Outline
A comprehensive Pediatric Pulmonology Fellowship was established at the University of Minnesota in 1986 by the faculty of the Pulmonary Division of the Department of Pediatrics. This three-year fellowship has a strong academic orientation, and is accredited by the Accreditation Council for Graduate Medical Education. The faculty of this training program is responsible for the Pediatric Pulmonary services of the Fairview-University Children's Hospital, Hennepin County Medical Center, Children's Hospitals and Clinics, Minneapolis and St. Paul. These clinical services, which are used extensively in fellow training, are comprised of active inpatient units and outpatient clinics, consultation and bronchoscopy services, and the Cystic Fibrosis Center of the University of Minnesota. In addition, the faculty has strong research interests in both clinical and basic realms of lung disorders. This research is greatly enhanced by several collaborations both locally and with other centers across the country.
This Pediatric Pulmonary Fellowship has one new position open each year, usually beginning in July. The Fellowship Program is designed to meet all qualifications for the practice of state-of-the-art pediatric pulmonology and for graduates of the program to become Board Certified in Pediatric Pulmonary Medicine. The program has also a strong academic orientation with a goal of preparing individuals for careers in research and academics. Preference will be given to applicants who have a clear commitment to a career in academic medicine. This is a three-year program consisting of 14 months of full-time clinical training, 20 months of research experience, and 2 months of elective experiences. The months of full-time clinical work are distributed over the three years to allow early entry into a research project during the first year. Each fellow is expected to choose a general Program Mentor from the faculty of the Division of Pediatric Pulmonology. The fellow will also choose a Research Mentor, who does not necessarily need to be in the division.
During their months of full-time clinical assignment, the fellows follow all hospitalized patients. They participate in the morning Teaching-Attending rounds with the pediatric housestaff and the attending physician. They see and examine new admissions and present a plan for management to the attending physician. While on the consultation service, the fellows also see all inpatient pediatric pulmonary consultations, making an independent patient evaluation and writing a consult note before reviewing the patient with the attending physician. Fellows are involved with all bronchoscopy consultations and procedures. They are responsible for the procedure note and appropriate follow-up.
Fellows also attend the Outpatient Chest Clinic two days a week. Fellow responsibilities to the outpatients include seeing the new referrals, their previous patients, as well as other patients of interest. Fellows are responsible for follow up of laboratory test results and dictations to the referring physician on their outpatients. Each fellow acquires a group of patients that they follow as the primary pulmonary physician.
While on clinical service, fellows are expected to participate in teaching rounds, to be in charge of clinical and patient conferences, to participate in teaching the pediatric residents, and to lead critical discussions of key reference papers available to them.
Pediatric and Medicine-Pediatric Residents (PL-1 to PL-3) take care of all the patients admitted to the Fairview-University Children's Hospital. Most of the pulmonary patients are admitted to the Children's Center. The ward team consists of two third year residents, and sometimes a medical student. Morning attending rounds are made daily. Special topics are discussed on a regular basis. Ward team members attend many of the weekly pulmonary conferences.
Each summer, one-month courses are provided for the pediatric pulmonary fellows in the following disciplines:
Periodically, the faculty provides a Pulmonary Basics Review Course designed as a broad overview of pediatric pulmonology to prepare individuals to take the pediatric pulmonary board examination.
Weekly:
Special:
The fellow's responsibility to medical students on the clinical pulmonary service is similar to the responsibility to the residents. It should be noted that the Department of Pediatrics has approximately forty fellows in various sub-specialties and they are each responsible for teaching medical students who are on their pediatric clerkships. This may involve up to six half-day periods during the year.
The fellow frequently interacts with pediatric medicine specialists, especially bone marrow transplant, endorcrinology, hematology, oncology, cardiology, infectious diseases, gastroenterology, and neonatology and with those in other specialties, especially pediatric otolaryngology, pediatric surgery, and transplant surgery
Our faculty view experiences in the design, content and presentation of a research project as an essential part of the fellowship. Fellows are encouraged to seek out a basic research project early in their first year of training. Numerous opportunities exist for collaboration with members of the pulmonary section and other members of the University faculty. Frequent research conferences are held in which faculty and guests present progress reports of ongoing projects. The fellows also present reports of their research at these conferences once or twice a year. While it is not a requirement of the Fellowship Program, some individuals with an interest in a traditional academic career may wish to pursue programs leading to the Master of Public Health, or Master of Science in Clinical Research degrees. An accelerated program for fellows in training is available for these degrees. Programs leading to a Doctor of Philosophy degree in a basic science are also available. Although some portion of the fellowship time may apply to such advanced degree programs, the bulk of the time necessary to obtain the degree would not be supported by the Fellowship Program.
