Fellowship Training Summary by Year

Training Summary by Year

Year 1

  • 2 weeks orientation
  • Around 6 blocks of inpatient service (Pediatric Pulmonology Inpatient Service and Pediatric Ventilator Service)
  • 2 weeks Allergy elective
  • 2 weeks Sleep elective
  • 4 weeks vacation
  • 18 weeks research
  • Weekly longitudinal outpatient clinic
  • Quarterly outpatient pediatric ventilator clinic
  • At-home call. Only on call when on inpatient service

Year 2 & 3

  • Around 3 blocks of inpatient service
  • 4 weeks vacation
  • Weekly longitudinal clinic
  • Quarterly outpatient pediatric ventilator clinic
  • 36 weeks research
  • At-home call. Only on call when on inpatient service

This training calendar is only a template. It can be modified according to the interests and career goals of each fellow. For example, a fellow doing blended sleep training will spend additional time in the sleep lab and less time on research. A fellow interested in asthma might spend more time in asthma clinics. 

2 week orientation

During the first two weeks of fellowship, the fellow is oriented to the hospital, the division and life as a fellow. We arrange small group training with expert physicians and associate staff. This includes training in flexible bronchoscopy using advanced simulation models, hands-on management of tracheostomies and ventilators, hands-on training on the use of various respiratory equipment such as inhalers and PEP devices, how to perform and interpret pulmonary function testing, observation of inpatient pulmonary and pulmonary ventilator service rounds, observation of specialty clinics including asthma clinic and home ventilator clinic, a detailed review of all department, house officer association and program policies and procedures, and a weekly 2-hour small group crash course on pediatric pulmonary physiology. By the end of orientation, fellows are well-equipped to start working independently but continue to get direct assistance and supervision from senior fellows and faculty. 

Pediatric pulmonology inpatient service 

Fellows typically do 2 weeks on service at a time including one weekend. While on service, fellows round with the inpatient resident team, see inpatient consults and perform inpatient bronchoscopies. There are usually 7-10 patients admitted to the Pediatric Pulmonology service including those with asthma, cystic fibrosis, acute respiratory infections, etc. Pediatrics residents write notes and orders; the pulmonology faculty and fellow are responsible for overseeing care and providing teaching. Pulmonology consultations are seen in many different units of the hospital including the emergency room, the general pediatric inpatient unit, the intensive care unit, the neonatal intensive care unit and the cardiothoracic unit. Fellows take call from home starting at 5 pm every other night and on the weekend. Weekend call ends Sunday night at 5 pm. Pages will often come from parents requesting help for a sick child, the emergency room requesting admission, or from the pediatrics resident requesting help for a sick child admitted to the hospital.  

Pediatric ventilator unit service

Fellows do a total of 2-4 weeks on the pulmonary ventilator service per year. While on service, fellows round and see consults with the nurse practitioner team. There are no overnight calls. The Pediatric Ventilator Unit is composed of 10 beds. Patients admitted to this unit require invasive or non-invasive mechanical ventilation secondary to a number of pathologies including bronchopulmonary dysplasia, bronchomalacia, neuromuscular disease and others. The fellow will present about one patient and one consult per day and participate in rounding on all of the other patients in the unit and consultations. 

Allergy elective

During this 2-week outpatient elective, fellows participate in outpatient pediatric allergy clinics. They also work with adult pulmonologists to see adults with severe atopic asthma. This elective is designed to help fellows learn about the atopic component of asthma and use of biologic therapy for asthma and other atopic diseases in children and adults. Fellows attend didactic allergy conferences and continue to attend pediatric pulmonology didactic conferences and their own weekly continuity clinics.  

Sleep elective

Fellows will spend time in sleep clinics to learn about the assessment and management of children with sleep-disordered breathing. They will also spend time in the sleep lab to learn how to protocolize and interpret polysomnograms. Fellows will attend didactic sleep conferences and continue to attend pediatric pulmonology didactic conferences and their own weekly continuity clinics. 


In their first year, fellows will use the research blocks to start exploring their research interests, meeting with different investigators, reading, and preparing for their research projects which are the focus of years two and three. In the second half of the first year, fellows are expected to have a better understanding of their main research interests and identify a research mentor. The program director will work closely with the fellow throughout this process. In years two and three, research will occupy a greater part of a fellow’s schedule. Fellows will work very closely with their research mentors and are expected to meet with their scholarly oversight committee 2-3 times per year in order to review the overall progress of the project. Fellows should plan to submit an abstract to the Pediatric Research Symposium every year and an additional abstract to a pertinent national conference (American Thoracic Society, North American Cystic Fibrosis Conference, SLEEP, etc)

Weekly longitudinal outpatient clinic

Fellows will see their patients on their own and staff with one of two attendings in clinic with them. They have clinic one half-day per week. Fellows develop very close relationships with their patients and families over the course of their training. During their clinics, fellows are expected to sign out their pagers to the attending on service in order to reduce distractions. Each fellow will see 4 patients per half day in the first year and 6 patients per half day in years 2 and 3. The care of patients with chronic diseases often requires a multi-disciplinary approach. Therefore, fellows will work alongside nurses, respiratory therapists, dieticians, social workers and others in order to provide optimal patient care.  

Quarterly outpatient pediatric ventilator clinic

Every 3 months, fellows will spend a half-day in the pediatric ventilator clinic with the attending and nurse practitioner. This is an opportunity to observe the management of children using ventilators at home including tracheostomy care, and ventilator adjustments and weaning. 

Additional elective experiences

Fellows who are looking for more experience with specific clinical diseases and programs are welcome to spend more time in subspecialty clinics. For example, those interested in chronic mechanical ventilation can spend more time in outpatient pediatric ventilator clinics or rounding with the pediatric ventilator service. Fellows can work with attendings in the severe asthma program, the aerodigestive program, the primary ciliary dyskinesia program, the complex respiratory infection program, the interstitial lung disease program, the bronchopulmonary dysplasia program, the pulmonary hypertension program, the single ventricle program, the congenital diaphragmatic hernia and chest wall disorders program, the neuromuscular program and others. Fellows have also taken additional time to work with faculty outside of the pulmonary division such as otolaryngologists, radiologists, and non-physician experts including respiratory therapists in the pediatric ventilator service. All of these can be arranged on a case-by-case basis. 

Global health experience

Fellows have opportunities to travel abroad to help support developing cystic fibrosis programs. Global electives need to be arranged several months in advance.  

Procedural training

Fellows undergo simulation training in pediatric flexible bronchoscopy using a combination of a 3D-printed airway and a virtual reality simulator. Thereafter, they received formative feedback and just-in-time training with every patient bronchoscopy. Fellows usually perform 40-50 bronchoscopies in their first year of training and fewer during their research years.