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Interventional Pulmonary Fellowship

The Interventional Pulmonary Fellowship at Beth Israel Deaconess Medical Center is designed to provide the trainee with the necessary tools to establish and direct a multidisciplinary academic interventional pulmonary program.

The IP program is part of the Division of Pulmonary and Critical Care Medicine with very close ties to Thoracic Surgery, Oncology and Chest Radiology. The multidisciplinary approach to patients is emphasized. The interventional pulmonary section is actively involved in the evaluation and postoperative management of complex airway patients and patients with pleural disorders.

The IP section at BIDMC also provides services at Children's Hospital and New England Medical Center. This ensures ample experiences in complex pediatric and lung transplant related airway disorders.

Scope of the Program

The program consists of the several clinical services:

Complex Airway Program: BIDMC serves as a regional and national referral center for patients with malignant and benign airway disorders. The entire scope of endoscopic interventions, including procedures such as rigid bronchoscopy, PDT, laser therapy, APC, cryotherapy, and stenting, are offered. A particular emphasis of the program is the endoscopic and surgical management of complex benign disorders. All surgical procedures such as tracheal resection and reconstruction, carinal resection and tracheoplasty are commonly performed.

Pleural Disease Program

Nearly all medical patients with pleural diseases are evaluated and treated by the IP service at some point in time. We offer medical thoracoscopy, ultrasound guided thoracentesis with pleural manometry, and PleurX catheter placement as procedures in the management of pleural disorders.

Medical Procedure Service

The IP service directs a medical procedure service assisting medical housestaff in performing thoracentesis and central line placements. Within the scope of these services we also perform percutaneous tracheostomy and percutaneous gastrostomy placement in patients with prolonged ventilator requirements in the medical intensive care unit.

Advanced Diagnostic Bronchoscopy

We perform TBNA, EBUS, AF bronchoscopy and image guided TBNA through Tt fluoroscopy or EBUS on many patients referred for challenging diagnostic or staging purposes.

Research

Research focused on the indications for and outcomes of interventional procedures as well as the implementation of new medical device is an important aspect of our program. Collaborations with many manufacturers and device developers exist. Many clinical trials are ongoing at any particular time and active participation of the fellow is expected. As a part of the research team, the fellow gains experience in designing and conducting animal and clinical research studies as well establishing budgets, writing protocols, and performing data analysis.

A sample of current and newly added clinical trials includes:

  • Endoscopic lung volume reduction
  • Electromagnetic guidance systems for transbronchial biopsy
  • AF bronchoscopy in early lung cancer detection
  • EBUS guided TBNA.

 

An active animal laboratory for large and small animals is onsite for airway, pleural and general chest procedure trials. The IP fellow is expected to be actively involved in IP related research and present results in conferences and publications.

In addition to active research, the IP section is responsible for a variety of educational activities such as a monthly multidisciplinary airway conference and several teaching and CME courses throughout the year. The IP fellow is actively involved in the moderation and organization of those conferences.