Fellows are encouraged to present their research findings at national meetings, publish their results in peer reviewed journals, and to write grant proposals. These grant requests are usually directed to national granting agencies that have special programs for supporting beginning investigators. This is a valuable experience that aids in the clarification of their project, may provide independent support for their third year, and if successful, begins a track record of grant support.
Two months of the three-year fellowship are allowed as elective time chosen at the fellow's discretion with the approval of the Program Mentor. This time may be spent in either clinical or research pursuits. With permission of the faculty some of this time may be spent away from the University of Minnesota if similar experience is not available here.
The beginning annual stipend is set for all residents and fellows at the University of Minnesota annually in July. This is adjusted depending on the number of years the fellow is post-pediatric residency. All Fellows of this department are registered as graduate students of the Medical School and have the resultant student privileges. Tuition and fees are paid by the Pulmonary Division. Each fellow is supported to attend one national pulmonary related meeting each year.
Other benefits include: health insurance (single coverage fully paid, or family coverage available with a fellow contribution), paid life insurance, paid disability insurance, paid malpractice insurance coverage for all clinical training experiences, membership dues for the American Thoracic Society, copying, literature searches, general office supplies, the use of computers and laser printers, desk, file cabinet, phone, and access to laboratory and secretarial assistance.
The Pediatric Pulmonary Division of the University of Minnesota has seven academic faculty members at the Fairview-University Children's Hospital, two at the Children's Hospitals and Clinics, St. Paul, and four at Children's Hospitals and Clinics, Minneapolis, and one at the Hennepin County Medical Center. These facilities also have a large number of consulting physicians and paramedical professionals who contribute to the education of the Pediatric Pulmonary Fellows.
Faculty based primarily at the Fairview-University Children's Hospital:
Warren J. Warwick, M.D. Annalisa Marzotto Professor of Pediatrics, Co-Director of the Cystic Fibrosis Center of Minnesota. Dr. Warwick did his pediatric training in this department. He has been a member of this faculty since 1960, and has been Director of the Cystic Fibrosis Center since 1962. His research interests are based in cystic fibrosis and include pulmonary physiology, ciliary function, bioengineering, biophysics, computer databases, and psychological intervention.
O. Douglas Wangensteen, Ph.D. Professor of Physiology and Pediatrics. Dr. Wangensteen is an active member of our division specifically in the area of research and education. His primary focus of research is in lung and airway permeability and acute lung injury.
Warren E. Regelmann, M.D. Associate Professor of Pediatrics, Director of the Pediatric Pulmonary Fellowship Program. Dr. Regelmann did his pediatric residency and infectious disease fellowship at the University of Minnesota. He is Board certified in pediatric pulmonology and infectious diseases. His research interest is in the role of the phagocyte oxidative response to bacterial infection in remodeling of lung tissue and in prevention and treatment of bacterial lung infections.
Imad Haddad, M.D. Associate Professor of Pediatrics. Dr. Haddad did his pediatric residency at the American University of Beirut and St. Joseph's Hospital in Phoenix and fellowship in critical care medicine at the University of Minnesota. He is Board certified in pediatric critical care. His research interest is in the role of nitric oxide and peroxynitrites in lung injury.
David Cornfield, M.D. Assistant Professor of Pediatrics, Director of the Division of Pediatric Pulmonology and Critical Care Medicine. Dr. Cornfield completed his pediatric fellowship training at University of Colorado, at Denver. He joined our faculty in 1993. He is Board certified in pediatric pulmonology and in critical care medicine. His active basic research focus is on nitric oxide, pulmonary vascular physiology and its developmental biology. He also has several active clinical research studies focused on treatment of acute lung injury.
Michael Shreve, M.D. Assistant Professor of Pediatrics. Dr. Shreve completed his pediatric training at the University of Minnesota. He joined our faculty in 1997. He is Board certified in pediatric pulmonology. His interests are in asthma education and pulmonary effects of bone marrow transplantation.
Valerie Ann Porter, Ph.D. Assistant Professor of Pediatrics. Dr. Porter received her Ph. D. in pharmacology from the University of Leeds, UK in 1994 and has done post doctoral research at University of Vermont. She joined the faculty in 1997. Her area of expertise is in electrophysiologic studies on calcium channels.
