PURPOSE: Requirements for July 2011 from the American College of Graduate Medical Education (ACGME) and guidelines developed by the Interventional Chest Diagnostic Procedures Network of the American College of Chest place a goal of 100 bronchoscopic procedures for pulmonary critical care fellows. Less than 30% of accredited pulmonary postgraduate programs in the United States meet the proposed number of interventional thoracic procedures required. The objective of this paper was to describe the pulmonary/critical care fellowship flexible bronchoscopic training experience at the University of Miami.
METHODS: A retrospective review of flexible bronchoscopic procedures (FOB) performed by pulmonary critical care fellows from June 2008 to May 2011, at the different training sites of our academic program. The number and types of procedures performed, according to fellowship year were evaluated. Invasive interventional procedures were categorized as endobronchial or transbronchial biopsies, bronchial needle aspiration, endobronchial ultrasound (EBUS), and others. Complications of procedures and exposure to clinical rotations were also documented.
RESULTS: There were a total of eleven fellows in training. The average number of total FOB procedures performed during the first year was 98, during the second year the average was 82, and in the third year, fellows averaged 44 procedures. At the end of three years, senior fellows had performed an average of 76 invasive FOB procedures. Each fellow averaged 9.5 procedures per clinical period. Complication rates ranged from 0.8% to 5%, most were mild and self-limiting.
CONCLUSIONS: Fellows who train in our academic institution meet about 90% of competency requirements by the end of the first year of training, with minimal complication rates. They can expect to complete these skills FOB in 11 of their required clinical rotations, allotting space for exploring research and other activities.
CLINICAL IMPLICATIONS: Evaluation of fellow outcomes allows objective measures of educational growth and areas for training.
DISCLOSURE: The following authors have nothing to disclose: Adriana Arcila, Horst Baier, Elio Donna, Alexandre Abreu, Jaime Avecillas, Michael Campos, Shirin Shafazand, Marylin Glassberg, Adam Wanner
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