Pulmonary Disease and Critical Care Medicine Fellowship

About the Program

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Welcome to the University of Iowa Pulmonary and Critical Care Fellowship Program. As of 2025, we will be interviewing for five fellows per year to enter into our fellowship. 

What makes Iowa an extraordinary place to advance your career? It starts with our commitment to your training. At Iowa you become proficient in clinical care while exploring for new knowledge to take that care to the next level. Simply put, our fellowship training program is our highest priority and we are blessed with a faculty who love to teach and learn in an academic environment.  To learn more about our training program, contact us today. We want to tell you more about Iowa!

Mission Statement

We strive to deliver compassionate state-of-the-art care for patients, educate the next generation of physicians and scientists, and discover new ways to cure disease and prevent illness.

Vision

Through delivery of patient care, education and discovery, we will work to prevent and treat respiratory, environmental, and work-related diseases and critical illnesses. We will accomplish this in a multidisciplinary, safe and supportive work environment, always respectful of the public trust.

Program Goals
  • Provide high-quality and compassionate health care for patients with respiratory, environmental and work-related diseases and critical illnesses at the University of Iowa Hospitals and Clinics, the Iowa City Veterans Affairs Medical Center, and their affiliated community programs.
  • Provide outstanding educational programs for all learners in the health professions and in the biomedical sciences to ensure acquisition of knowledge and skills commensurate with the needs of society
  • Develop new knowledge about human biology by conducting a spectrum of important research related to the pathogenesis, prevention, diagnosis and treatment of human disease.
  • Provide a work environment that engenders mutual respect, facilitates satisfaction, and fosters career development for all who carry out or participate in our missions.
  • Demonstrate through our actions the highest standards of professional and ethical behavior.
  • Provide regional, national and international leadership for the betterment of society.

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Fellows as Clinician Educators Program (FACE)

For future clinician-educators.

Internal Medicine Fellows' Conference

Common curriculum for fellows in all divisions of the Department.

Clinical Training - Year 1

Year 1
Fellow and faculty performing intubation simulation

The first year of the fellowship is primarily a clinical year of training in both Pulmonary and Critical Care Medicine. Fellows care for both inpatients and outpatients. They develop proficiency in various procedures including endotracheal intubation, mechanical ventilation, chest tube insertion, bronchoscopy, thoracentesis, ECMO, central lines, dialysis catheters, arterial lines, and interpretation of pulmonary function tests. Each fellow spends six months in the first year working in the University of Iowa medical intensive care unit. Fellows also rotate for three months at the VA hospital - across the street from University of Iowa. The other three months are spent on the anesthesia, surgical ICU and lung transplant/thoracic surgery services.

University of Iowa Medical Intensive Care Unit

The MICU  is a 26-bed closed unit which averages over 200 admissions per month. Two fellows are assigned to the MICU every month. They work closely with the attending physician and provide clihcial oversight of the house officers and medical students on the service. The fellows are responsible for performing and/or supervising all critical care procedures, including airway  management. Each fellow performs about 100 intubations in the first year of training.

VA Hospital

Each fellow rotates for three months at the VA hospital in the first year which allows a mix of critical care, pulmonary consultation, bronchoscopy, and pulmonary clinic.

Lung Transplant/Thoracic Surgery

Fellows are actively involved in the inpatient and outpatient evaluation of lung transplant candidates and recipients. Fellows have the opportunity to observe a variety of thoracic surgeries including lung resection, decortication, lung transplant, and mediastinoscopy. They gain the surgical perspective on management of patients with lung disease.

Anesthesia

During this month, fellows work in the operating room setting to improve airway management skills through training with our anesthesia colleagues. This training includes assessment of airway difficulty, pre-oxygenation techniques, bad-mask ventilation, rapid sequence intubation, LMA placement, and other airway skills.

Surgical ICU

Fellows rotate through the surgical/neurologic intensive care unit working with a variety of patients on the surgical services including trauma, orthopedics, neuro, cardiothoracic, vascular, urology, gynecology, and general surgery. Each fellow oversees a 10-bed bay, working closely with a surgical critical cre attending.

Procedures

The University of Iowa has strong tradition of procedural training  pulmonary and critical care medicine.  Training involves simulation and numerous clincial opportuniteis. Airway management education starts in the first weeks of fellowship, and fellows (on average) perform about 100 intubations within their first year.  Fellows are also trained in bronchoscopy (including endobronchial ultrasound), thoracentesis, and chest tube thoracostomy. Pulmonary procedures take place in a state of the art facility within our main hospital. By the end of the program, fellows have performed 150-200 bronchoscopies, including 40-60 endobronchial ultrasounds. Fellows will also learn how to recognize and treat a patient that would benefit from extracorporeal membrane oxygenation (ECMO) [UIHC ECMO link]  and have the opportunity to seek advanced ECMO education if desired. Critical care ultrasound is also a strong primary focus of education within the Iowa program. Fellows participate in the University of Iowa Midwest Ultrasound Symposium in July of their first year and continue to expand their ultrasound skills throughout fellowship with regular feedback from our ultrasound-trained physicians.

