomies, liver resections, living donor nephrectomies, major vascular surgeries, pancreatectomies, radical nephrectomies, surgeries in patients who have undergone previous transplantation, transplant patient’s bring-backs or Whipple procedures.

Additionally, the fellow will participate in at least 50 cases of liver transplantation, including combined liver-kidney and multivisceral transplant. Fellows will have the opportunity to participate in cadaveric kidney and pancreatic transplantation, intestinal transplantation, living-related kidney transplantation and pediatric liver transplantation.

Fellows interested in research can pursue opportunities to work with mentors at Jackson Memorial Hospital (county hospital), the University of Miami Hospital (private hospital) and the Miami Veterans Hospital. Mentors doing work in clinical, translational, and basic science research are available to provide guidance, education, and research experience no matter what level of experience with research each fellow has. We work to help coordinate mentor-mentee meetings and review milestones to ensure meaningful work is being accomplished. Through our NIH T32 and support from the Miami VA system, we are able to provide dedicated time up to 12 months to select fellows who are focused on a career in grant funded clinical, translational, or basic science research.

The critical care rotation is designed to provide fellows with a well rounded education in the management of critically ill patients. While focused on medical patients, trainees completing the program will have sufficient experience to competently provide critical care for surgical and trauma patients as well. A modern intensive care unit does not exist in isolation, but functions as an integral part of the hospital setting, coexisting and coordinating with other services, including medical, ancillary, quality management, and administrative. Fellows will be trained in the necessary skill sufficient to permit competent administration of an intensive care unit.

Clinical training in critical care medicine takes place at all three teaching hospitals, Jackson Memorial Hospital, Veterans Affairs Medical Center and the University Of Miami Hospital and Clinics. Fellows will spend a minimum of nine months and not more than fifteen months in a critical care unit. The program incorporates three months of training in a non-medical intensive care unit, i.e. Surgical Intensive Care Unit, Trauma Intensive Care Unit, Neurosurgical Intensive Care Unit, or Chest Surgical (Transplant) Intensive Care Unit. Fellows will gain an understanding of the pathophysiology of a broad range of critical illnesses including respiratory failure of various causes, sepsis and septic shock, hemorrhage and hemorrhagic shock, renal failure, hepatic failure, status epileptics, acute stroke, acute cardiac events including myocardial infarction and cardiogenic shock and many other conditions. Fellows will learn and master therapeutic techniques including invasive and noninvasive ventilatory support, resuscitation, invasive monitoring and bedside diagnostic techniques, intubation, pacemaker insertion, tube thoracostomy, use of vasoactive agents conscious sedation and therapeutic sedation, and nutrition support in the critically ill. These rotations are also designed to instruct the fellows in aspects of intensive care unit administration. Fellows will be intimately involved in evaluating patients for appropriateness of intensive care. They will become familiar with anticipated staff loads based on patient acuity, thus learning how to utilize an intermediate care setting. Fellows will participate in quality management activities of the intensive care unit under the direct supervision of the attending. They will become familiar with the intricacies of explaining critical illness to families of patient, with associated issues such as advance directives. Autopsy and Morbidity/mortality conferences will be attended when relevant.

Pulmonary fellows undergo two weeks of intensive pulmonary physiology training annually. This focused training is crucial in developing a deep understanding of the fundamental principles underlying respiratory function and pathophysiology. Mastery of pulmonary physiology is essential for pulmonologists, as it forms the basis for diagnosing and managing a wide range of respiratory conditions.

During these sessions, fellows will delve into the mechanics of breathing, gas exchange, respiratory muscle function, and the regulation of ventilation. They will also explore the physiological changes associated with various pulmonary diseases, enhancing their ability to interpret complex clinical presentations and tailor treatment strategies effectively. During this rotation fellows will also learn to interpret pulmonary function tests, cardiopulmonary stress tests, nocturnal oximetry and sleep studies.

Our program offers unparalleled exposure to solid organ transplantation including heart, lung, liver, kidney, pancreas and multivisceral. At the Miami Transplant Institute our fellows gain hands-on experience with lung transplants, serving as the primary care service for patients throughout the entire process. This service is also the ECMO service where fellows will gain invaluable experience managing patients on ECMO. Our fellows have the privilege of training in one of the nation’s busiest transplant centers, providing comprehensive care to a diverse patient population. This unique clinical exposure allows you to enhance your clinical skills and expertise through complex transplant cases. Additionally, you’ll receive mentorship from leading experts in the field, with opportunities to participate in cutting-edge research and innovative procedures.

We offer a transplant track for our fellows who are interested in pursuing a career in lung transplantation. This track is designed for one or two pulmonary and critical care fellows per year (third year), and provides additional training in ECMO, advanced hemodynamics, echocardiography, and lung transplant management both in inpatient and outpatient settings, under the direct supervision and teaching from the critical care transplant medical and surgical faculty of the Lung Transplantation Program. The trainee will become a UNOS certified physician by the end of the fellowship

For more information visit the Lung Center website.

Adam Wanner, MD
Alejandro D. Chediak, MD
Andrew Quartin, MD
Daniel H. Kett, MD
Hayley B. Gershengorn, MD
Naresh M Punjabi, MD, PhD
Robert M. Jackson, MD
Roland M. Schein, MD
Shirin Shafazand, MD, MS
Tiago Machuca, MD

Alexandre R. Abreu, MD
Andres Pelaez, MD
David J. De La Zerda, MD
Elio Donna, MD
Gregory E. Holt, MD, PhD
Juan Salgado, MD
Mauricio Pipkin, MD
Michael A. Campos, MD
Sixto A. Arias, MD
Tanira B. Ferreira, MD
Trishul Siddharthan, MD

Adhiraj Gosine, MD
Andrea Shioleno, MD
Bianca Sarmento, MD
Brian Garnet, MD
Christopher Mallow, MD, MHS
Cody Adkinson, MD
Daniel Gorman, DO, MS
Eric A. Lang, MD
Erick A. Palma, MD
Hannah Ferenchick, MD
Jeffrey M. Scott, DO MBA FCCM
Jonathan Auerbach, MD
Jorge L. Cabrera, DO
Juan Fernandez-Castillo, MD
Kori Ascher, DO
Lesley A. Farquharson, MD
Lisa Domaradzki, MD
Maria G. Tupayachi-Ortiz, MD
Martin Zak, MD
Morgan Carbajal, MD
Rafael Calderon-Candelario, MD, MSc
Rene Rico Tresgallo, MD
Saramaria Afanador, MD
Sergey Gerasim, MD
Susan Vehar, MD
Waleed Sneij, MD
Yaroslav Buryk, MD
Yoslay Perez, DO

Eliana P. Mendes

Horst J. Baier, MD, JD
Matthias A. Salathe, MD
Philip L. Whitney, PhD