Pulmonology Section

MAKATI  MEDICAL  CENTER   SECTION  OF  PULMONARY  MEDICINE       

PULMONARY  MEDICINE  AND  PULMONARY  CRITICAL  CARE  FELLOWSHIP  PROGRAM  

   1.   Objectives  of  the  Pulmonary  Medicine  Fellowship  Training  Program  

  

1.1. To  develop  professional,  competent  and  skilled  pulmonologists  and  pulmonary      critical   care  specialists.  

1.2. To  develop  and  foster  an  aptitude  for  scientific  investigation  and  research  in  the  field  of   pulmonary  medicine  and  pulmonary  critical  care.  

1.3. To  promote  moral  and  ethical  practice  of  pulmonary  medicine  and  pulmonary  critical  care   1.4. To  encourage  social  consciousness  and  civic-­‐mindedness  in  the  practice  of  pulmonary  

medicine  and  pulmonary  critical  care.  

  

2. Makati  Medical  Center  Section  of  Pulmonary  Medicine  Standards  and  Requirements  for  Training   Institutions:  

  

2.1. Makati  Medical  Center,  Section  of  Pulmonary  Medicine  will  be  having  at  least  two  (2)   training  fellows  per  year  level.  

2.2. The  hospital  has  a  sufficient  number  of  in-­‐patient  and  outpatient  populations  that  will   provide  the  fellow-­‐in-­‐training  with  adequate  supervised  exposure  to  gain  expertise  in  the   evaluation  and  management  of  pulmonary  problems.

  

2.3. MMC  has  21  Medical  Intensive  Care  Unit  (MICU),  4  Surgical  Intensive  Care  Unit  (SICU),  2   Neurological  Intensive  Care  Unit  (NICU),  2  Neurosurgical  Intensive  Care  Unit  (NSICU)  beds   with  standard  ICU  monitoring  equipment.  

2.4. Basic  Equipment  :     

2.4.1.

2.4.2.

2.4.3.

Pulmonary  diagnostic  equipment/devices  :  

2.4.1.1.

2.4.1.2. 2.4.1.3. 2.4.1.4. 2.4.1.5.

Pulmonary  function  testing  equipment  capable  of  spirometric   measurement,  measurement  of  lung  volumes  and  diffusing  capacity   Arterial  blood  gas  machine   Pulse  oximeter  

Peak  flow  meter   Access  to  the  following:     1.  Body  phlethysmograph     2.  Cardio-­‐pulmonary  exercise  testing  machine     3.  Polysomnograph     4.  Impedance  plethysmograph  (IPG)  

     Non-­‐invasive  diagnostic  equipment/  facilities:   2.4.2.1. Chest  x-­‐ray   2.4.2.2. Chest  ultrasound   2.4.2.3. Chest  computed  tomography  (CT)  scan   2.4.2.4. Access  to  the  following  :  

1. V/Q  scan     2. Chest  MR     3. Gallium  scan     4.PET  scan  (outside  rotation)     5.   Duplex  scan  

   Available  invasive  diagnostic  devices/equipment/facilities:  

2.4.3.1. 2.4.3.2. 2.4.3.3. 2.4.3.4.

Fiberoptic  bronchoscope/videoendoscope   Devices  for  performance  of  thoracentesis   Devices  for  performance  of  pleural  biopsy   Equipment  for  performance  of  percutaneous/fine  needle  aspiration   lung  biopsy  

  

Access  to  :     

2.4.3.5. 1.  Video-­‐assisted  thoracoscope     2.  Rigid  bronchoscope  

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2.6.3.  Updated  PCCP  Consensus  publications   2.7.  Consultant  Staff:    

                    

2.4.4.

2.4.5. 

2.4.6.

2.4.7. 

2.4.8.

Pulmonary  therapeutic  equipment/devices:   

2.4.4.1.  Nebulization  and  humidification  equipment     

2.4.4.2.  Incentive  spirometers      

Cardio-­‐pulmonary  resuscitation  and  intubation  equipment  available  in  the   emergency  room,  intensive  care  unit  and  other  critical  areas  of  the  institution     

Invasive  mechanical  ventilators  with  the  following  features:   

2.4.6.1.  Volume,  pressure  or  timed  limited  with  basic  monitoring  displays  for  pressure  and  flow  or  volume  measurements;   

2.4.6.2.  Built-­‐in  features  for  PEEP  and  minimum  modern  capabilities  for  pressure  

support  and  SIMV/IMV.   

