Fellows will demonstrate an awareness of and responsiveness to the larger context and system of healthcare by practicing in multiple clinical settings throughout the program. By assisting with care coordination for long-term and acute patients on clinical services such as consults, fellows will learn to call effectively on other resources in the area to provide optimal health care. Another opportunity to incorporate systems-based practice and understanding the social determinants of health into a fellow’s practice is during the HIV clinic experience, which will take place longitudinally throughout the fellowship program. This clinic provides care for patients with HIV/AIDS in the Hudson Valley, and alongside our multidisciplinary team members the clinic provides case management services, such as assessment of needs, service planning, coordination of services, monitoring and follow up, reassessment, and crisis intervention. Our fellows will work alongside supervising faculty and other members of the healthcare team to provide compassionate care to the clinic’s patient population, which is disproportionately affected by social determinants of health.

The Pulmonary Disease and Critical Care Medicine Fellowship Program is committed to providing a high-quality fellow education throughout the entirety of the program. The Program provides extensive teaching rounds that occur longitudinally throughout all clinical settings for fellows. Teaching rounds will occur three hours daily five days per week. In the Medical and Surgical Intensive Care Units, the teaching rounds will primarily occur at the bedside between faculty, residents, nursing, advanced practice professionals, and fellows. This style of teaching rounds allows for immediate questions and feedback from the fellow regarding specific patient cases. When providing consultations, teaching will occur in a separate room with faculty and fellows. This separate space allows for appropriate patient care, while giving the fellow consistent opportunities for formative feedback and increased learning. Finally, in the office setting, teaching rounds occur in a patient-to-patient format. This allows for true integration of teaching into patient care responsibilities. During all teaching rounds within the program, faculty are committed to providing consistent feedback to each fellow and allowing for opportunities of learning to facilitate individual fellow growth.

Fellows will attend Clinical Case Conferences as part of the Program’s Conference Series monthly. This conference will involve presentation of a challenging patient case by rotating fellows. Fellows will also be asked to perform a study of the literature to present with the case. Faculty and fellow discussions will then occur regarding the specific patient case and diagnosis.

The Core Curriculum Conference Series will include weekly one-hour meetings with a concentration on core pulmonary disease topics such as interstitial lung disease, pulmonary vascular disease, COPD, asthma, cystic fibrosis, sleep medicine, complex ventilator management with waveform analysis, procedural instruction for thoracentesis, chest tubes, bronchoscopy, and airway management to be given by VBMC faculty as well as guest faculty.

Morbidity and Mortality Conferences

Fellows will participate in Morbidity and Mortality (M&M) conferences on a monthly basis. Faculty and fellows will participate in discussions regarding patient cases that had adverse patient outcomes. The group will also analyze system-wide level impacts on the case and create suggestions for systemwide changes, if deemed necessary. Evidence-based literature reviews are also included in the conference, as appropriate.

Quality Improvement Conference Quality Improvement Conferences

Quality Improvement (QI) Conferences occur monthly in the Pulmonary Disease and Critical Care Medicine Fellowship Program as part of the ongoing conference series. Fellows and faculty will participate in an analysis of data and patient care outcomes regarding a particular process. Collectively, the group will determine whether processes are achieving the desired outcomes. Fellows will rotate leading this conference, with the assistance of faculty mentorship

Research Conference

Fellows will participate in a research conference on a quarterly basis. All fellows will perform their own research throughout the program, under guidance from faculty mentors. Quarterly, fellows will present current findings and changes in their research projects and allow for faculty and fellow feedback. This critical conference allows for changes in methodology and analysis as needed throughout the active research process.

Journal Club

Journal Club will occur every other month during the Pulmonary Disease and Critical Care Medicine Fellowship conference series. Fellows will choose an article relevant to current patient care scenarios and present this article to the group of fellows and faculty. The fellow will then guide a discussion regarding the merit of the research as well as potential changes to patient care techniques/strategies.

