Roger Williams Medical Center Program

Program Overview

The Pulmonary Diseases Fellowship at Roger Williams Medical Center (RWMC) is a two-year training program that is accredited and well-established, having been in operation since the late 1970s. As a major teaching affiliate of Boston University, this fellowship aims to cultivate physicians who are proficient in internal medicine, pulmonary medicine, and critical care. The program boasts an impressive record of 100% first-time pass rates for its fellows on board examinations, which showcases the effectiveness of its training regimen.

Program Structure

Candidates for the fellowship must have completed a three-year ACGME-accredited categorical residency program in internal medicine and have passed all components of the USMLE. A minimum of three letters of recommendation is required, reflecting the clinical judgment, academic potential, and ethical standards sought in candidates.

Training Sites and Facilities

The fellowship utilizes multiple facilities for training, including the ICU, Bone Marrow Transplant Unit (BMT), and General Medical Floors at RWMC. Outpatient pulmonary continuity clinics are conveniently located near the primary training site. The program also allows for one away elective per year, with recommendations for electives at Rhode Island Hospital focusing on Pulmonary Hypertension or Boston Medical Center for specialized training.

Curriculum and Rotation Schedule

Over the two years, fellows engage in a comprehensive curriculum that covers a variety of respiratory conditions and procedures. The anticipated schedule includes:

• 12 months on service with daily ICU rounds, consults, and procedures.
• Two half-days per week dedicated to outpatient pulmonary continuity clinics.
• Specialized training in Pulmonary Hypertension and elective rotations.

This structure emphasizes both in-patient and out-patient experiences, ensuring a well-rounded education.

Research Opportunities

Research is heavily encouraged within the fellowship. Each fellow is expected to present at least one poster at annual conferences, such as ATS or Chest, and engage in quality improvement projects. For instance, fellows may investigate new protocols for preventing ventilator-associated pneumonia.

Didactic Instruction

The program features multiple didactic sessions throughout the week, including:

• Daily ICU didactic rounds and case reviews.
• Weekly conferences such as the Brown Pulmonary Conference.
• Specialized sessions on lung physiology and pathology.

These didactics are designed to enhance the fellows' clinical capabilities and understanding of pulmonary medicine.

Procedural Training

Fellows can expect to perform and master a wide range of procedures during their training, including:

• Approximately 50 EBUS procedures.
• At least 100 bronchoscopies.
• Placement and management of pleurex catheters and endobronchial stents.

The fellowship emphasizes hands-on experience, with procedures conducted under the supervision of attending staff.

Competitiveness and Visa Support

The fellowship is designed to be competitive, attracting a diverse pool of applicants, including U.S. medical graduates and international medical graduates (IMGs). The program also provides visa support and can sponsor J-1 and H-1B visa types for international candidates.

Evaluation and Feedback

Fellows receive continuous evaluation throughout the program, with monthly assessments from attending physicians and biannual comprehensive reviews. This structure ensures that each fellow can progress effectively toward becoming an independent and skilled pulmonologist.

Supervisory and Teaching Responsibilities

Fellowship provides numerous opportunities for fellows to teach and supervise residents and medical students. This is an important aspect of the training, as teaching is seen as a method for solidifying knowledge and assessing one's understanding.