2.4.6.3.  CPAP  capabilities  

2.4.6.4.  Basic  mechanical  ventilator  testing  equipments:  respirometer,  oxygen   meter,  pressure  monitor  

Non-­‐invasive  mechanical  ventilators  -­‐  BIPAP  machine      Access  to  other  diagnostic  and  therapeutic  equipment/facilities  as  follows:       

1. Ventilators  with  newer  forms  of  mechanical  ventilator  modes  such  as   Pressure  control,  Airway  pressure  release  ventilation  and  Proportional  assist   ventilation.  

2. Pulmonary  catheterization  and  hemodynamic  studies   

3. Heart-­‐lung  machine  

   2.5. Other  diagnostic  /laboratory  facilities  as:  

         2.5.1.  Facility  for  PPD  testing   2.5.2.  Facility  for  Gram  staining  and  AFB  staining   2.5.3.  Cytologic  and  histologic  facilities   2.5.4.  Basic  microbial  isolation  and  drug  sensitivity  tests   2.5.5.  Access  to:    

1.TB  culture  and  sensitivity  testing   

2.6.  Library  facilities:  

  

  

2.6.1.  Basic  Pulmonary  Medicine  textbooks  (latest  edition)  :                       

2.6.1.1.  Textbook  of  Respiratory  Medicine  by  Murray  and  Nadel  

2.6.1.2.  Pulmonary  Diseases  and  Disorders  by  Alfred  Fishman       

2.6.1.3.  Textbook  of  Pulmonary  and  Critical  Care  Medicine  by  Roger  Bone     

2.6.1.4.  Textbook  of  Pulmonary  Medicine  by  Fraser  and  Parefor  chapter/s  on  chest  

radiology  only  

     

2.6.2.  Journals  with  up-­‐to-­‐date  subscription  and/or  internet  access  to:  

  2.6.2.1.  American  Journal  of  Respiratory  and  Critical  Care  Medicine    

  2.6.2.2.  Chest   2.6.2.3.  Philippine  Journal  of  Chest  Diseases  

  

2.7.1. 

2.7.2.

2.7.3.

The  Section  Head,  Dr.  Alipio  S.  Abad,  Jr.  is  an  active  Fellow  of  the  PCP  and  PCCP   The  Training  Officer,  Dr.  Gregorio  P.  Ocampo,  will  oversee  and  supervise  the   training  of  pulmonary  fellows.     Dr.  Nazario  Macalintal,  Jr.,    Dr.  Emmanuel  Kasilag,  Dr.  Norman  Maghuyop,  Dr.   Manuel  Ko  are  also  active  PCP  and  PCCP  fellows.      

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3.Entry  and  Terminal  Competencies  of  Pulmonary  Fellows-­‐in-­‐Training:  

  

3.1. Entry  Competency  for  First  year  Fellow:     

  

3.1.1.

3.1.2. 3.1.3.

3.1.4. 3.1.5.

3.1.6. 3.1.7.

3.1.8. 

3.1.9.Must  have  completed  residency  training  in  Internal  Medicine  in  a  PCP-­‐accredited   institution  and  be  either  PCP-­‐qualified  or  PCP  diplomates  at  the  time  of  entry  to  the   training  program.  Those  training  fellows  who  are  only  PCP-­‐qualified  are  required  to   take  the  PCP  certifying  examinations  every  year  of  their  training  until  they  pass  the   examination.   Must  have  a  basic  knowledge  of  the  anatomy  and  physiology  of  the  respiratory   system.   Must  be  able  to  demonstrate  an  ability  to  obtain  a  comprehensive  and  accurate   history  of  present  illness  for  a  variety  of  pulmonary  disease  presentations  and   physical  examination  skills  specific  to  the  respiratory  system.   Must  be  able  to  identify  salient  features  of  common  pulmonary  conditions  or   diseases  and  arrive  at  a  corresponding  diagnosis.   Must  be  able  to  identify  normal  chest  radiographs  and  common  pulmonary   radiographic  abnormalities.   Must  have  a  basic  knowledge  of  arterial  blood  gas  and  spirometry.   Must  have  performed  at  least  one  thoracentesis  and  one  endotracheal  intubation   during  his/her  residency  training  in  internal  medicine.   Must  have  adequate  knowledge  of  mechanical  ventilatory  support  and  care.   Must  have  basic  and  advanced  knowledge  of  cardio-­‐pulmonary  resuscitation.  