Pathology Conference

Pathology Conferences are held on a quarterly basis for fellows. This conference involves core pathology topics and contain a mix of didactic presentations as well as lecture series. This conference is led by rotating sub-specialty pathologists in their respective fields. This conference will also cover updates regarding laboratory techniques or current global pathology events.

“Point of Care Ultrasound (POCUS)” conference

Theses conferences are held weekly basis for fellows. POCUS uses ultrasound systems that allow quick diagnoses of medical conditions or echographic guidance of interventions. It is emerging as a reliable and valid tool in various clinical situations, such as emergency departments, intensive care units, perioperative care, general ward, and even in pre-hospital situations.

Pulmonary Function Testing (PFT) Conference

Fellows will attend this meeting on a weekly basis. PFT is a complete evaluation of the respiratory system including patient history, physical examinations, and tests of pulmonary function. The conference will focus on the primary purpose of pulmonary function testing to identify the severity of pulmonary impairment. Pulmonary function testing has diagnostic and therapeutic roles and helps clinicians answer some general questions about patients with lung disease.

Thoracic Tumor Board

Fellows will meet on a weekly basis with the goal of improving the quality of thoracic cancer care of patients receive, provide educational opportunities for all those participants that treat thoracic oncology patients, and become an asset to the hospital and community. The Thoracic Oncology Tumor Board provides a forum for the discussion of new research and treatment strategies, through continual updates of the standard of care. It is anticipated that the attendees would adjust their practice based on

clinical evidence and outcomes discussed at this tumor board. This is a system wide 1.5-hour weekly conference that involves pulmonary/critical care, thoracic surgery, medical oncology, thoracic oncology, and pathology. During this conference, cases are discussed in a multidisciplinary manner with clinical and pathological correlation.

The Nuvance Health Pulmonary Disease and Critical Care Fellowship Program at Vassar Brothers Medical Center (ACGME 1563514004 ) thanks you for your interest in applying to our program. We accept all applications through ERAS only and participate annually in the NRMP Match Program. We hope you choose to join us.

Requirements: The following items are required for consideration of interview. All items must be received through ERAS application portal:

• Personal Statement
• Current CV
• 3 Letters of Recommendation
• USMLE Step 1 CK or COMLEX Level 1 Score
• USMLE Step 2 CS or COMLEX Level 2 PE Score (we understand that due to COVID-19 and USMLE changes some people may not have been able to take CS or PE)
• USMLE Step 2 CK or COMLEX Level 2 CE Score
• USMLE Step 3
• Program Director’s Letter

Timeline: We will interview candidates during select dates in August, September, and October. Exact dates will be provided to the invited fellowship applicants via email notification.

After reviewing applications in ERAS, we will send out invites via e-mail with available dates for interviewing. All interviews will be done virtually for the 2022 interview season.

Timothy P. Collins, DO, FCCP
Program Director, pulmonary and critical care medicine

Dr. Collins joined the intensivist group at Nuvance Health in 2007. For the next 5 years he worked as an intensivist at Vassar Brothers Medical Center in Poughkeepsie and North Shore University Hospital in Manhasset in the neuro critical care unit. In 2011 he started the pulmonary practice at Nuvance health. In 2016 he combined to the divisions of pulmonary, critical care and sleep medicine at Vassar Brothers Medical Center and started a pulmonary rehabilitation and adult cystic fibrosis program. Dr. Collins has been Division Chief of pulmonary/critical care/sleep medicine as well as the adult cystic fibrosis program director since 2016. He received his medical degree from New York College of Osteopathic Medicine. He completed his internal medicine training at Albany medical College where he was selected to be a 3rd year Chief resident. He then completed his pulmonary/critical care training at the Lahey clinic in Massachusetts. In 2018 Dr. Collins took on the role of subspecialty education coordinator for critical care at Vassar Brothers Medical Center under the internal medicine residency program and has been actively involved in education since its inception. Dr. Collins interests include pulmonary vascular disease, advanced bronchoscopy, difficult to control asthma, point-of-care ultrasound and quality improvement.