Early training focuses on procedural competence (e.g., central lines, bronchoscopy, thoracentesis), simulation-based learning, and intensive didactics through bootcamps, workshops, and a summer lecture series. Fellows also receive communication training and exposure to point-of-care ultrasound (POCUS). Clinical training occurs across multiple major institutions, including quaternary and community hospitals, providing exposure to a diverse and multilingual patient population with complex, high-acuity conditions.
The first-year clinical experience is heavily structured, with rotations in the medical ICU, inpatient consult services, VA Medical Center, interventional pulmonology, dedicated outpatient blocks, and electives. Fellows manage critically ill patients with conditions such as ARDS, septic shock, advanced organ failure, and transplant-related complications, while participating in specialized rescue programs (e.g., ECMO, lung transplant evaluation). There is also a strong emphasis on procedural volume and skill development, supported by dedicated services. Outpatient training is integrated to build competence in pulmonary diagnostics, longitudinal care, and interdisciplinary teamwork, reflecting the growing importance of ambulatory medicine.v
Clinical rotation experiences are supplemented with a robust curriculum focused on development of clinical, teaching, and leadership skills. Fellows engage in daily educational sessions, specialty conferences, and research discussions, while also developing skills in teaching, feedback, and peer coaching. As fellows progress to upper years, training shifts toward mastery, with increased autonomy, advanced procedural skills, expanding leadership and educational roles, and subspecialty focus, preparing fellows for independent practice and academic careers.
Clinical training sites
The Hospital of the University of Pennsylvania (HUP) serves as home base for clinical fellowship training. HUP, a 695-bed teaching hospital located on the university campus, was the first hospital in the nation to provide bedside training for medical students. The hospital serves the neighboring urban community and provides tertiary referral care to patients from the region as well as across the nation. HUP has distinguished itself through its multidisciplinary approach to care of complex patients. Fellowship training also takes place at the Philadelphia Veterans Administration Medical Center (VAMC) and Penn Presbyterian Medical Center. The VA is located across the street from HUP and serves a major role in clinical training. Penn Presbyterian is a tertiary care hospital and Level 1 trauma center with a community hospital ethos, situated five blocks from HUP and fully integrated into Penn's clinical activities.
Clinical rotation experiences
First year
| Rotation | Research Scholar | Clinician Scholar |
|---|---|---|
| HUP MICU | 3 months | 3 months |
| ICU nights | 2 weeks | 2 weeks |
| Inpatient pulmonary consults | 1.5 months – HUP 0.5 months – PPMC |
1.5 months – HUP 0.5 months – PPMC |
| VAMC (mixed outpatient/inpatient consults) | 1.5 month | 1.5 month |
| Outpatient | 2 month | 2 month |
| Critical care outreach and procedure service | 0.5 month | 0.5 month |
| Interventional pulmonology | 1 month | 1 month |
| Inpatient subspecialty consult elective (pulmonary hypertension or lung transplant | 0.5 month | 0.5 month |
| Vacation | 1 month | 1 month |
Upper years
| Rotation | Research Scholar | Clinician Scholar |
|---|---|---|
| Trauma SICU | 1 month | 1 month |
| Neuro ICU | 1 month | 1 month |
| Interventional pulmonology | 1 month | 1 month |
| Lung transplant | 0.5 month | 0.5 month |
| VA MICU | 1 month | 1 month |
| Critical care elective | 0 month | 3 months |
| Pulmonary elective | 1.5 months | 0.5 month |
Our fellowship offers a structured, robust training in ambulatory medicine, including experiences in a variety of different practice settings and exposure to a broad spectrum of patient populations and diseases. All fellows maintain a continuity clinic throughout at least three years of their fellowship, at the HUP or PPMC Harron Lung Center sites or at the Philadelphia VA Medical Center. In 2024, we implemented an innovative block scheduling model for first year fellows to enhance ambulatory education, Dedicated outpatient blocks allow for earlier and focused exposure to outpatient subspecialty pulmonary medicine without competing demands of inpatient rotations. In addition to clinic sessions, fellows also have dedicated time to learn about important outpatient topics, including pulmonary diagnostics, interdisciplinary care coordination, inbox management, and population health.
In the upper years of the fellowship, fellows have ambulatory clinic approximately once weekly, maintaining their continuity clinics and spending several months at a time in subspecialty clinic rotations of their choosing. Subspecialty clinic opportunities include general pulmonary, advanced COPD, asthma, pulmonary vascular disease, interstitial lung disease, lung transplant, bronchiectasis/non-tuberculous mycobacterial disease, cystic fibrosis, home ventilation/neuromuscular disease, lung cancer, and sleep medicine.
Each academic year begins with the Summer Lecture Series. This three-month course is comprised of over 35 lectures covering a spectrum of topics fundamental to the practice of Pulmonary and Critical Care Medicine. Thereafter, educational conferences are scheduled every day of the week for the remainder of the year. These include the following:
- Pulmonary Case Conference
- Critical Care Conference
- Year in Review/Journal Club
- Pulmonary Grand Rounds Series
- Ethics and Humanism Conference
- Clinical Reasoning Conference
- Critical Care Skills Conference
- Radiology Conference
- Outpatient Management Conference
- Quality, Safety, Value Conference
- Research Works in Progress: Clinical Research, Bench/Translational Research, Medical Education
- Clinical Diagnosis/Management Multidisciplinary Conferences: ILD, Sarcoidosis, NTM/Bronchiectasis, Tumor Board, General Pulmonary