3.2. Terminal  Competency  for  First  Year  Fellow/  Entry  Competency  for  Second  Year  Fellow:    Aside  from  fulfilling  the  entry  competency  of  a  first  year  fellow,  at  the  end  of  his/her  first   year,  the  pulmonary  fellow  in  training:     

 3.2.1.  Must  have  a  comprehensive  knowledge  of  the  anatomy  and  physiology  of  the   respiratory  system.  

 3.2.2.  Must  be  able  to  fully  explain  the  pathophysiology  behind  common  pulmonary   disorders.  

 3.2.3.  Must  be  able  to  identify,  interpret  common  chest  radiographic  abnormalities  and   provide  clinical  correlation.  

 3.2.4.  Must  be  able  to  identify  and  distinguish  normal  from  abnormal  structures  on  chest  CT   scan.  

 3.2.5.  Must  have  an  ability  to  integrate  an  interpretation  of  chest  x-­‐rays,  chest  CT  scans  and   other  radiographic  tests  related  to  pulmonary  diseases  like  ventilation/perfusion   scans,  chest  ultrasounds,  pulmonary  angiograms  to  provide  a  therapeutic  plan  for   patients  with  pulmonary  conditions.  

 3.2.6.  Must  be  able  to  correctly  interpret  arterial  blood  gas  and  spirometric  examination   results.  He/she  must  have  adequate  knowledge  of  the  performance  of  the  tests,   evaluate  acceptability  and  reproducibility  of  tests,  and  identify  the  errors  attendant   therein.  

 3.2.7.  Must  have  exposure  to  V/Q  scan,  Duplex  scan  and/or  IPG.   

 3.2.8.  Must  have  exposure  to  Swan  Ganz  pulmonary  artery  catheterization.   

3.2.9.  Must  be  able  to  perform  and  adequately  interpret  PPD  tests,  basic  sputum  examinations  such  as  gram  stain,  AFB  smear,  and  KOH  smear.   

 3.2.10.  Must  be  able  to  identify  inflammatory  and  carcinomatous  cells  on  histopathological  

specimens.   

 3.2.11.  Must  have  demonstrated  competency  in  the  performance  of  the  following  procedural  

skills:   

      3.2.11.1.  diagnostic  or  therapeutic  thoracentesis  (at  least  10)     

      3.2.11.2.  pleural  biopsy  (at  least  3)         

      3.2.11.3.  fiberoptic  bronchoscopy  with  biopsy  (  at  least  10  )   

      3.2.11.4.  chemical  pleurodesis  (at  least  5)   

      3.2.11.5.  arterial  puncture   

      3.2.11.6.  tuberculin  testing   

      3.2.11.7.  endotracheal  intubation    

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3.2.12.  Must  have  exposure  to  transbronchial  biopsy,  rigid  bronchoscopy,  percutaneous  lung   biopsy  (fluoroscopic,  ultrasound  and/or  CT  guided),  chest  tube  thoracostomy,   thoracoscopy  (VATs),  and  thoracotomy.  

3.2.13.  Must  have  the  competency  to  provide  a  preoperative  pulmonary  evaluation  and  post-­‐ operative  pulmonary  care  plan  for  patients  undergoing  thoracic  surgical  procedures.  

3.2.14.  Must  know  the  basics  of  mechanical  ventilatory  support  i.e.,  operating  principles,   mechanics,  indications,  monitoring,  complications,  and  weaning.  

3.2.15.  Must  have  completed  at  least  one  (1)  retrospective/descriptive  research  paper  or  case   report  which  should  be  submitted  to  the  PCCP  at  the  end  of  the  first  year.  