Ernesto Resnik, Ph.D. Assistant Professor of Pediatrics. Dr. Resnik received his Ph.D. in Biochemistry, Molecular Biology and Biophysics from the University of Minnesota. He has done post-doctoral research in developmental biology and joined the faculty in 1998. His area of expertise is in the molecular aspects of the development of the lung.
Carlos Milla, M.D. Instructor of Pediatrics. Dr. Milla completed his pediatric residency at the State University of New York Downstate Medical Center at Brooklyn and his pulmonary fellowship and training in public health at the University of Minnesota. He has been a faculty member since 1996. He is Board certified in pediatric pulmonology. He has an active research program in epidemiologic studies of lung disease in cystic fibrosis. He is Co-Director of the Cystic Fibrosis Center.
Faculty based at the Children's Hospitals and Clinics, St. Paul:
Stephen Blythe, M.D. Instructor of Pediatrics. Dr. Blythe trained in both general pediatrics and pediatric pulmonology at the University of Wisconsin, Madison. He has been a member of the faculty since 1986. He is Board certified in pediatric pulmonology and is skilled in flexible bronchoscopy.
Paul Kubic, M.D. Instructor of Pediatrics. Dr. Kubic did his pediatric residency in this department, and he has been a member of the faculty since 1980. He is Board certified in pediatric pulmonology, and he has a special interest in asthma and other forms of reactive airway disease. He is active in pediatric education of both residents and medical students.
Faculty based at Children's Hospitals and Clinics, Minneapolis:
Stephen C. Kurachek, M.D. Clinical Assistant Professor of Pediatrics. Dr. Kurachek is the Medical Director of the Pediatric Intensive Care Unit. He received his M.D. from the University of Miami Medical School. His pediatric pulmonary training was done at Harvard University, Boston. He is Board certified in pediatric critical care medicine and pulmonology. He is primarily interested in intensive care pulmonary medicine.
John J. McNamara, M.D. Clinical Assistant Professor of Pediatrics. Dr. McNamara joined the faculty in January of 1990. He received his M.D. from the University of Florida College of Medicine. His pediatric training was completed in Rochester at Strong Memorial Hospital and his pediatric pulmonary training at The Children's Hospital in Boston. He is Board certified in pediatric pulmonology. He is particularly recognized for his teaching skills.
William B. Wheeler, M.D. Clinical Assistant Professor of Pediatrics. Dr. Wheeler received his M.D. and training in Pediatrics at the University of Tennessee. His pulmonary training was obtained at Harvard Medical School in Boston. He is Board certified in pediatric critical care medicine and pulmonology. Presently, he is the Medical Director of the Pulmonary Function Laboratory and the Apnea Program.
Roy C. Maynard, M.D. Clinical Instructor of Pediatrics. Dr. Maynard received his M.D. from Jefferson Medical College in Philadelphia, and his residency and training in Pediatrics and in Neonatology and Pulmonology at the University of Minnesota. He is Board certified in neonatology and pulmonology. He has special interests in bronchopulmonary dysplasia and congenital malformations of the lung.
Faculty based at Hennepin County Medical Center, Minneapolis:
Gail M. Brottman, M.D. Assistant Professor of Pediatrics. Dr. Brottman-Kagan joined the faculty in 1992. She received her M.D. degree from UHS/Chicago Medical School. She trained in pediatrics and did her pulmonary fellowship at the University of Minnesota. She is Board certified in Pediatric Pulmonology and currently is head of the Division of Pediatric Pulmonology at Hennepin County Medical Center. Her interest is in asthma and airway epithelial damage from eosinophil products.
Other Team Members of the Pediatric Pulmonary Division:
Mary Jo McCracken, R.N., M.S., C.C.R.N, P.N.P: Ms. McCracken is responsible for patient education especially those with cystic fibrosis. Her special research interest is in modalities for teaching coping skills to adolescent and young adults.
Susan Severson, R.N., B.S.N. Ms. Severson is responsible for coordination of patient involvement in and is overall coordinator of our clinical research protocols.
Jacquelyn Zirbes, R.N., MA, C.P.N.P Ms. Zirbes coordinates the care of pediatric patients being evaluated for lung transplantation and coordinates several clinical research protocols.
Jean Herron, B.S. Ms. Herron is an Assistant Scientist who is responsible for cellular and molecular laboratory operations, including our CLIA certified Phagocytic Cell Function Laboratory.