Vacation

Each fellow receives 4 weeks of vacation/personal time per year. In the 1st year vacation is taken during the SNICU, TCV and anesthesia rotations.

Clinical Training - Years 2 and 3

Pulmonary Consultation Service (UI Health Care Inpatient)

During their second and third year of training fellows spend 1.5 months/year on the inpatient pulmonary consultation service. They see an extremely wide array of pulmonary and critical care diseases and learn the art of functioning as a subspecialist consultant.

Procedures/Physiology Service

During their second and third years of training fellows spend 1.5 months/year on a multidisciplinary service where they perform pulmonary procedures in the morning (bronchoscopy, thoracentesis, etc) and attend sleep medicine and pulmonary rehabilitation clinics and perform cardiopulmonary exercise tests in the afternoon.

Subspecialty Clinics

Each fellow attends subspecialty clinics ½ day/week for a total of six months during their second and third year. A wide variety of subspecialty clinic experiences are available including lung cancer, cystic fibrosis, TB, interstitial lung disease, asthma, occupational medicine, sleep medicine, lung transplantation and pulmonary hypertension.

Continuity of Care (COC) Clinic

Each fellow has a COC clinic throughout their three years of fellowship. During the 1st year fellows have clinic for a total of 8 months. During all of the second and third years fellows have clinic ½ day each week – rotating between UI Health Care Medical Center and VA Medical Center. These clinics are staffed by attending physicians dedicated to the fellow’s clinic - chosen specifically for their teaching interest and ability. The clinic patient mix encompasses the entire spectrum of pulmonary medicine.

Career Pathways

The training goal of our division is to provide mentorship and guidance for each fellow to develop a career path that best fits his or her interests and aspirations. The University of Iowa Pulmonary/Critical Care Division has developed four career paths: Master Clinician Pathway; Medical Education Pathway; Clinical Investigator Pathway and Basic Research Pathway. The different career paths are designed to produce physicians who will have the skills and training to become leaders in their field of expertise - in academic medicine or in the community. The common threads throughout each path are the pursuit of excellence and contribution to scholarship (broadly defined). Fellows will identify a career path at the end of their first year and then work with their individual mentors and the program leadership to develop an individualized comprehensive curriculum. It is important to recognize that these pathways are not “silos” – there may be crossover or hybridization between them – depending on the goals and aspirations of each fellow.

Master Cliniciam Pathway

The goal of the Master Clinician Pathway is to develop the skills and knowledge to provide specialized patient care at the highest level – and to be a “go to” clinical leader at the national and/or local level. Master Clinicians should also be educators and may also participate in clinical research. Requirements (final requirements determined by each fellow’s mentoring committee) for this pathway include:

  1. Completion of common core requirements
  2. Two (or more) additional months of clinical service in both the second and third year of fellowship. This would usually involve more general training in the second year and more specialized training in the third year. The potential clinical services are diverse and include – ICU training in the SICU, CVICU or Burn Unit, RSCU, Anesthesia, consultative services both within and outside the Division/Department, Sleep Medicine Training, echocardiography, right heart catheterization, etc.
  3. Chest Radiology Training.
  4. Completion of the FACE program.
  5. Additional subspecialty clinic experience – as determined by the specific interests of the fellow.
  6. Completion of the University of Iowa Department of Internal Medicine Quality Improvement and Patient Safety Fellows curriculum – with development and completion of a Patient Safety/QI project.
  7. Scholarly Activity: examples - completion of a book chapter, review article, case report or manuscript of a QI/PS project.
  8. Involvement in case conferences, lectures, etc - as determined by the specific interests of the fellow.
  9. Attendance at a national meeting - ATS, ACCP, etc – in each of the second and third years.
  10. Mentoring committee review meetings every six months during the second and third years.