3.2.16.  Must  have  satisfactorily  passed  the  evaluation  given  by  consultants  (see  Evaluation).    

   Either  supervised  or  assisting:  supervised  means  the  Fellow-­‐in-­‐training  is  the  one  actually  performing  the   procedure  supervised  by  a  consultant;  assisting  means  the  Fellow-­‐in-­‐training  simply  assists  the   consultant  in  performing  the  procedure.       

3.3.  Terminal  Competency  of  the  Second  Year  Fellow:    Aside  from  fulfilling  the  aforementioned  competencies,  at  the  end  of  his/her  second  year,  the   pulmonary  fellow  in  training:       

 3.3.1.  Must  be  able  to  provide  a  good  clinico-­‐pathological  correlation  of  pulmonary  diseases   and  disorders,  particularly  the  more  common  ones.  

 3.3.2.  Must  have  the  skill  in  interpreting  abnormalities  on  chest  radiographs  and  chest  CT   scan  and  provide  clinical  correlation.  

 3.3.3.  Must  demonstrate  the  ability  to  interpret  arterial  blood  gas  results  and  spirometric   examinations  including  lung  volume  determinations,  airway  resistance,  DLCO,  and   bronchoprovocation  tests  and  a  have  a  good  knowledge  of  actual  performance  of   these  procedures.  

 3.3.4.  Must  demonstrate  the  competency  in  performing  all  the  procedural  skills  :   3.3.4.1.  fiberoptic  bronchoscopy  w/  lavage,  endobronchial  biopsy(at  least  20  )   3.3.4.2.  thoracentesis  (at  least  20  )   3.3.4.3.  pleural  biopsy  (at  least  3)  

    3.3.4.4.  chemical  pleurodesis  (at  least  5)   3.3.4.5.  arterial  puncture   3.3.4.6.  tuberculin  testing   3.3.4.7.  endotracheal  intubation  

  3.3.5.  Must  be  able  to  distinguish  a  normal  V/Q  scan,  IPG  and/or  Duplex  scan  from  an  

abnormal  tracing  and  identify  the  abnormalities  noted  therein.   

  3.3.6.  Must  have  exposure  to  cardiopulmonary  exercise  tests  and  polysomnography.   

  3.3.7.  Must  be  able  to  interpret  Swan  Ganz  pulmonary  catheterization  results.     

  3.3.8.  Must  be  adept  in  performing  and  interpreting  simple  microbological  laboratory  tests  as  

gram  stain,  AFB  smear,  and  KOH  smear.     

  3.3.9.  Must  have  the  knowledge  and  skills  for  ventilator  management  of  critically  ill  patients.     

  3.3.10.  Must  be  able  to  make  sound  judgment  on  the  approach  to  the  diagnosis  and  

management  of  pulmonary  diseases.     

  3.3.11.  Must  have  completed  at  least  one  prospective  research  paper  as  a  requirement  for  

taking  the  PCCP  Diplomate  Certifying  Examinations.    

  3.3.12.  Must  have  satisfactorily  passed  the  evaluation  given  by  the  consultants  (see  

Evaluation).  

 

Either  supervised  or  assisting:  supervised  means  the  Fellow  is  the  one  actually  performing  the  procedure   supervised  by  a  consultant.;  assisting  means  the  Fellow  simply  assists  the  consultant  in  performing  the   procedure.     

␣ Fellows  will  be  going  on  duty  at  the  ICU  and  wards  during  their  rotation.   ␣ Morning  endorsements  will  start  at  7am  and  afternoon  endorsements  at  4pm   ␣ They  are  expected  to  make  rounds  everyday  including  Sundays  and  holidays.   ␣ They  will  see  all  patients  admitted  and  referred  to  the  Section  of  Pulmonology  during  their  tour  

of  duty.     

