Core Clinical Training

Our three-year fellowship program provides excellent exposure to the broad range of clinical activities within PCCM, and does so with clinical rotations provided in the three hospitals in our program, including Stanford University Medical Center (SUMC), The VA Palo Alto Health Care System (VAPAHCS), and The Santa Clara Valley Medical Center (SCVMC). The core clinical training blocks are typically front-loaded in the fellowship, providing appropriate core clinical training to precede additional advanced training. Clinical elective rotations are also available covering a broad scope of areas relevant to PCCM.

Sample PCCM three-year fellowship schedule (13 four-week blocks per year)

Note that the schedule allows options for the pursuit of either a Clinical Track or Research Track, with Track decision-making and divergence of training trajectory to be determined in the first year of training.

	1^st year Example	2^nd year Example	3^rd year Research Focused Example	3^rd year Clinical Focus Example
Rotation 1	SUMC Consult	Clinic	Research	Research
Rotation 2	VA ICU	SUMC ICU	Research	Elective (ILD)
Rotation 3	SCVMC Consult	Elective (CVICU)	Research	SUMC ICU
Rotation 4	Clinic	Research	Research	Research/Elective (Pall Care)
Rotation 5	VA Sleep	SCVMC Consult	Research	Elective (NCC)
Rotation 6	VA Consult	SUMC ICU	Research	Elective (CVICU)
Rotation 7	SUMC Consult	Elective (PH)	Research	Elective (IP)
Rotation 8	VA ICU	SUMC ICU	Elective (IP)	VA ICU #2
Rotation 9	Lung Transplant	Elective (IP)	Research	SUMC ICU
Rotation 10	VA Sleep	SUMC Consult	Elective (PH)	Research
Rotation 11	SCVMC ICU	Research	Research	Elective (SICU)
Rotation 12	VA Consult	VA ICU #2	Research	Elective (ILD / PH)
Rotation 13	Lung Transplant	SCVMC ICU	Research	Research

Abbreviation Key

SUMC: Stanford University Medical Center

VA: Veterans Affairs Palo Alto Health Care System (VAPAHCS)

SCVMC: Santa Clara Valley Medical Center

Consult: Pulmonary Consult Service

ICU: Intensive Care Unit

CVICU: Cardiovascular ICU

ILD: Interstitial Lung Disease

IP: Interventional Pulmonary

NCC: Neuro Critical Care

Pall Care: Palliative Care

PH: Pulmonary Hypertension

SICU: Surgical ICU

Clinical Electives

A broad array of clinical electives are available for fellows with interest in gaining added exposure and training in specified subset clinical aspects of PCCM. More information can be found here.

Core Clinical Rotations

Our core clinical rotations cover the necessary inpatient and outpatient components to develop the necessary tools to become an outstanding Pulmonary & Critical Care physician after training completion, ideally, in an academic environment. These core clinical blocks include the following:

Stanford University Medical Center blocks

Stanford Pulmonary Consult Service: This inpatient and urgent outpatient rotation covers the typical range of lung pathology encountered in a major regional referral academic center, with an emphasis on procedures. It provides consultative services to general medical wards, hematology/oncology wards, including bone marrow transplant patients, coronary care unit patients, and a variety of immunocompromised patients undergoing solid organ transplants.

Stanford ICU Service: The Stanford Critical Care Program is a vital multidisciplinary component of PCCM that includes Anesthesia and General Surgery. The Stanford ICU service cares for medical, surgical (including Orthopedics, ENT, Plastic Surgery, OB/GYN, Neurosurgery), and Neuro-Critical Care service patients. Fellows rotating on the ICU service include dedicated Critical Care fellows from Anesthesiology, Emergency Medicine, and Internal Medicine Residency Training Programs as well as Neuro-Critical Care fellows.

Center for Advanced Lung Disease Service (CALD): The CALD at Stanford cares for patients with interstitial lung disease, cystic fibrosis and lung transplants. Our fellows are exposed to the entire transplantation process, from a candidate's initial outpatient evaluation and transplant listing activity to managing him/her postoperatively in-house and as an outpatient after the recovery. This is a hands-on immersion into critically ill patients with end-stage lung disease with an emphasis on procedures. Fellows will be able to evaluate a candidate's transplantation eligibility and manage his/her postoperative complications upon completion of this rotation. There is also added sub-specialty training in Lung Transplantation for third year fellows desiring more extensive education.

VA Palo Alto Health Care System (VAPAHCS) blocks

VA Pulmonary Consult Service: The VA Consult Fellow services the main hospital as well as providing outpatient support for the interventional pulmonary service, the general pulmonary clinics and urgent referrals as well as the campus' rehab ward. The clinical cases covers typical "bread and butter" cases, including the typically greater number of smoking related lung dieseases and thoracic malignancies encountered in a VA population.
VA ICU Service: The VA ICU service is a closed multi-disciplinary ICU service covering both the Medicine, Surgical and Cardiothoracic Service patients at the VA. Fellows will gain skills in managing typical cardiothoracic post-operative patients here in addtion to manging routine medical and surgical ICU patients.
VA Sleep Service: The VA Sleep rotation offers expert training in sleep disorder evaluation, including polysomnogram interpretation as well as in therapeutic management of individuals with sleep disorders. While the VA Sleep program does not provide formal training sufficient for specialty board eligibility (a minimum of 12 months is now required), we do have access to a world-class sleep program at Stanford, where additional formal sleep medicine fellowship training is available.
Learn more about the VAPAHCS faculty

Santa Clara Valley Medical Center (SCVMC) blocks:

SCVMC Pulmonary Consult Service: The SCVMC patient population spans the richest and most diverse array of pulmonary pathology amongst the three hospitals in no small measure to its large immigrant and/or medically indigent patient populations that often present with newly diagnosed advanced disease processes. The Pulmonary Consultation service thus encounters a broad mix of infectious dieseases (including MTB and HIV/AIDS). The fellow runs the service with housestaff from the County and reports to Adjunct Stanford Faculty who are based solely at SCVMC.
SCVMC ICU Service: The SCVMC MICU is a busy, tertiary referral medical service of usually 10 to 20 patients with a mix of severe and complex respiratory failure, sepsis, GIBs and liver failure. Fellows "cut their teeth" in this rich and rugged training environment during their first year prior to entering into the Stanford ICU environment in their second year.
Learn more about the Santa Clara Valley Medical Center's faculty

SCVMC Pulmonary Consult Service: The SCVMC patient population spans the richest and most diverse array of pulmonary pathology amongst the three hospitals in no small measure to its large immigrant and/or medically indigent patient populations that often present with newly diagnosed advanced disease processes. The Pulmonary Consultation service thus encounters a broad mix of infectious dieseases (including MTB and HIV/AIDS). The fellow runs the service with housestaff from the County and reports to Adjunct Stanford Faculty who are based solely at SCVMC.
SCVMC ICU Service: The SCVMC MICU is a busy, tertiary referral medical service of usually 10 to 20 patients with a mix of severe and complex respiratory failure, sepsis, GIBs and liver failure. Fellows "cut their teeth" in this rich and rugged training environment during their first year prior to entering into the Stanford ICU environment in their second year.
Learn more about the Santa Clara Valley Medical Center's faculty