Transplant Pulmonology Fellowship

Following the completion of the Lung Transplant Medicine Fellowship the trainee will:

• Be qualified for certification as a Lung Transplant Pulmonologist, based on the requirements of the United Network for Organ Sharing.
• Be qualified to engage in retrospective and prospective clinical research studies related to lung transplantation.
• Be qualified to engage in scholarly activity related to lung transplant medicine. 

Development of clinical skills related to lung transplant medicine will include:

• One half-day per week in the lung transplant clinic, including post-transplant visits and new patient evaluations. This Fellow will participate in our regularly scheduled Wednesday lung transplant clinic weekly. All clinic experience will be supervised by a Northwestern University Physicians lung transplant Pulmonologist at the Northwestern University Transplant Center training site.  As 40-50 transplants are performed per year at Northwestern Memorial Hospital, the Fellow will meet or exceed the UNOS requirement for participation in the primary care of 15 or more lung and heart/lung transplant patients. A recipient log will be maintained by the Fellow; the log will include the medical record and UNOS identification number and the date of transplant, as per UNOS requirements.
• Five months per year experience on the Lung Transplant service, which cares for all of our hospitalized lung transplant candidates and recipients. This service provides primary hospital care for these patient populations. The Lung Transplant Service carries an average daily census of 20-30 patients. The Lung Transplant Service also performs daily consulting visits for newly transplanted patients cared for primarily by the Thoracic Surgery service. The attending physician on the Lung Transplant Service is a Northwestern University Physician and lung transplant Pulmonologist.  All inpatient training will occur at the Northwestern Memorial Hospital site. A patient log will be maintained by the Fellow, to document completion of the UNOS requirements for lung transplant pulmonologists.
• Full participation at the weekly multidisciplinary lung transplant conference. Activities including discussion of new transplant candidates; discussion of post-transplant inpatients and outpatients with active clinical problems; lung transplant program policy program development; and continuous quality improvement activities related to the lung transplant program. These activities will satisfy the UNOS requirements for lung transplant physicians.
• Interpretation of physiologic data under the supervision of a lung transplant Pulmonologist.
• Participation in lung donor management, procurement, and implantations, as specified in the requirements of the Network for Organ Sharing (attached). These activities will be achieved in collaboration with the Thoracic Surgery Division of the Department of Surgery, who have primary responsibility for these activities. The Fellow will maintain a log of these activities to document their completion.
• Review guidelines for recipient selection for lung transplantation. Understand outcomes following transplantation, including survival and physiologic results, and the complications following lung transplantation.
• Demonstrate basic understanding in the management of lung transplant recipients in the immediate post-operative period in the ICU. This includes mechanical ventilator management, management of patients coming off cardiopulmonary bypass, and management of VV ECMO.
• Demonstrate proficiency in flexible fiber-optic bronchoscopy, broncho-alveolar lavage, and trans-bronchial biopsy and other invasive procedures as indicated.
• Per request, the trainee can get free access to lung transplant lecture series via American Society of Transplantation comprehensive trainee curriculum.

All Lung Transplant Medicine Fellows will engage in a structured program of clinical research training, which will occur primarily when s/he is not serving on the Lung Transplant service. Research activities will include, but not be limited to:

• Design and completion of clinical research projects involving retrospective patient chart reviews.
• Participation in the industry- and NIH-sponsored clinical research projects as a sub-investigator.
• Fellows funded by the Pulmonary Medicine training grants will be expected to fulfill all of the additional requirements of the training grant program, including coursework toward a Masters in Clinical Research or Masters in Public Health degree; or participation in laboratory research.
• All Fellows will be required to complete all research-related institutional training courses including Responsible Conduct of Research, Parts 1 and 2, and HIPAA certification.

Lung Transplant Medicine Fellows will be expected to engage in scholarly activities including, but not limited to:

• Publication of one to two manuscripts per year.
• Participation in translational research projects.
• Submission of research abstracts to national and international lung and organ transplant meetings.

Lung Transplant Medicine Fellows will regularly participate in additional educational activities, including but not limited to:

• Attendance at the monthly lung transplant research conference.
• Attendance and participation in the Lung Transplant Medicine multidisciplinary meetings
• Attendance at a minimum of one national/international organ transplant meeting/year, including the American Society of Transplantation Fellows Conference on at least one occasion.

Evaluation of the Fellow’s clinical activities will be performed by the relevant Lung Transplant Medicine and Clinic attending physicians in a manner identical to the evaluation of other Pulmonary Fellows.

Evaluation of the Fellow’s research activities will be performed by the relevant research mentor(s) in a manner identical to the evaluation of other Pulmonary Fellows.

Each transplant fellow much complete the following core set of rotation blocks which are to last a minimum of 4 weeks each.

• Inpatient Transplantation Block (5 months): During this block, the trainee is responsible for following duties: rounding on a daily basis on an average of 10-20 patients on Lung Transplant Service. The trainee is expected to round during one whole weekend for each of the blocks along with the assigned faculty member.
• Cardio-Thoracic Intensive Care Unit (2 months): During this block, the trainee will directly manage the immediate post-operative critical care issues of all those lungs, heart/lung transplant recipients and ECMO under the supervision Lung Transplant Surgeon. During these blocks, the trainee will also go to the operating room to observe a minimum of 3 transplantation surgeries.
• Bronchoscopy Suite Block (1 month): During this block, the trainee is responsible for performing procedures assigned to this suite. The trainee must complete history and physical, as well as discuss the available imaging before each bronchoscopy. There are no weekend responsibilities during this block.

Electives (1 months):

• Thoracic Pathology
• Transplant Infectious Disease
• Medical Intensive Care Unit
• Thoracic Radiology
• Outpatient (clinic) Elective: includes transplant, ILD, PH and CF clinics

Research (2 month):
Outcome research or a quality improvement project. However, lung transplant fellow with adequate funding can choose to do translational research.

The Lung Transplant Medicine Fellowship is a one year program designed to train clinicians and clinical scholars in lung transplant medicine.   Lung transplant fellowship will provide excellent exposure to all aspects of lung transplantation medicine. The fellowship is focused on clinical training and research in lung transplantation with the Division of Pulmonary, Allergy & Critical Care Medicine. The program is designed to prepare trainees for academic careers in transplantation. The duration of the fellowship program is one year. Curriculum can be adjusted based on the goals of the trainee. There are opportunities to gain in-depth research experience in transplant immunology.

Goals: Following the completion of the Lung Transplant Medicine Fellowship the trainee will:

1.    Be qualified for certification as a Lung Transplant Pulmonologist, based on the requirements of the United Network for Organ Sharing.

2.    Be qualified to engage in retrospective and prospective clinical research studies related to lung transplantation.

3.    Be qualified to engage in scholarly activity related to lung transplant medicine. 

This fellowship is available to individuals who have successfully completed an ACGME accredited Internal Medicine program or equivalent and are eligible for medical licensure in the State of Illinois.

To apply, please send CV, Certification of completion of residency, and 3 letters of recommendation to Kelly Flemm at Kelly.flemm@nm.org

The Northwestern Medicine Transplant Pulmonology program is integrated across all Northwestern Medicine sites, including the northern, central, and western regions of the greater Chicagoland area. The Transplant fellow spends their time at the downtown Northwestern Memorial Hospital, but interaction with other sites provides the fellow with an understanding of both academic and community Transplant practices.

Downtown Chicago Lung Transplant Team