The Division of Pulmonary and Critical Care Medicine provides a comprehensive training program that utilizes the resources of our Division as well as other Divisions and Departments on the University of Maryland, Baltimore campus. We also have resources available from other local institutions, including the National Institutes of Health and the Johns Hopkins University. The major two facilities in which our fellows train are the University of Maryland Medical Center and the Baltimore VA Medical Center located on the University of Maryland, Baltimore campus in downtown Baltimore.
The University of Maryland Medical Center is a major tertiary and primary care facility with approximately 900 beds. The Medical Center cares for more than 30,000 inpatients and 500,000 outpatients each year. In each unit, doctors, nurses, students, clinical pharmacists and support staff work as a team to promote unified and comprehensive care for every patient.
There are multiple medical teams at UMMC, including 6 medical services. There are numerous critical care units, including the Medical Intensive Care Unit (MICU), Coronary Care Unit (CCU), Cardiothoracic ICU (CT-ICU), General Surgery ICU (SICU), Neurologic ICU, and four critical care units whithin the Maryland Shock Trauma Center. Most of these critical care units have step-down units (IMC) as well. Several specialty units are located within UMMC, including the Bone Marrow Transplant Unit and the Greenebaum Cancer Center. Medical residents provide patient care under the direct supervision of faculty and subspecialty fellows serve as consultants and participate in specialized care.
In January 1993, the new Baltimore VA Medical Center opened adjacent to University of Maryland Medical Center (UMMC). Both hospitals are conveniently connected by a walk-way which facilitates integration of educational and clinical activities. The Baltimore VA Medical Center serves as the central referral hospital for pulmonary diseases for a large area serving West Virginia, central Pennsylvania, Maryland and Delaware.
The VA Medical Center is a 324 bed facility. The hospital contains a fully digitalized radiology department, as well as a computerized medical record system, which gives physicians ready access to clinical data, discharge summaries and laboratory results in all team conference rooms and nursing units. This computerized medical record allows all progress notes and orders to be entered electronically, and physicians can easily retrieve and enter information for their patients.
The Baltimore facility is only one of two VA Medical Centers in the country that have two large federally funded programs in geriatrics -- the Geriatric Research Education Clinical Center (GRECC) and a Claude D. Pepper Older Americans Independence Center. It is ranked among the top 5 percent of VA Medical Centers in VA-funded research.
University Specialty Hospital is part of the University of Maryland Medical System and is located a few blocks from the University of Maryland Medical Center in downtown Baltimore. It offers 180 beds, 70 of which are dedicated to the ventilator/weaning unit. The ventilator unit cares for patients with a wide spectrum of diseases, of which COPD is the most common reason for admission. At present, of the approximately 180 admissions per year, 30 percent will be weaned from mechanical ventilation. We expect this weaning success rate to improve with continuing revisions in our weaning and rehabilitation protocols. Recently, University Specialty Hospital has embarked on a mission to expand the care it provides to include rehabilitation services that are specific to patients with respiratory failure and to provide pulmonary rehabilitation to patients with COPD, both in the inpatient and outpatient setting. University Specialty Hospital provides a multi-disciplinary approach to therapy, providing a team of physical, occupational and speech therapists that evaluates and cares for each patient as well as a pulmonologist dedicated addressing the specific needs of patients with respiratory failure and COPD.
Outpatient continuity clinic experience in our Fellowship Program occurs during each year of fellowship training at the Faculty Practice Office Building, which is located just across the street from the University of Maryland Medical Center, and at the Baltimore VA Medical Center.
The University of Maryland Medical Center has a 29 bed MICU/Intermediate Care Unit located in the newly completed Weinberg building (seen at the right), and the VA Medical Center has a 10 bed MICU. Fellows learn basic and advanced clinical skills required for intensive care medicine. The fellow is expected to assist the attending in supervising the team members, managing the clinical care of patients, and educating the medical residents. These state-of-the art MICUs allows us to provide patient care of the highest quality and to expand our opportunities for translational and outcomes research.
As the regional referral center for critical care and with a large, active cancer center and transplant programs, patients with a wide range of common and rare diseases are seen in our critical care units. The medical, surgical, and pediatric critical care programs share a monthly interdisciplinary critical care conference and a translational research conference, clinical and outcomes research programs, and a critical care visiting professor program. These resources provide outstanding opportunities for clinical training, exposure to other critical care disciplines, and clinical, outcomes, and translational research in diseases of the critically ill.