Introduction: 

The Naval Medical Center San Diego’s Pulmonary Disease/Critical Care Medicine Fellowship Program is designed to equip physicians, who have previously qualified in general Internal Medicine, with comprehensive clinical training in pulmonary disease and critical care medicine. This three-year program complies with current guidelines established by the American Thoracic Society/American Lung Association, American Board of Internal Medicine, and the Accreditation Council of Graduate Medical Education (ACGME). The program uniquely offers pulmonary disease subspecialty consultation, comprehensive critical care, and primary care in support of peacetime, combat, and humanitarian operations of the U.S. Armed Forces. Graduates are eligible to sit for the pulmonary disease and critical care medicine subspecialty examinations administered by the American Board of Internal Medicine, provided they have achieved basic internal medicine certification. A program curriculum outline is provided below, with a more detailed description of each clinical rotation and conference/lecture series available in subsequent sections of this handbook.

Core Competencies:

The ACGME Program Requirements for Graduate Medical Education in Pulmonary Disease and Critical Care Medicine provide an updated, detailed guide to the program’s Core Competencies. As required by the ACGME, the program focuses on achieving competency in six primary areas of pulmonary and critical care medicine: Medical knowledge, Communication, Patient care, Professionalism, Systems-Based Practice, and Practice-Based Learning.

The essential knowledge and demonstration of ACGME competencies are obtained through formal instruction and clinical experience. A basic overview of the competency areas is included below, with detailed requirements for core competencies and specific educational goals contained in Appendix 1 “ACGME Program Requirements for Graduate Medical Education in Pulmonary Disease and Critical Care Medicine” Section IV.B.

Pulmonary Medicine:  The program furnishes an environment and resources for fellows to acquire knowledge and competence in the diagnosis and management of pulmonary diseases, technical and procedural skills related to Pulmonary Medicine, supervisory skills, and basic scientific knowledge with emphasis on molecular biology, pulmonary physiology, and pulmonary immunology.

Critical Care Medicine:  The program provides an environment and resources for fellows to gain knowledge and competence in the diagnosis and management of critical care diseases, technical and procedural skills related to critical care medicine, supervisory skills, and basic scientific knowledge with emphasis on molecular biology, pulmonary physiology, and pulmonary immunology.

Other Integrative and/or Cross-Disciplinary Competencies:  The program equips fellows with knowledge and competence in quantitative clinical reasoning, evidence-based medicine practice, medical practice management, legal medicine, medical informatics, preventive medicine, ethics and palliative medicine, and diversity and inclusion.