Ione Brown, B.S. Ms. Brown is an Assistant Scientist who is responsible for pulmonary physiology, sweat chloride and nasal potential difference laboratory operations. She coordinates our CLIA certified Pediatric Pulmonary Function and Sweat Testing Laboratories.
The clinical pulmonary team also includes: A Database Manager, Genetic Counselors, Nutritionists, Psychologists, Pharmacologists, Physical and Occupational Therapists, Pulmonary Triage Nurses, Social Workers, and Respiratory Therapists.
Department of Pediatrics of the University of Minnesota
The Department of Pediatrics of the University of Minnesota is a large, academically oriented department with a strong research base. It was established in 1915 and has grown to encompass all phases of pediatric medicine. The Department has over 100 full-time faculty who provide care in all the major medical facilities of the Twin Cities. In addition, there are over 250 practicing pediatricians of the region who enjoy clinical faculty appointments and contribute to the educational mission of the Department of Pediatrics.
The inpatient pediatric pulmonary service at Fairview-University Medical Center is composed of a primary service and a consultative service. Inpatients up to age twenty-one are admitted to the Children's Center, a 25-bed ward for pediatric pulmonary and cystic fibrosis patients, which is shared with three other subspecialties. There are physical therapy rooms adjacent to the ward. Adults on the pediatric pulmonary service, such as those with cystic fibrosis, are preferentially admitted to adult stations. When indicated, patients are admitted to the NICU at Fairview-Riverside or PICU(4E) and cared for jointly with the neonatologist or intensivist.
There is a fully staffed endoscopy suite for the bronchoscopies, as well as a special procedures room near the PICU for selected inpatient bronchoscopies including those requiring transbronchial biopsy.
Outpatient clinic is held five days a week for pulmonary and cystic fibrosis patients. It is located on the 4th floor of the Phillips-Wangensteen Building. It has 15 available examining rooms and two treatment rooms. A conference room and other support facilities are also available. The Pediatric (including Infant) Pulmonary Function and Sweat Chloride Laboratories are adjacent to the clinic. Other clinical laboratories run by members of the Pediatric Pulmonary Division are the Phagocytic Cell Function, and Cilia Motility Laboratories.
The Pediatric Pulmonary Division sees outpatients five mornings a week with a broad referral base from a five-state region. Our Cystic Fibrosis Center cares for approximately 435 cystic fibrosis patients. We also have referrals from around the country for lung or heart-lung transplantation. Our inpatient services are divided among our primary patients, consultations, and the bronchoscopy service.
The clinical material available to the Fellowship Program includes the following:
Fairview-University Children's Hospital and Clinic
Outpatients -- approximately 2,200 patient visits per year, with 2-4 new patients a week. These are generally distributed as follows: cystic fibrosis (~75%); asthma (10%); others (15%) that include bronchiectasis, pneumonia, chronic bronchitis, tuberculosis, immotile cilia syndrome, immune deficiencies, bronchopulmonary dysplasia, etc.
Inpatients -- there are approximately 200 hospital admissions per year to the Pulmonary Division to the Fairview-University Children's Hospital, with an average daily census of 10 to 14 patients.
Hospital Consultations -- 10 to 12 per month (excluding consultations for bronchoscopy)
Bronchoscopies -- approximately 120 procedures per year: cystic fibrosis (~5%), bone marrow transplantation (25%), liver transplantation (7.5%), atelectasis (7.5%), chronic pneumonia (5%), leukemia (5%), immune deficiencies (5%), lung transplantation (15%), other (15%) with about 5% including trans-bronchial biopsy.
The Heart-Lung Transplantation Program was begun in 1986 for adult patients and extended to children in 1987. Several pediatric patients have now been transplanted and others are now being added to the lung transplant waiting list. The children with lung transplants are followed jointly with the surgical transplantation team.
Children's Hospitals and Clinics, St. Paul
Outpatients -- about 2500 patient visits per year, with 10 new patients per week.
Inpatients -- approximately 300 admissions per year (80 new), with an average daily census of 5 patients, and 3 new consultations a week.
Bronchoscopies -- about 50 per year
Children's Hospitals and Clinics, Minneapolis
Outpatients -- about 1250 patient visits per year, with 5-6 new patients per week.
Inpatients -- approximately 550 admissions per year (400 new), with an average daily census of 15 patients, and 5 consultations per week.
