I must apologize for picking on the state of Florida in this
discussion, but I live there, was involved in all the matters that
occurred, and have little knowledge of affairs in other states. Not
only did the medical schools cut the numbers of fellows trained, but
the American Lung Association (ALA) suddenly prevented the Florida Lung
Association (or any other state associations) from funding clinical
fellows. I was distressed by this decision because in 1979, the
division heads from the three medical schools in Florida initiated the
Pulmonary Wintercourse sponsored by the Florida Thoracic Society and
the Florida Lung Association. The single purpose for founding this
course was to raise money to fund the training of clinical fellows.
This goal was accomplished, and the Florida Lung Association funded the
training of one fellow in each of the three institutions for 18 years.
Since 1997, however, funding has been restricted by the ALA to
research, including money generated by the Wintercourse. I was one of
the three division heads that started the course. I felt betrayed in
1997 when the money could not be used for the purpose that we
originally intended. I strongly believe that the ALA restrictions
should now be lifted in the wake of the publication of recent data that
support more fellowship training. That was the original intention, but
it was sidetracked by national events. The decision should be reversed.
In fact, I believe that clinical fellowship training in general should
be funded again by both the National Institutes of Health and the ALA
in every state.