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4. Learning  Activities/  Instructional  Methods:     

              

4.1.  Training  Program:   

4.1.1.  Makati  Medical  Center  will  have  a  training  program  that  will  enable  a  fellow-­‐in-­‐training  

to  meet  the  criteria  for  entry  and  terminal  competencies  so  stated  in  this  document.   4.2.  Conferences:    

    

Pulmonary  Didactic  Conference:   ␣ Head:  Dr.  Norman  Maghuyop   ␣ 2nd  and  4th  Monday  of  the  Month  

   ␣ Goal:  To  provide  the  trainees  the  opportunity  to  critically  review  literature  and  interact  

with  the  consultant  staff  in  the  discussion  of  various  topics  in  the  fields  of  pulmonary  and  

critical  care   ␣ Objectives  :    

1. To  provide  instruction  on  the  basics  and  physiology  of  pulmonary  medicine  and   critical  care.  

2. To  provide  specific  and  detailed  knowledge  of  diagnosis,  treatment,  prevention  of   pulmonary  diseases.  

   ␣ Educational  experience  :  This  conference  is  to  be  held  at  least  twice  a  month  and  lectures  

or  interactive  discussions  may  be  conducted  by  a  member  of  the  consultant  staff  or  by  a   senior  fellow  with  a  consultant  staff  on-­‐hand  to  act  as  resource  person.     

␣ Evaluation  and  feedback  :  Written  quizzes  may  be  given  at  the  beginning  or  end  of  the   didactic  conference  or  the  topics  discussed  may  be  included  in  the  scope  of  the  in-­‐house   periodic  evaluation  examinations.     

   Pulmonary  Case  Conference:     Head:  Dr.  Emmanuel  Kasilag  

␣ 2nd,  3rd,  4th  Friday  of  the  month     

Goal:     1. To  provide  the  trainees  the  opportunity  to  present  pulmonary  and  critical  care  

consultations  for  peer  review.   2. To  provide  the  trainees  the  opportunity  to  learn  presentation  skills  

     Objectives  :    

1. To  learn  the  pathophysiology,  diagnosis  and  management  of  patients  hospitalized   with  pulmonary  and  critical  illnesses  

2. To  review  historic  and  current  literature  relevant  to  the  case(s)  presented  for   discussion.  

     Educational  experience:  This  conference  is  to  be  held  at  least  three  times  in  a  month.   The  educational  objectives  will  be  obtained  by  the  following  procedure  :    

1. The  inpatient  service  will  select  the  case(s)  for  presentation.   2. The  selected  case(s)  will  be  presented  including  relevant  laboratory  data  and  

radiographic  material.     3. A  discussion  of  relevant  literature  will  follow  the  case  presentation.     4. A  reference  list  or  copies  of  relevant  articles  should  be  available  for  all  the  

conference  participants.  

     Evaluation  and  Feedback:  Fellow  presenters  will  be  critiqued  by  the  consultant  staff  and   will  include  feedback  on  content  and  manner  of  presentation.       

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Pulmonary  Grand  Rounds     ␣ Head:  Dr.  Manuel  Antonio  Ko   ␣ 1st  Thursday  of  the  month  

Goal:  To  provide  trainees  the  opportunity  to  discuss  an  interesting  or  problematic  case   from  a  multidisciplinary  perspective.        Objectives  :    

1. To  present  clinical  problems  in  pulmonary  medicine  and  critical  care  by  focusing   on  interesting  and  problematic  cases  and  discuss  the  appropriate  diagnostic  and   treatment  approaches  from  a  multi-­‐  disciplinary  perspective    

2. To  provide  new  information  on  these  cases  and  enhance  clinical  reasoning  skills  in   the  management  of  such  cases.    

   

Educational  experience  :  

1. This  conference  is  held  at  least  once  a  month  and  should  be  attended  by  

representatives  from  the  different  departments  in  addition  to  the  pulmonologists,   namely,  the  radiologist,  pathologists,  thoracic  surgeons,  medical  oncologists,  etc.   As  such,  the  fellow-­‐in-­‐training  will  be  the  presenter  and  the  consultant  specialists   will  be  the  reactors  or  resource  speakers.    

2. As  an  alternative  to  above,  the  Grand  Rounds  may  also  feature  renowned   practitioners  or  researchers  presenting  topics  of  interest  or  an  invited  visiting   faculty  or  consultant  delivering  a  didactic  lecture.    

