Transplant Pulmonology Fellowship

Clinic Experience

The fellow will spend one half-day per week in the lung transplant clinic, participating in post-transplant visits and new patient evaluations. The fellow will attend the weekly Wednesday lung transplant clinic, supervised by a Northwestern Medicine lung transplant pulmonologist at the Northwestern Transplant Center. With 40 to 50 transplants performed annually at Northwestern Memorial Hospital, the fellow will meet or exceed the UNOS requirement of providing primary care for 15 or more lung and heart/lung transplant patients. A recipient log will be maintained, including medical records, UNOS identification numbers and transplant dates, as per UNOS guidelines.

Inpatient Experience

Fellows will spend five months each year on the Lung Transplant Service, providing primary hospital care for lung transplant candidates and recipients. The service maintains an average daily census of 20 to 30 patients and conducts daily consults for newly transplanted patients managed by the Thoracic Surgery service. All inpatient training will occur at Northwestern Memorial Hospital under the supervision of a Northwestern lung transplant pulmonologist. A patient log will be maintained to document the completion of UNOS requirements.

Multidisciplinary Conferences

Fellows will participate in weekly multidisciplinary lung transplant conferences, which cover topics such as new transplant candidates, post-transplant inpatient and outpatient care, program policy development, and quality improvement initiatives. These activities fulfill UNOS requirements for lung transplant physicians.

Data Interpretation & Donor Management

Fellows will interpret physiologic data under the guidance of a lung transplant pulmonologist and participate in lung donor management, procurement, and implantation activities, in collaboration with the Thoracic Surgery Division. A log will be maintained to document these activities.

Transplant Guidelines & Outcomes

Fellows will review recipient selection guidelines and develop an understanding of outcomes, including survival rates, physiologic results and post-transplant complications.

Post-Operative Management

Fellows will gain experience managing lung transplant recipients in the ICU during the immediate post-operative period. This includes ventilator management, weaning patients off cardiopulmonary bypass and managing VV ECMO.

Procedural Proficiency

Fellows will demonstrate proficiency in performing flexible fiber-optic bronchoscopy, bronchoalveolar lavage, transbronchial biopsy and other invasive procedures as indicated.

Educational Resources

Fellows have free access to the American Society of Transplantation’s comprehensive trainee curriculum, which includes a lung transplant lecture series upon request.

All fellows will engage in a structured program of clinical research training, which will occur primarily when 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.

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.

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.

Core Rotation Blocks

Inpatient Transplantation Block (5 months)

Rounding daily on an average of 10 to 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)

Managing the immediate post-operative critical care issues of all those lungs, heart/lung transplant recipients and ECMO under the supervision Lung Transplant Surgeon. The trainee will also go to the operating room to observe a minimum of 3 transplantation surgeries.

Suite Block (1 month)

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 month)

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

Research (2 months)

Outcome research or a quality improvement project. However, lung transplant fellows with adequate funding can choose to do translational research.

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 three 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