Pediatric Pulmonology Fellowship Training
Our Fellowship Training Program provides approximately 14 months of clinical training out of three years, and 19 months of research training. Clinical training is concentrated in the first year (nine months), with decreasing time in the second and third years. This schedule provides increasing time for research as the fellowship progresses. It also allows the fellow to gain an idea about the subject matter of the subspecialty first, in order to decide what might interest him or her, and determine which faculty member he or she may want to work with.
Our fellows take care of patients from basic to complex cases. Our patient population ranges from basic asthma to more multifaceted disease which will include but not limited to:
- Asthma (Mild to severe)
- Chronic Lung Disease
- Cystic Fibrosis
- Diaphragmatic Pacing (CCHS)
- Home Mechanical Ventilation
- Pulmonary Physiology
- Sleep Medicine
Learn More About the Training Program
The Children's hospital Los Angeles Fellowship training program in Pediatric Pulmonology is designed to train physicians to assume a leadership role in the development of the subspecialty. In addition to excellence in clinical care, our program provides training in the scholarship activities of research and proficiency in teaching. Fellows who successfully complete our fellowship qualify for American Board of Pediatrics eligibility in Pediatric Pulmonology. We accept up to two fellows per year for a three year program. Some fellows will stay for a fourth year, often to enhance their research. Training occurs on an apprenticeship basis with our faculty. You will get to know our faculty and fellow colleagues quite well, and they will be your teachers.
- Clinical: 9 months (4.5 months Inpatient, 4.5 months Outpatient/Lab)
- Research: 2 months
- Vacation: 1 month
- Clinical: 3 months (1.5 month Inpatient, 1.5 months Outpatient/Lab)
- Research: 8 months
- Vacation: 1 month
- Clinical: 2 months (1 month Inpatient, 1 months Outpatient/Lab)
- Research: 9 months
- Vacation: 1 month
- Clinical: 14 months
- Research: 19 months
- Vacation: 3 months
- Clinical Training
- Inpatient Service
- Outpatient Service
- Pulmonary and Sleep Laboratories
- Flexible Fiberoptic Bronchoscopy
- Night Call
- Training in Scholarship Skills
An important role of Fellowship Training is to provide comprehensive training in the diagnosis and management of infants, children, and adolescents with respiratory disorders so that graduates are capable of providing care for these patients without supervision. At CHLA, the unifying philosophy behind our fellowship training program is the understanding and application of respiratory physiology to the diagnosis and management of respiratory disorders. Fellows learn to use the laboratory and apply physiologic principles in their patients' daily care.
The inpatient service averages approximately 25 patients on any given day. Our program provides a broad clinical experience, ideal for the fellow who learns best by seeing and doing. CHLA has the only Pediatric Pulmonology program in the central Los Angeles metropolitan area. Thus, we see a large number of all types of respiratory disorders, even rare disorders.
During the inpatient rotation, fellows will gain experience in:
- Chronic lung disease of infancy
- Cystic fibrosis
- Pulmonary infections
- Respiratory disorders in systemic diseases and in immunocompromised hosts
- Neuromuscular diseases
- Disorders of ventilatory control
- Interstitial lung diseases
- Congenital malformations of the respiratory system
- Acute and chronic respiratory failure.
Fellows will learn to use supplemental oxygen, home mechanical ventilation, non-invasive mask ventilation, diaphragm pacing, and other technologies. Fellows function at a junior consultant level, providing consultation, guidance, and education to Pediatric house officers. The fellow is also responsible for teaching any medical students or residents taking the Pulmonary Elective. Fellows are frequently asked to give mini-presentations on pulmonary problems to house staff ward teams. Although there is no separate ICU rotation, approximately 15-25% of pulmonary inpatients are in the intensive care unit, giving the fellow ample ICU experience and education.
