The Interventional Pulmonology Fellowship provides robust clinical opportunities and procedural training with the goal of developing future leaders in the field.

The fellowship consists of 12 months of continuous training.  Eleven months are spent in the following areas:

• Complex airway procedural suite
• Diagnostic bronchoscopy and complex pleural procedures suite
• Inpatient interventional pulmonology/pleural disease consult service
• Outpatient pleural diseases clinic
• A new state of the art procedure suite will be added in January 2026 to complement our existing interventional pulmonary OR.

With four procedural services functioning simultaneously, there may be several interesting cases at any given time.  Staff help the fellow ensure that the fellow maintains awareness of the scheduled procedures in these areas and to participate in the procedures most beneficial to the fellow.

The fellow is scheduled in clinic on Thursday afternoons and conducts a combination of in-person and virtual visits.  Additionally, there are routine time points to check in with patients by phone following bronchial stent placement and pleuroscopy procedures.

During the 12-month curriculum, an option for a one month elective rotation in thoracic surgery may be pursued. There is also an option, though not requirement, for a funded IP away elective at our Mayo Clinic campus in Florida.

Aside from direct patient care, a human cadaver lab and a state-of-the-art medical simulation center are used during this fellowship to augment the procedural experience and ensure optimal hands-on training while ensuring patient safety.

Clinical training

This is a high-volume procedural fellowship. The procedural volumes well exceed all requirements for accreditation. Although procedural volumes vary slightly from year-to-year, it is reasonable to expect the following:

In addition, fellows can expect to gain expertise in the use of laser, argon plasma coagulation, cryotherapy and cryobiopsy electrocautery, balloon and rigid dilation, among other procedures. Pleuroscopy procedures will include training on biopsy, lysis of adhesions, and talc poudrage.

The procedural group also performs more than 2,000 diagnostic and therapeutic flexible bronchoscopies, 600-800 endobronchial ultrasound-directed procedures, and 1200 thoracenteses and 500 ultrasound-guided pleural pigtails yearly.

All procedures and patient encounters will be conducted under the supervision of the responsible attending, ensuring appropriate oversight and support. At the beginning of the training year, this may involve the attending being immediately present. As the fellow gains experience and demonstrates competency, the level of supervision will be gradually adjusted to encourage increasing independence in clinical practice.

Call frequency

Weekend coverage of the interventional pulmonary/pleural consult service is expected one weekend per month.  If available, fellows are invited to attend any unique learning opportunities that occur overnight or on non-call weekends but this is not mandatory.

All duty responsibilities are maintained within the guidelines of the Accreditation Council for Graduate Medical Education (ACGME).

Moonlighting

Moonlighting is not permitted during the interventional pulmonology fellowship experience.

Didactic training

Didactic instruction is multifaceted and includes faculty-delivered lectures as well as pre-recorded lectures and videos, lecture sets provided by the AIPPD, case discussions and presentations, journal club presentations, and required reading assignments.

Conferences

There are several conferences scheduled throughout the work week.  Fellows are welcome to attend any or all of them as time permits (all are available virtually).

• Every weekday, 1-1:30 PM: Multidisciplinary Tumor Board
• Tuesday, 7:15-7:45 AM: Bronchoscopic Lung Volume Reduction Meeting
• Wednesday, 7:30-8:30 AM: Pulmonary Case Conference
• Wednesday (generally every other week), 4-5 PM: Interventional Pulmonology Case Conference
• Thursday (once per month), 12-12:30 PM: Lung Transplant Stent Review

Committee assignments

The Interventional Pulmonology fellow has the opportunity to serve as a trainee representative on the Fellowship Program Evaluation Committee.  This is an optional assignment.

Research training

The Interventional and Advanced Diagnostic Pulmonology Fellowship faculty consider it their responsibility to ensure graduates are highly competitive for academic employment and view demonstrated academic accomplishments as a key indicator.

At any given time, numerous studies are underway within the Interventional Pulmonology group, as well as in the Divisions of Pulmonary and Critical Care and Thoracic Surgery. Fellows are encouraged to become actively involved in at least one prospective interventional study that aligns with their clinical interests. With guidance and mentorship, they will also have the opportunity to develop a research question and carry a project through to completion. Over the course of the fellowship year, fellows are expected to complete at least one retrospective study and contribute to a review article, with ample support provided throughout the process.

Given the condensed nature of the one-year fellowship, there is no extended block of time solely dedicated to research. However, fellows are encouraged to make the most of available unscheduled time to pursue their research projects, with the goal of producing work suitable for publication. Ongoing mentorship and guidance will be provided to help fellows balance these efforts with their clinical responsibilities.

Mayo Clinic has a very generous travel policy for fellows to present their research, and it is expected that fellows will travel to and present at one or more national or international conferences during their fellowship year. Opportunities also exist to earn credits toward a master's degree in clinical research via the Mayo Graduate School during the fellowship year.

Teaching opportunities

Effective teaching is considered an essential skill of all graduates. Fellows have opportunities to teach rotating pulmonary and critical care fellows in the bronchoscopy suites, as well as teach residents and fellows during conferences.

The quality of bedside/intra-procedural teaching will be assessed by the supervising consultant with timely feedback provided. Fellow presentations to the Division of Pulmonary and Critical Care will be assessed by members of the division's education committee with written evaluations provided. These evaluations will be reviewed by the program director and remain as part of the fellow's official record.

Career development

It is our goal to assist and prepare each fellow to be highly competitive for positions of their choice upon graduation. Since the fellowship began in 2013, all of our fellows are practicing as interventional pulmonologists at multiple outstanding academic centers.

Evaluation

To ensure proficiency is gained and corresponding technical skills are developed, performance is monitored throughout the Interventional Pulmonology Fellowship. A procedure log is required to be kept up to date and must include data pertaining to diagnostic yield and complications.

Fellows are formally evaluated by their supervising faculty member after each clinical rotation and then evaluations are reviewed with the program director. Fellows also have opportunities to regularly evaluate the faculty to confirm that educational needs are met.