3. The  PCCP  inter-­‐hospital  symposium  held  in  the  respective  institutions  may  be   credited  as  a  Pulmonary  Grand  Rounds  for  that  particular  month.   

       

Goal:  To  provide  the  trainee  the  educational  experience  and  skills  to  critically  evaluate   the  medical  literature  relevant  to  pulmonary  medicine  and  critical  care.

Objectives  :    

1. To  provide  a  review  of  current  literature  in  pulmonary  medicine  and  critical  care.     2. To  provide  an  understanding  of  statistical  methodology  used  in  research  articles  :  

emphasis  to  be  placed  on  hypothesis,  experimental  design,  methods,  data  

analysis,  appropriateness  of  conclusions  and  clinical  relevance  of  journal  articles.     3. To  develop  skills  in  evaluating  the  quality  and  critical  appraisal  of  published  

pulmonary  and  critical  care  literature.  

Educational  experience:  

This  conference  is  to  be  held  at  least  twice  a  month.        The  educational  objectives  will  be  obtained  by  the  following  procedure:    

1. Each  trainee  is  expected  to  present  1  or  2  articles  for  detailed  review.  These   articles  are  those  recently  published  in  leading  medical  journals.    

2. The  assigned  trainee  will  select  the  article  and  a  consultant  will  review  the  article   with  the  trainee  prior  to  the  conference  presentation.    

3. The  trainee  should  submit  the  articles  to  the  Department/Section  secretary  for   distribution  one  week  prior  to  the  conference.    

4. The  trainee  will  present  the  journal  article(s)  and  lead  the  discussion.       

Evaluation  and  feedback:  Fellow  presentations  will  be  critiqued  by  the  Consultant  staff   present  at  the  time  of  presentation  and  will  include  feedback  on  content  and  manner  of   presentation.     

  

Pulmonary  Journal  Club     ␣ Dr.  Alipio  S.  Abad  Jr.   ␣ 2nd  and  4th  Thursday  of  the  month  

  

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Morbidity  and  Mortality  Conference     ␣ Dr.  Nazario  A.  Macalintal  Jr.   ␣ 3rd  Thursday  of  the  month  

   o Goal:  To  provide  the  trainees  the  opportunity  to  discuss  and  learn  about  problems  in  

patient  management  that  contributed  to  morbidity  and  mortality.  

   o Objectives  :  

1. To  identify  problems,  limitations  in  the  diagnostic  process,  institution  of  treatment   that  contributed  to  morbidity  and  mortality  in  pulmonary  patients.    

2. To  recognize  and  analyze  adverse  outcomes  of  medical  care  and  formulate   appropriate  solutions.    

3. To  correlate  clinical  and  pathologic  aspects  of  disease.       

␣ Educational  experience:  This  conference  is  to  be  held  at  least  once  a  month.  All  M  &  M   cases  will  be  briefly  reviewed  and  a  few  will  be  selected  for  a  a  more  detailed  presentation   and  analysis.     

    

Radiology  Conference     ␣ Head:  Dr.  Gregorio  P.  Ocampo   ␣ 3rd  Monday  of  the  month  

Goal:  To  provide  the  trainees  didactic  training  in  chest  radiography  and  and  appropriate   clinical  correlates.        Objectives  :    

1. To  review  basic  principles  in  radiography  and  learn  skills  in  the  interpretation  of   chest  x-­‐rays,  chest  CT  scans,  and  other  relevant  modalities.  

2. To  provide  clinico-­‐radiographic  correlates.       

Educational  experience:  This  conference  is  to  be  held  at  least  once  a  month.          

  

Pulmonary  Pathology-­‐TCVS  Conference  (Surgico-­‐Patho  Conference)     ␣ Head:  Dr.  Alipio  S.  Abad  Jr.   ␣ 2nd  Saturday  of  the  month     

o Goal  :  To  provide  the  trainees  the  opportunity  to  discuss  the  pathophysiologic  and   surgical  correlates  of  interesting  or  problematic  pulmonary  or  critical  care  cases.       

o Objectives:       

1. To  increase  understanding  of  the  pathologic  mechanisms  that  are  involved  in   specific  cases  that  underwent  surgical  intervention.    

