OUTLINE FOR DESCRIPTION OF ROTATION

ROTATION: Pulmonary

PRECEPTORS: Drs. Donald Strong and Paul Guzzetta

DURATION: One Month

1. GOALS/OBJECTIVES OF ROTATION:

--- Develop a good pulmonary history and physical to include an occupational history.

--- Develop diagnostic and management skills for common pulmonary disorders (i.e., asthma, COPD, pneumonia, tuberculosis, pulmonary embolus, evaluation of cough and dyspnea, etc.).

--- Understand proper use of pulmonary tools including peak flow, pulmonary function tests, chest x-ray, bronchoscopy, hyperbaric oxygen.

--- Functional knowledge of oxygen therapy and basic ventilator management.

--- Perform thoracentesis and if possible arterial line and chest tube placement.

--- Better understand the role of the family physician and when to utilize the skills of the pulmonary specialist.

2. EXPECTATIONS OF ROTATION:

--- Inpatient Care:

--- Promptly examine and write up new patients and consultations on the inpatient service. If possible, see patients before rounding with each attending.

--- Outpatient Service:

--- Most clinics are spent with Dr. Strong

--- Other educational activities:

--- See item 7 concerning discussions on basic topics, attendance in pulmonary lab, and observation of one sleep study.

3. SUGGESTED PREPARATION/REFERENCES:

--- A syllabus will be provided to you in advance of the rotation so that you can begin reading articles prior to arrival.

4. TYPICAL DAY/WEEK:

--- Highly variable, note section 2 above. Average inpatient census will be 6-8. Adjust the amount of clinic time based on available time.

5. WORK-UPS/WRITE-UPS:

--- Write up inpatient evaluations prior to seeing attendings. For outpatient evaluations, ask attendings if they would like you to write a note.

6. PROCEDURES:

--- Both attendings are interested in teaching thoracentesis. A limited number of arterial lines may be available. You should observe at least two bronchoscopies with Drs. Neumann and Klaas. Drs. Guzzetta and Baldwin do chest tube placement, which you might want to participate in.

7. AVAILABLE EDUCATIONAL EXPERIENCES/CONFERENCES:

--- You are required to schedule one sleep study that you will observe; discuss with attendings which night you will choose (Monday through Thursday - note they begin at approximately 10:00 p.m.). The tech can review with you the overall procedure. You should discuss with attendings indications, diagnostic findings, and cost of this important tool.

--- Attend for one half day the pulmonary function lab with Larry

--- Undergoes full spirometry on self and properly interprets findings with attendings.

--- Review articles in syllabus.

8. IMPACT OF OFFICE SCHEDULE/NOON CONFERENCES SCHEDULES:

--- You will be scheduled for two half days per week in your own office. Other program educational conferences continue to be required.

9. CALL AND SHARED CALL:

--- Be available on weekdays to cover infrequent admissions or consults through the night (Monday through Thursday).

10. WEEKEND REQUIREMENTS:

--- You will be responsible to cover the service for one full weekend and one additional Saturday, leaving the balance of two full weekends off. If you desire additional experience, attendings would welcome your participation on other Saturday mornings and you would be finished by noon.

11. VACATION/TIME OFF:

--- One week - preferably at the beginning or end of the rotation.

12. EVALUATION:

--- Attendings will base their evaluation on your investment in learning and participation.

13. CRITERIA FOR SUCCESSFUL COMPLETION:

--- As noted above.

14. SUPERVISION:

--- All experiences will be supervised by Drs. Strong and Guzzetta.

Revised: 6/1/05 – LSL:lmc