The Manhattan VA, Harbor Healthcare System, is located adjacent to Bellevue Hospital Center on First Avenue at 24th Street. Its patient care and teaching activities are integrated with New York University School of Medicine. The veterans’ population includes many patients with lung cancer, chronic obstructive lung disease, and asbestos exposure.
Unit first and second year fellows spend a month each in the 11-bed ICU on the Medical Service but also acts as consultant in the Cardiac and Surgical ICUs. The fellow supervises house staff assigned to the ICU, who have primary patient care responsibility. The fellow reviews each case in detail with the advice of an assigned attending, directs the diagnostic work-up, performs appropriate procedures and directs therapy. Dr. Robert Smith directs the ICU. During this time the fellow is also responsible for preliminary interpretation of all pulmonary function tests performed by the laboratory.
A second year fellow provides consultation throughout the hospital for pulmonary consults, and reviews the cases at morning report with the pulmonary faculty. This is a procedure-oriented service and the fellow receives further supervised training in flexible bronchoscopes and pleural biopsy. During this time the fellow is also responsible for a weekly pulmonary consultation clinic.
A first year fellow spends two months under the supervision of Dr. Beno Oppenheimer learning aspects of surgical critical care. Fellows get exposure to cardiac, general surgery, thoracic, orthopedic and neurosurgical cases. Fellows have anesthesia exposure and also spend time in the OR.