Pediatric Pulmonology Fellowship Training
Our three year fellowship training program provides 15.5 months of clinical training and 17.5 months of research training. Clinical training is concentrated in the first year, with decreasing time in the second and third years. This schedule provides increasing time for research as the fellowship progresses. This allows the fellow to gain familiarity with the subspecialty, decide what might interest them, become familiar with our faculty, and eventually choose a mentor and research project. We also believe in emphasizing bronchoscopy training in the senior years of fellowship to build and maintain procedural skills and competency.
Our fellows take care of patients from basic to complex cases, including but not limited to the following conditions:
- Asthma
- Chronic Lung Disease
- Cystic Fibrosis
- Diaphragmatic Pacing (CCHS)
- Home Mechanical Ventilation
- Aerodigestive disorders
- Sleep disordered breathing
- Interstitial lung disease
- Neuromuscular respiratory weakness
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, medical education, quality improvement, and advocacy. 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. Fellows work closely with the faculty and co-fellows, creating a community of teachers, mentors, advisors, and eventually life long colleagues and friends.
First Year
- Clinical: 7 months (4.5 months Inpatient, 1.5 months bronchoscopy/lab)
- Research: 4 months
- Vacation: 1 month
Second Year
- Clinical: 4.5 months (1.5 month Inpatient, 2.5 months bronchoscopy/lab)
- Research: 6.5 months
- Vacation: 1 month
Third Year
- Clinical: 4 months (1 month Inpatient, 2.5 months bronchoscopy/lab)
- Research: 7 months
- Vacation: 1 month
Total
- Clinical: 15.5 months
- Research: 17.5 months
- Vacation: 3 months
Clinical Training
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.
Inpatient Service
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:
- Asthma
- 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.
Outpatient Service
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.
Pulmonary and Sleep Laboratories
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.
Flexible Fiberoptic Bronchoscopy
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
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.
Training in Scholarship Skills
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.
Why CHLA?
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:
- Bronchoscopy
- Sleep Studies
- Pulmonary Function Testing
- Exercise Stress Testing
- Diaphragmatic Pacing
How to Apply
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.
Program Fast Facts
ACGME Accredited: Yes
Number of open positions per year: Two
Boards passing rate within last 5 years: 100%
Salary Minimums:
Post Graduate Year 4: $78,531 minimum
Post Graduate Year 5: $81,677 minimum
Post Graduate Year 6: $84,712 minimum
Post Graduate Year 7: $87,652 minimum
Post Graduate Year 8: $90,952 minimum
Post Graduate Year 9+: Please contact gme@chla.usc.edu
Benefits Include: Health and dental insurance, 14 days paid vacation+ 6 protected sick days, yearly educational stipend, monthly meal stipend, and 401(k) matching up to 3%
Children's Hospital Los Angeles is an Equal Opportunity Employer. Our Program follows the recruitment guidelines of the NRMP Pediatric Pulmonology match.