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The MICU Service provides 24-hour comprehensive care to patients with life-threatening or potentially life-threatening medical illnesses of all major organ systems. Over the past six years our MICU service has expanded to three teams to provide higher quality and competent care of patients. Working closely with the MICU service attending physician, the three assigned MICU fellows are the team leaders for the monthly rotation block-assigned medical residents and will direct and actively participate in patient care including performance and supervision of all ICU-related invasive procedures.

Under the mentorship of the attending physician, fellows are responsible for providing pulmonary consultation services throughout the hospital during this month-long rotation. Additionally, all inpatient and outpatient procedures are performed by the service. Fellows also direct the internal medicine residents and student team assigned to the Pulmonary Consultation Service.

Fellows gain experience in the outpatient management of a broad diversity of respiratory disorders. Longitudinal patient follow-up and new referrals are seen one half-day per week in the pulmonary clinic, located in the Doctor's Office Building across the street from SSM Health Saint Louis University Hospital. Each fellow also rotates through the Adult Cystic Fibrosis subspecialty clinic during their fellowship training.

This clinic offers each fellow the opportunity to participate in the ambulatory management of adult patients with cystic fibrosis , under the supervision of directors Ravi Nayak, M.D. and Christopher Barrios M.D.

Fellows receive training in the diagnosis and evaluation of diverse sleep disorders in conjunction with divisional faculty. Aspects of training include taking a comprehensive sleep history, establishing the differential diagnosis of respiratory-related sleep disorders (e.g. narcolepsy, periodic leg movements, schedule-related disorders, insomnia and excessive daytime sleepiness), and reviewing polysomnograms with faculty. Saint Louis University is accredited by the American Sleep Disorders Association (ASDA).

Fellows develop communication skills on ward rounds, ICU rounds and at various educational conferences. Fellows teach second-year medical students physical diagnosis of the chest during two afternoon sessions of the Phase II Respiratory Module curriculum.

Fellows are expected to write and submit for publication the results of their research projects under the guidance of their faculty advisors. Ample opportunity is given to present data at national meetings. Individuals completing the laboratory investigations or clinical investigation research track are well trained in research techniques related to pulmonary diseases and critical care medicine. Competence will be gained in intensive care medicine, consultative chest medicine as well as the ability to compete successfully for research funds and academic positions in pulmonary disease medicine or critical care medicine.

Each resident on rotation and in clinics is directly supervised at all times by an attending teaching physician who is responsible for teaching, reviewing patient care and monitoring duties. Residents are responsible for patient care in the hospital and outpatient clinics. Residents participate in direct patient care and in consultation to other physicians. Residents engage in continuity of care experiences with outpatient care.

Pulmonary Disease/Critical Care Medicine Divisional Conference

Grand Rounds, Topic in Review and Research presentations are given by faculty and fellows from our division, faculty from the Department of Internal Medicine and faculty from various departments and divisions throughout Saint Louis University School of Medicine as well as visiting professors and speakers.

Course Director: Ravi Nayak, M.D.
Tuesdays at 12 p.m.

Pulmonary Disease/Critical Care Medicine Core Curriculum Conference

This conference is divided into the following areas: Pulmonary Anatomy and Physiology Course, Pulmonary Diagnostics Course, Pulmonary Pathology Course and Pulmonary Therapeutics Course. Division faculty as well as guest speakers present pertinent topics in these areas.

Course Director: Joseph Espiritu, M.D.
Wednesdays at 12 p.m.

Internal Medicine Grand Rounds

The Division of Pulmonary, Critical Care and Sleep Medicine is responsible for presenting four lectures throughout the year at the Internal Medicine Grand Rounds. Three are presented by current faculty members. The fourth is a national guest speaker who presents at the Annual Dr. Herbert Sweet Memorial Lecture (first Friday in October).

Fridays at 7:30 a.m.

Thoracic Cancer Multidisciplinary Tumor Conference

Fridays at 12 p.m.

Multidisciplinary Chest Radiology Conference

Thoracic imaging cases presented.
Course Director: Nadeem Parkar, M.D.
First and third Thursday of each month at 12 p.m.

Multidisciplinary Chest Conference

Fellows currently on pulmonary consult rotation present cases and a group discussion is held by conference attendees.

Course Director: Soophia Naydenov, M.D.
Second and fourth Thursday of each month at 12 p.m.

Journal Club

Articles presented by fellows followed by discussions.
Course Director: Sadashiv Santosh, M.D.
Second Monday of the month at 12 p.m.

CPET of the Month

Interesting case presented by fellows followed by discussion.
Course Director: Soophia Naydenov, M.D.
Third Monday of the month at 12 p.m.

Ultrasound Conference

Course Director: Zafar Jamkhana, M.D.
Last Monday of the month at 12 p.m.

Director/Fellows Meeting

Monthly meeting between program director and fellows.
Course Director: Ravi Nayak, M.D.
Third Tuesday of the month at 7:15 a.m.

QI Conference

Course Director: Zafar Jamkhana, M.D.
Fourth Wednesday of each month at 7 a.m