2. To  provide  clinico-­‐radio-­‐pathologic  correlates.  Educational  experience  :  This   conference  is  to  be  held  once  a  month.  The  thoracic  surgical  and  pathology   consultant  staff  should  be  leading  the  discussion.    

3. Proper  documentation  (including  date  of  conference,  diagnosis/es  of  discussed   case/s  and  attendance  of  consultant  staff)  of  each  conference  should  be  made.       

4. Performance  of  Procedures:     

Each  fellow-­‐in-­‐training  must  accomplish  the  required  number  of  procedures  so  stipulated  in  the   document  of  entry  and  terminal  competencies.          

           

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5. Evaluation:     

6.1.  Each  fellow-­‐in-­‐training  must  undergo  evaluation  of  his/her  performance  through  the   following:  (  with  corresponding  percentages)  

6.1.1.  Written  examinations  held  at  least  every  6  months  (25  %)     6.1.2.  Performance  in  the  clinical  areas  of  rotation  (wards,  ICU,  etc.)  (25  %)     6.1.3.  Skills  assessment  in  performance  of  required  procedures  (20  %)     6.1.4.  Assessment  as  presentors  during  required  conferences  (20  %)     6.1.5.  Peer-­‐based  assessment  of  work  attitude  (10  %)     6.1.6.  Oral/Practical  examinations  may  be  conducted  at  least  once  a  year  but  only  a  

passed  or  failed  a  grade  will  be  given.  Failure  in  these  may  result  in  the  fellow-­‐  in-­‐ training  incurring  additional  assignments  or  rotations  as  deemed  necessary  plus   another  oral/practical  exam  until  the  fellow  can  earn  a  passing  grade    

6.2  Evaluation/assessment  tools  or  instruments  used  in  the  evaluation  Copies  of  the  template   tools  or  instruments  utilized  in  the  program  should  be  submitted  to  the  Board  every  year  as   part  of  the  review  requirement.       

6.3.  All  fellows-­‐in-­‐training  should  take  the  PCCP  in-­‐service  examinations  as  required.       

7.  Research:      Each  fellow-­‐in-­‐training  should  complete  at  least  one  (1)  descriptive  research  paper  or  case  report  and   one  (1)  prospective  study  within  his/her  two  years  of  training.        8.  Community  Service      Each  fellow-­‐in-­‐training  must  participate  in  PCCP-­‐initiated  community  service  program.  He/she  may  use   these  patients  to  fulfill  the  requirements        9.  Inter-­‐hospital  Symposium:      Attendance  in  the  PCCP-­‐initiated  Inter-­‐hospital  Symposia  is  required,  a  minimum  of  80  %  of  all  symposia   ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ept  by  the  PCCP  Secretariat.        10.  Post-­‐Graduate  Course  on  Bioethics  and  Professional  Ethics  Attendance  in  the  PCCP-­‐initiated  post-­‐

graduate  session  on  Bioethics  and  Professional  Ethics  is  required.  Certification  of  attendance  to   these  sessions  will  be  required  for  fellows-­‐in-­‐training.       

11.  Eligibility  for  Transfer  of  Training  Venue:  

11.1.  A  trainee  is  eligible  for  transfer  only  when  he/she  has  completed  a  year  of  training  in  a  duly   accredited  hospital  or  institution.  He/she  must  present  to  the  receiving  institution  a   certificate  stating  (1)  the  completion  of  the  first  year  of  fellowship  training,  (2)  the  latest   comprehensive  evaluation  by  the  training  officer,  (3)  the  reason  for  transfer,  and  (4)  a   statement  that  he/she  has  no  pending  or  unfulfilled  requirements  prior  to  transfer.  Said   certificate  should  be  duly  signed  by  both  the  training  officer  and  the  head/chair  of   section/department  where  the  trainee  spent  his/her  first  year  of  pulmonary  fellowship   training.  

    

  

Prepared  by:  

  

  

GREGORIO  P.  OCAMPO,  MD  

Training  officer     

   

Noted  by:         

ALIPIO  S.  ABAD  JR.,  MD   Section  Chief  

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