Bronchoscopies -- about 75 per year
Hennepin County Medical Center
Outpatients -- about 1221 patient visits per year, with 1-2 new patients per week.
Inpatients -- approximately 290 admissions per year, with an average daily census of 5 patients, and 3 consultations per week.
Bronchoscopies -- about 20 per year
This Pulmonary Division has several areas of research interests, including pulmonary developmental biology, host defense and cystic fibrosis. In addition, we participate in multicenter clinical studies. As integral members of the Pediatric Pulmonology team, our fellows are encouraged to understand and participate in all of these investigative activities.
Research laboratories and support facilities for the Pulmonary Division are housed on the 4th Floor of the Variety Heart Research Center and the Phillips-Wangensteen Building of the Medical School. Many other facilities are shared with other divisions especially those of Dr. Douglas Wangensteen in the Department of Physiology.
We have a computer-based clinical data base that contains records of all our cystic fibrosis patients since 1975. This includes demographic, medical record, laboratory, X-ray, treatments, and psychological data. Files are updated on a regular basis. This database is available to our fellows for research projects.
The Clinical Research Center of the Fairview-University Medical Center is funded by the NIH. This inpatient facility is available for a variety of clinical research projects. Projects must be approved by the local peer review committee of the CRC.
The biomedical library contains over 333,354 volumes with over 4000 current journal subscriptions. The library is connected to the Phillips-Wangensteen Building. The faculty maintains a teaching file of reprints and lecture outlines that are available to the fellows. Copying equipment and computers (Macintosh and IBM or compatibles) are available for the fellow's use. Besides the excellent search facilities at the library we have capabilities to do literature searches on our personal computers.
At the University of Minnesota Hospital and Clinic the faculty of the Pediatric Pulmonary Division work closely with the other pediatric subspecialty groups, including Bone Marrow Transplantation, Endocrinology, Gastroenterology, Infectious Disease, Immunology, Intensive Care, and Neonatology; the pediatric and cardiothoracic surgeons; adult pulmonology; ENT; human genetics; and pulmonary physiology.
In the community, Mrs. Mary Jo McCracken is a past president of the local Cystic Fibrosis Foundation. Dr. Regelmann is a member of the Research Committee, the Pediatric Lung Disease Committee and Advisor to the Board of the American Lung Association of Minnesota. Faculty and fellows are also members of the Minnesota and American Thoracic Society.
The Twin Cities of Minneapolis and St. Paul are ethnically diverse communities, well known for their quality of life. Their cultural and artistic facilities are numerous, including the Minnesota Symphony, the St. Paul Chamber Orchestra, the Guthrie Theater, the Minnesota Opera Company, the St. Paul Science Museum of Minnesota and Omni Theater, the Minneapolis Museum of Art, the Walker Art Museum and Sculpture Garden, the Minnesota Zoo, the Como Park Zoo, the Como Park Conservatory, and the Arboretum of the University of Minnesota. In addition, there are a large number of musical and theatrical events each year produced locally or by national touring companies. And, of course, there is the Mall of America.
Sports, both spectator and participatory, play a large role in the life of Minnesotans. Professional sports include football (Vikings), baseball (Twins), basketball (Timberwolves) and hockey (Minnesota Wild). The extensive city and county park systems offer a wide variety of all-season participatory sports, such as running, cycling, canoeing, swimming, sailing, ice skating, fishing, hunting, cross-country and downhill skiing. State and national parks that are within an easy drive offer a wide range of outdoor activity.
Both of the Twin Cities and their suburbs have quality schools noted for their strong programs in both academic subjects and enrichment programs. There are numerous affordable residential areas in each city easily accessible to the University of Minnesota and to our affiliated hospitals.
Applications are accepted at any time. The Fellowship normally coincides with the academic year, July 1 through June 30, but arrangements can be made for alternative dates.
All applicants must be eligible to take the examinations of the American Board of Pediatrics
at the time of starting the fellowship.
Click here for a link to the ABP web-site describing the requirements
Please send the enclosed application form and supporting letters and information to:
(Please note that we are not currently accepting electronic submissions for applications
please send hard-copy to Dr. Regelmann at the address below)
E-mail: regel001@tc.umn.edu
For further information, please feel free to telephone, e-mail or visit any member of the faculty. The Pediatric Pulmonary Division Office is located in room 413 of the Variety Heart Research Center. Our telephone phone number is (612) 626-4440.
Last updated March 16, 1999
