2024-2025 M3/M4 Course Syllabi
Internal Medicine
COURSE NUMBER:
07 27 20
TITLE:
Interventional Pulmonology: An Emerging Procedural Field -ICE
The student will work with the interventional pulmonology fellow, pulmonary fellows, and interventional pulmonology faculty in the care of patients with benign and malignant pulmonary pathology, pleural diseases, lung cancer screening, and airway obstruction and collapse. The student will participate in the ambulatory evaluation of patients, inpatient evaluation of patients, as well as attend procedures including those performed in the OR setting.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP)

Successfully complete the Internal Medicine Core Clerkship.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
4 weeks
DIRECTOR:
Patrick Kosciuk
kosciupk@ucmail.uc.edu
5135582475
Medical Sciences Building, 6465
ADMINISTRATIVE SUPPORT PERSON:
Gabriela Ionascu
ionascgi@ucmail.uc.edu
513-558-2592
MSB, 6055A
SITE(S):
Barrett Cancer Center
UCMC - CONSULTS
UCMC - Inpatient
UCMC - MICU
UCMC - MSD
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 1
2 06/03/2024 - 06/28/2024 1
3 07/01/2024 - 07/26/2024 0
4 07/29/2024 - 08/23/2024 0
5 08/26/2024 - 09/20/2024 0
6 09/23/2024 - 10/18/2024 1
7 10/21/2024 - 11/15/2024 1
8 11/18/2024 - 12/13/2024 1
9 12/16/2024 - 01/10/2025 0
10 01/13/2025 - 02/07/2025 1
11 02/10/2025 - 03/07/2025 1
12 03/10/2025 - 04/04/2025 1
13 04/07/2025 - 05/02/2025 1

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
7:30 AM - 4:00 PM Monday-Friday
REPORT 1ST DAY:
Please email elective director Patrick Kosciuk, MD at kosciupk@ucmail.uc.edu within 48 hours of start date for rotation. Back-up contact is the IP fellow listed in Qgenda (for which they carry the IP phone to obtain direct contact): 513-551-7571

INSTRUCTION

LEARNING ACTIVITIES:
  • Clinical Experience - Inpatient
  • Conference
  • Discussion- Large Group (>12)
  • Discussion-Small Group (Small Group (=12)
  • Independent Learning (Instructor-guided learning activities to be performed by the learner outside of formal educational settings.)
  • Lecture
  • Mentorship
  • Patient Presentation--Learner
  • Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
  • Ward Rounds
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
75% Attending Physician
25% Fellow Physician
FEEDBACK:
ASSESSMENT:
 N/A

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
FINAL GRADE:
GRADE ASSIGNED BY:

OBJECTIVES

Curricular Resources :
Principles and Practice of Interventional Pulmonology by Springer

https://aabronchology.org/aabip-fellows-reading-list/

Both of these are higher level instructional materials given the subspecialty within a subspecialty niche that Interventional Pulmonology falls within, although may be used to obtain additional information.
Instructional Methods:
This course will be taught in the clinical setting with observation and structured participation in patient care and procedures.
Knowledge/Skills:
  1. Begin a basic work-up for lung nodules or masses including the impact of EBUS for staging.
  2. Initiate diagnostic work-up for hemoptysis and be exposed to interventions that interventional pulmonology can employ in the stability and treatment of this problem.
  3. Recommend bronchoscopy for various clinical scenarios.
  4. Demonstrate basic pre-procedural evaluation regarding airway procedures (bronchoscopy) and pleural procedures.
  5. Be able to work-up a pleural effusion and interpret thoracentesis findings.
  6. Identify a COPD patient population that can benefit from bronchoscopic lung volume reduction (BLVR).
  7. Discuss therapeutic options for problems identified by interventional pulmonology.
Main Course Topics :
  • Airway stricture from benign and malignant causesAmyloidosis
  • Lung Cancer
  • Carcinoid Tumors
  • Chronic Cough
  • Compressed Airways
  • Central Airway Stenosis
  • COPD
  • Coronavirus disease (COVID-19)
  • Hemoptysis
  • Endobronchial tumors
  • Fibrosing Mediastinitis
  • Granulomatosis with Polyangiitis
  • Pleural Effusion
  • Persistent Respiratory Failure
  • Recurrent Respiratory Papillomatosis
  • Relapsing Polychondritis
  • Tracheobronchomalacia
  • Tuberculosis
  • Histoplasmosis
  • Asthma
  • Interstitial Lung Disease
  • Empyema
  • Silicone Y-stent placement for malignant and benign disease
  • Significant tumor burden debulking with rigid bronchoscopy
  • bronchoscopic laser use
  • medical thoracoscopy
  • navigational bronchoscopy
  • endobronchial ultrasound FNAs (EBUS)
  • Dynamic bronchoscopy
  • Metal Stent Placement and Removal (Malignant and Benign Indications)
  • Bronchoscopic Lung Volume Reduction
  • Persistent Air Leak Valve Placement
  • Argon Plasma Coagulation (APC) for Hemoptysis
  • Transbronchial Parenchymal Lung Biopsies (Cryobiopsy)
  • Mechanical and Thermal Tumor Debulking
  • Photodynamic Therapy for Curative Intent and Tumor Debulking
  • Thoracentesis
  • Chest Tube Placement
  • Indwelling Pleural Catheter Placement (PleurX)
  • Percutaneous Tracheostomy
Procedures:
Procedures are not required for this rotation - although the procedures that the student will be exposed to are listed under the Key Words for course topic section.
Remediation Plan:
 N/A

SAMPLE WEEK

Monday:
8:30AM 12:00PM Barrett Center Amb Clinic (Rm 2049)
1:00PM 5:00PM Barrett Center Amb Clinic (Rm 2049)
Tuesday:
7:30AM 12:00PM Endoscopy Procedures (Rm 6)
1:00PM 4:00PM Endoscopy Procedures (Rm 6)
Wednesday:
7:30AM 9:00AM IP Didactic (Teams)
9:00AM 12:00PM OR vs Endo Procedures (Rm 6)
1:00PM 4:00PM OR vs Endo Procedures (Rm 6)
Thursday:
7:30AM 12:00PM Endoscopy Procedures (Rm 6)
1:00PM 4:00PM Endoscopy Procedures (Rm 6)
Friday:
7:30AM 12:00PM Endoscopy Procedures (Rm 6)
1:00PM 4:00PM Endoscopy Procedures (Rm 6)
SCHEDULE NOTE:

We typically are comprised of two teams at any given time: IP Team 1 – largely the inpatient service providers performing almost all of the procedures and IP Team 2 – largely the outpatient service with a few procedures performed on Wednesday and help as back-up if needed. You will be rotating with both services – so in a given week you will be typically interacting with 2 IP attendings.

Given ambulatory obligations on Monday and Tuesday, the Medical Student will be involved in performing initial consultations and follow-ups of inpatient consults with IP team 1 (either IP fellow or pulmonary fellow) on Wednesday through Friday.

Additional lectures that you can participate in are the general pulmonary lectures as follows:

  1. Monday - M&M vs Journal Club, 12-1pm
  2. Tuesday - ILD vs Radiology conference, 12-1pm
  3. Wednesday - Medical Grand Rounds, 12-1pm; & Critical Care Conference, 1-2pm
  4. Thursday - Lecture vs Board Review, 11:30am-12:30pm
  5. Friday - Journal Club vs M&M, 12-1pm


ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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