IMPACT OF INTERVENTIONAL PULMONOLOGY FELLOWSHIPS ON THE PROCEDURAL TRAINING OF PCCM FELLOWS

Abstract

SESSION TITLE: Education, Research, and Quality Improvement Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: There has been an increase in the number of interventional pulmonology (IP) fellowships, raising concern about their impact on the procedural training of PCCM fellows due to potential competition for procedures. We aim to conduct a survey of PCCM program directors (PD) to determine their expectations in procedural training for their fellows and to assess the impact of IP fellowships on that training. METHODS: An online survey was distributed to members of the Association of Pulmonary and Critical Care Medicine Program Directors in May 2020. PCCM PDs were invited to complete a survey. Data was collected using the Beth Israel Deaconess Medical Center REDCap database, and descriptive analysis was performed. RESULTS: Forty-nine of 173 PDs completed the survey (28.3% response rate). 82% of respondents have an interventional pulmonologist on faculty while 31% host a formal IP fellowship. The majority of PCCM programs have pulmonology as the team primarily responsible for performing thoracentesis, pigtail chest tube insertion, bronchoscopy with BAL, and bronchoscopy with transbronchial biopsy (collectively, “standard pulmonary procedures”). Thoracic surgery is most commonly responsible for surgical chest tube insertion, and IP, for performing endobronchial ultrasound (EBUS). When asked which team should be primarily responsible, the responses were congruent with the reported services currently in place with the exception for EBUS. 55% of respondents reported that pulmonology should be the primary service responsible for EBUS. More than 90% of programs expect their PCCM fellows to be fully competent and independent in performing standard pulmonary procedures while 76% expect this for EBUS. 27% of respondents reported that the presence of an IP fellowship does/would affect the procedural training of PCCM fellows neither negatively nor positively; 25%, somewhat negatively; 21%, very positively. 69% of respondents reported that the presence of an interventional pulmonologist on faculty very positively affected the procedural training of PCCM fellows. CONCLUSIONS: Almost all PCCM PDs expect their fellows to demonstrate competence in standard pulmonary procedures. Accordingly, the pulmonology service is the primary team responsible for these procedures at many institutions. From the PD perspective, there is significant variation in how the presence of an IP fellowship affects the procedural training of PCCM fellows; however, the presence of IP faculty is very valuable. These results are similar to that reported in a survey of PCCM fellows. A substantial number of PDs expect their fellows to achieve competency in performing EBUS, a procedure usually performed by IP. CLINICAL IMPLICATIONS: Thus, there are opportunities for further collaboration between PCCM and IP PDs to optimize the training and educational experience of PCCM fellows, particularly in performing EBUS. DISCLOSURES: No relevant relationships by Alex Chee, source=Web Response No relevant relationships by Van Holden, source=Web Response no disclosure on file for Fayez Kheir; Consultant relationship with Boston Scientific Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with olympus Please note: $5001 - $20000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with pinacle biologics Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with cook medical Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Mihir Parikh, source=Web Response Consultant relationship with Medtronic Please note: $1001 - $5000 Added 06/11/2020 by Edward Pickering, source=Web Response, value=Consulting fee Consultant relationship with Merit Endotek Please note: $1-$1000 Added 04/06/2020 by Ashutosh Sachdeva, source=Web Response, value=Consulting fee Consultant relationship with Medtronic Please note: $1001 - $5000 Added 04/06/2020 by Ashutosh Sachdeva, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with COOK Please note: $1001 - $5000 Added 04/06/2020 by Ashutosh Sachdeva, source=Web Response, value=Honoraria Consultant relationship with Medtronic Please note: $1001 - $5000 by Ashutosh Sachdeva, source=Web Response, value=Consulting fee Unrestricted education grant relationship with Olympus Please note: $1001 - $5000 by Ashutosh Sachdeva, source=Web Response, value=Grant/Research Support Consultant relationship with COOK Please note: $1001 - $5000 Added 04/27/2020 by Ashutosh Sachdeva, source=Web Response, value=Honoraria