The Interventional Pulmonary Fellowship at Beth Israel Deaconess Medical
Center is designed to provide the trainee with the necessary tools to
establish and direct a multidisciplinary academic interventional pulmonary
The IP program is part of the Division of Pulmonary and Critical Care
Medicine with very close ties to Thoracic Surgery, Oncology and Chest
Radiology. The multidisciplinary approach to patients is emphasized. The
interventional pulmonary section is actively involved in the evaluation and
postoperative management of complex airway patients and patients with
The IP section at BIDMC also provides services at Children's Hospital and
New England Medical Center. This ensures ample experiences in complex
pediatric and lung transplant related airway disorders.
Scope of the Program
The program consists of several clinical services:
Chest Disease Center
The Chest Disease Center provides multidisciplinary evaluation, treatment
and care to patients who have benign and malignant lung diseases, including
complex airway disease, pleural disease, benign esophageal disease, cancers
of the lung and esophagus, COPD, and emphysema.
Complex Airway Program
BIDMC serves as a regional and national referral center for patients with
malignant and benign airway disorders. The entire scope of endoscopic
interventions, including procedures such as rigid bronchoscopy, PDT, laser
therapy, APC, cryotherapy, and stenting, are offered. A particular emphasis
of the program is the endoscopic and surgical management of complex benign
disorders. All surgical procedures such as tracheal resection and
reconstruction, carinal resection and tracheoplasty are commonly performed.
Pleural Disease Program
Nearly all medical patients with pleural diseases are evaluated and treated
by the IP service at some point in time. We offer medical thoracoscopy,
ultrasound guided thoracentesis with pleural manometry, and PleurX catheter
placement as procedures in the management of pleural disorders.
Medical Procedure Service
The IP service directs a medical procedure service assisting medical
housestaff in performing thoracentesis and central line placements. Within
the scope of these services we also perform percutaneous tracheostomy and
percutaneous gastrostomy placement in patients with prolonged ventilator
requirements in the medical intensive care unit.
Advanced Diagnostic Bronchoscopy
We perform TBNA, EBUS, AF bronchoscopy and image guided TBNA through Tt
fluoroscopy or EBUS on many patients referred for challenging diagnostic or
Research focused on the indications for and outcomes of interventional
procedures as well as the implementation of new medical device is an
important aspect of our program. Collaborations with many manufacturers and
device developers exist. Many clinical trials are ongoing at any particular
time and active participation of the fellow is expected. As a part of the
research team, the fellow gains experience in designing and conducting
animal and clinical research studies as well establishing budgets, writing
protocols, and performing data analysis.
A sample of current and newly added clinical trials includes:
Endoscopic lung volume reduction
Electromagnetic guidance systems for transbronchial biopsy
AF bronchoscopy in early lung cancer detection
EBUS guided TBNA.
An active animal laboratory for large and small animals is onsite for
airway, pleural and general chest procedure trials. The IP fellow is
expected to be actively involved in IP related research and present results
in conferences and publications.
In addition to active research, the IP section is responsible for a variety
of educational activities such as a monthly multidisciplinary airway
conference and several teaching and CME courses throughout the year. The IP
fellow is actively involved in the moderation and organization of those