Training & Rotations

Clinical rotations at Harbor-UCLA

Medical ICU – Fellows play the central role in the activities of our Medical ICU. The critical care team includes 4-5 interns, 1-2 medicine residents, 1-2 fellows, and a supervising critical care attending. The rotation affords fellows a structured experience in the comprehensive evaluation and care of critically ill patients along with building proficiency in a wide range of procedures. Fellows will also develop as leaders of a multidisciplinary team and actively participate in the teaching of students, interns, and residents. Direct supervision of on-call interns at night is transitioned to in-house residents and the fellow takes call from home. Weekend rounding is rotated among fellows.  Fellows work with increasing levels of independence under supervision of the critical care attending.

Pulmonary Consultation Service – The consultation service evaluates and provides consultative care to acutely ill inpatients with a wide range of disease processes including acute and chronic infections, airways diseases, pleural processes, primary and secondary malignancies, parenchymal lung disease, sleep disordered breathing, pulmonary vascular disease, immunological disorders, neuromuscular disease, and structural conditions affecting the respiratory system. Fellows become proficient in a range of procedures including fiberoptic bronchoscopy, linear EBUS, thoracentesis, chest tubes, and indwelling pleural catheter placement. They also participate in advanced procedures such as medical thoracoscopy and a wide range of interventional airway procedures.

Respiratory Physiology Service – Fellows in the physiology laboratory interpret all physiologic studies including pulmonary function tests and related studies. Fellows also become proficient in conducting and interpreting cardiopulmonary exercise tests and have the opportunity to learn interpretation from world renown experts in CPET.

Trauma/Surgical ICU – Harbor UCLA is a level I trauma center and rounds in the surgical ICU are conducted by critical care trained members of the Trauma Surgery service. Second year fellows rotating on this service gain appreciation for the unique aspects of critical care related to acute trauma, surgical stresses and peri-operative care.

Neurocritical Care Service – Second year fellows rotate with the Neurocritical care service who work with the Neurology and Neurosurgery services to provide critical care for patients with a wide range of acute neurological disorders including stroke, intracranial hemorrhage, status epilepticus, and neuromuscular diseases. Fellows gain experience with specialized monitoring and specific management considerations in patients with critical neurological conditions.

Clinical rotations at Affiliate Institutions:

Advanced Lung Diseases, UCLA – Senior fellows provide highly specialized care to patients with advanced lung diseases at the Ronald Reagan UCLA Medical Center including pre-, post- and peri-operative lung transplant patients and patients with severe pulmonary vascular disease including pulmonary hypertension.

Liver ICU, UCLA – Senior fellows provide care to patients with advanced liver disease in a critical care setting at the Ronald Reagan UCLA Medical Center, including individuals who are pre- or post-liver transplantation. Fellows gain valuable experience working in a multidisciplinary, largely non-medical ICU caring for pre- and peri-operative surgical patients.

Multidisciplinary ICU, Kaiser Medical Center Downey – Second and third year fellows are afforded an increased level of autonomy in this closed multidisciplinary unit. The experience includes care of critically ill medical, surgical and cardiac patients, and opportunities to perform a wide range of pulmonary and critical care procedures. Fellows rotate through Anesthesia for a focused experience with endotracheal intubation and advanced airway management.

Special Pulmonary Populations; Long Beach Medical Center – Fellows rotate in the Medical ICU and in outpatient clinics gaining experience working with highly specialized interdisciplinary care teams and the unique clinical populations they serve. Services include adult cystic fibrosis, pulmonary rehabilitation, and hyperbaric medicine.

Continuity Clinic

A weekly pulmonary clinic is based at Harbor UCLA. Fellows see a panel of continuity patients as well as new referrals from within the hospital system and outlying primary care clinics. From their clinic experience, fellows become proficient in general pulmonary care and have exposure to a wide range of pathology including initial presentations of uncommon conditions. The clinic population reflects the cultural, ethnic, and medical diversity of the Southern California region and the under-resourced individuals whom it is our mission to care for.

Specialty Clinics

Pulmonary Hypertension, Harbor-UCLA – A weekly specialty clinic caring for patients with pulmonary hypertension staffed by pulmonary and cardiology faculty. Fellows rotate in this clinic while on their physiology rotations.

Cystic Fibrosis Clinic, Long Beach Medical Center – While on rotation at LBMC (Cystic fibrosis enter of excellence), fellows attend CF clinic to gain exposure and learn from experts in the field.

Fellow Research at Harbor-UCLA

Each fellow participates in a substantive research project in an area of their choosing. Most find projects within ongoing research activities of the Division which include in particular, clinical research related to chronic obstructive pulmonary disease, exercise physiology or pulmonary rehabilitation, long haul COVID, lung ultrasound, venous thromboembolism, and interventional pulmonology. Research time is generally six months and scheduled in the second and/or third year of training.