Much of Pediatric Pulmonology involves the ongoing care of children with chronic disorders in the outpatient setting. In the outpatient rotation, the Fellow attends Pulmonary Clinic, supervised by a full-time Pulmonologist five days per week. In addition, the other Attending Pulmonologists each have one/two days of clinic per week. Therefore, the fellow is exposed to the different styles and clinical expertise of several different faculty members. Fellows see new consultations, follow-up visits for interesting or unusual patients, and answer sick calls from patients who develop acute illnesses four days per week. Fellows also have a continuity clinic over their entire three years, where they follow a select number of patients with a variety of disorders to learn the long-term management of pediatric respiratory disorders. Each fellow’s continuity clinic is a half day per week, where the fellow schedules his or her own patients.
Here at CHLA, our center offers an Accredited Sleep Center. We have four board certified sleep specialist who you will work closely with you to finesse your knowledge of interpreting sleep studies. Our sleep center caters to a complex demographic. Many of our patients have special healthcare needs and are supported by technology including positive airway pressure, ventilators, or oxygen therapy.
An important part of the Pediatric Pulmonology Fellowship training is an understanding of respiratory physiology and the use of the physiology laboratory in the diagnosis and management of patients. In the outpatient rotation, one full day per week is set aside for this activity and teaching. The Fellow also participates in the performance of specialized tests, such as graded exercise stress tests and infant pulmonary mechanics, so that he or she will be able to perform them after fellowship. Thus, fellowship training provides extensive exposure to the performance and interpretation of routine pulmonary function tests, sleep studies, exercise stress tests, and tests of ventilatory muscle strength. A challenging aspect of this subspecialty, our fellows learn to adapt these physiologic tests to children of different ages, sizes and abilities.
Fellows will be able to master procedures required for subspecialists, notably flexible fiberoptic bronchoscopy. Fellows primarily learn bronchoscopy during their second and third years. However, all fellows participate in monthly sessions learning to maneuver the bronchoscope on an airway model.
Night call is by pager, arranged by the fellows and generally shared equally.Usually, fellows receive a number of telephone calls when on call at night, but they do not usually have to come back into the hospital. The on-call fellow does round on all inpatients with the attending on week-ends and holidays.
The goal of fellowship training is to produce academic leaders in the subspecialty. The American Board of Pediatrics requires that all pediatric subspecialty fellows demonstrate excellence in some scholarly pursuit, and that the product of this activity is a written document, such as a thesis or publication. While the Board permits a variety of scholarly activities to meet this requirement, it recognizes that individual fellowships should not offer a complete menu of pathways unless they have demonstrated excellence in each area. Therefore, at CHLA, the traditional route for Pulmonary fellows is to engage in either basic or clinical biomedical research. However, expertise is available to guide Fellows through scholarly activities in medical education, bioethics, outcomes research, and quality improvement. CHLA provides a Core Curriculum in Scholarship Skills for all pediatric subspecialty fellows in the institution during all three years, which provides training in research methodology and proficiency in teaching.
Our center provides a high volume patient population, which can offer various exposure to many cases on either side of the complexity spectrum. We have the capacity to train you in all aspects of pulmonology:
- Sleep Studies
- Pulmonary Function Testing
- Exercise Stress Testing
- Diaphragmatic Pacing
- How to Apply
- Program Fast Facts
CHLA Pediatric Pulmonology Fellowship Program is a part of the National Resident Matching Program (NRMP) . Our program takes applications via the Electronic Residency Application Service (ERAS). If you are interested in applying for our fellowship program, you will need to apply through ERAS application process.
ACGME Accredited: Yes
Number of fellows per year: Two
U.S. News and World Report Pediatric Pulmonology Ranking: #13
Boards passing rate within last 5 years: 100%
First year fellow: $63,344
Second year fellow: $65,018
Third year fellow: $67,225
Benefits Include: Health and dental insurance, 14 days paid vacation + 6 personal days, and yearly educational stipend
Children's Hospital Los Angeles is an Equal Opportunity Employer. Our Program follows the recruitment guidelines of the NRMP Pediatric Pulmonology match.