Medical Education Pathway

The goal of the Medical Education Pathway is to prepare the fellow for an academic career in medical education. This pathway also recognizes that clinical expertise plays a foundational role in clinical education. Requirements (final requirements determined by each fellow’s mentoring committee) for this pathway include:

  1. Completion of common core requirements.
  2. Completion of the Masters or Certificate Program in Medical Education (tuition supported by the division)
  3. Completion of a Patient Safety/Quality Improvement project – potentially centered on education.
  4. Participation in medical student, resident and peer education
  5. Scholarly activity:
    • Development of an educational portfolio with a series of presentations to a diversity of audiences (lay persons, medical students, residents, peer) on an area of clinical interest – with a minimum of 8 self-authored presentations
    • Development of a new curriculum project – for example, educational modules for students and/or residents on the pulmonary consultation service.
    • Dissemination of research/curriculum development is highly recommended: e.g. publication in a peer-reviewed medical education journal (Journal of Graduate Medical Education for example) or presentation at an education meeting (AAMC for example).
  6. Attendance at a meeting focused on medical education – PCCM Program Director Meeting, AAMC or ACGME regional/national meetings.
  7. Mentoring committee review meetings every six months during the second and third years.

Clinical Research Pathway

The goal of the Clinical Research pathway is to develop the skills and expertise for a successful academic career in Clinical Research.

  1. Completion of common core requirements
  2. Completion of a Master’s degree, Certificate Program or selected coursework in Clinical and Translational Science, Public Health or other graduate program (tuition supported by the division).
  3. Identification of a research project/mentor(s) – 18 months of clinical research during second and third years of fellowship (minus time devoted to COC and subspecialty clinics and sleep medicine/exercise testing requirements).
  4. Scholarly activity:
    • Development of a research proposal – with submission to the IRB if appropriate
    • Presentation/publication of research
    • Apply for peer-reviewed funding – if appropriate, depending on the research project.
  5. Attend a workshop on scientific writing and presentation
  6. Attendance at 1 (or more) IRB meetings
  7. Presentation of research yearly at the divisional Research Conference
  8. Mentoring committee review meetings every six months during the second and third years.
  9. Option for a 4th and 5th year of research experience supported by the training grant.

Basic Science Research Pathway

The goal of the Basic Science Research pathway is to develop the skills and expertise for a successful academic career in Basic Science Research

  1. Completion of common core requirements.
  2. Identification of a research project/mentor(s) – 18 months of basic research during second and third years of fellowship (minus time devoted to COC and subspecialty clinics and sleep medicine/exercise testing requirements).
    • Development of a research proposal – with submission to the IRB and/or Animal Care Committee if appropriate
    • Presentation (nationally)/publication of research findings
    • Apply for peer-reviewed funding
  3. Attend a workshop(s) on scientific/grant writing and presentation.
  4. Option for a 4th and 5th year of research experience supported by the training grant.
  5. Presentation of research yearly at the divisional Research Conference
  6. Mentoring committee review meetings every six months during the second and third years.

Research Training

Felow and faculty using a microscope

A primary goal of the division is to train future academic leaders in the field of Pulmonary and Critical Care Medicine. A large number of research training opportunities exist – incluidn in basic scine, translational science, and clinical investigation. During the first year of training, fellows identify a research area of interest and will identify a mentor or mentoring committee. The process of finding a project and mentor is facilitated by faculty Research Conference presentations, the Introduction to Research Conference series and individual meetings with research faculty. The fellow and mentor work together to develop a research project.

Fellows frequently collaborate with mentors and investigators both inside and outside fo the division. A high level of interdepartmental collegiality at Iowa enhances our fellows' research training. The fellows present their proposed research project at the beginning of second year for constructive feedback, and then present a completed project at the conclusion of fellowship. The second and third year of training allow  approximately 16-18 months of dedicated time to pursue the academic experience. Fellows receive training in hypothesis generation, experimental design and techniques, data interpretation and statistics, and preparation of oral presentation and written manuscripts. Attendance at regional and national meetings is encouraged and financially supported by the division, both to learn and to present their research findings. Opportunities exist for Master's Degrees in areas of clinical and translational investigations and medical education. 

Educational Conferences

The division takes special pride in the quality of our educational conferences. Conference attendance is facilitated by the close proximity of the VA and University hospital, and by the high divisional priority placed on fellow’s formal educational experience.

Conferences include:

  • Clinical Pulmonary/Critical Care Conference
  • Journal Club
  • Core Conference Series:
    • Core Lecture Topics – a three-year series of presentations covering all major content areas of pulmonary and critical care medicine. Experts from outside the division frequently come to share their expertise with us
    • Physiology Conference – a monthly discussion of applied physiology topics
    • Chest Radiology Conference – a bimonthly review of interesting and instructional chest filmsResearch Conference
  • Pathology Conference
  • Summer Introductory Lecture Series
  • Multidisciplinary Lung Cancer Conference
  • Pulmonary Research Conference
  • Critical Care Ultrasound Conference

Program Facilities Tour

UI Health Care Medical Center

University of Iowa Health Care is Iowa’s comprehensive academic health system.

Iowa City VA Medical Center

The VA Iowa City Healthcare System provides outstanding health care, trains America’s future health care providers, and conducts important medical research.