Clinical Service

Rotation Schedule

Clinical service consists of three main rotations: inpatient/consult service, outpatient clinics, and bronchoscopy. The rotation schedule is flexible depending on the individual fellow’s goals, but generally is structured as follows:

Inpatient/consult service

The Pediatric Pulmonology inpatient/consult team leads the inpatient service, performs inpatient and outpatient consults, and addresses any urgent medical issues that cannot be met by a patient’s primary provider. All inpatient rotations take place at the NC Children’s Hospital that is part of the main Chapel Hill campus. Pediatric Pulmonology inpatients “Blue” team includes the Pediatric Pulmonology attending and fellow, a Pediatrics intern, a Pediatrics resident, a ward team coordinator, as well as medical students and residents on elective rotations. The team is also supported by multiple ancillary services including and inpatient pharmacist, respiratory therapy, and CF nurses, all of whom often round with the Blue team. Fellows typically cover the service in one-week blocks, though weekends and weekdays may be scheduled separately. Fellows round with the team in the mornings, address consults and urgent inpatient and outpatient needs in the afternoons, then take home call in evenings and nights while on service.

Outpatient

UNC Pediatric Pulmonology fellows serve as the primary pulmonary provider for their own cohort of patients, with one full-day clinic per week (except when on service). Most patients are seen in the NC Children’s Outpatient Center within the NC Children’s Hospital on the main campus in Chapel Hill. In addition, approximately once per month fellows see patients at our satellite clinic in Raleigh, the NC Children’s Specialty Clinic. Each fellow is assigned to a division nurse to help address patient needs outside of clinic, including phone calls and follow up.

Bronchoscopy

Our division is one of the largest bronchoscopy services in the Southeast, regularly performing between 500-700 procedures each year. Fellows are assigned to cover elective bronchoscopies twice weekly, and they also perform many procedures while on inpatient/consult service. In addition to routine bronchoscopy, fellows often perform more complex bronchoscopic procedures including flexible fiberoptic intubation, brush biopsies, and mucous plug removal. Fellows also regularly participate in combined airway evaluations with ENT on patients with tracheostomy or other airway problems. All of our fellows attend the Bronchoscopy Course in Cincinnati during first year (which is taught by many of our faculty), and most fellows have performed >150 procedures by the end of fellowship.

Elective Rotations

All fellows are required to do an elective month with Sleep Medicine, seeing patients in the outpatient Sleep clinic, attending sleep conferences, and reading sleep studies. The UNC Sleep Center includes a dedicated 4-bed pediatric sleep laboratory for polysomnography and Multiple Sleep Latency Tests (MSLT).

Other elective rotations on other services such as Allergy/Immunology, Pediatric Critical Care Medicine, and Palliative Care are available, though are not required. Fellows can also participate in the PCD Clinical and Research Center, and several of our fellows have started their own PCD clinics following fellowship.