Pulmonary Critical Care MedicineProgramFellowship WELCOME TO THE UNIVERSITY OF TENNESSEE GRADUATE SCHOOL OF MEDICINE
Fellowship ProgramDirector Associate Professor
Leadership Team
TinaDudney, MD, D’ABSM, FCCP
Rajiv Dhand, MD, FCCP, FACP, FAARC
DEPARTMENT OF MEDICINE
Francisco Soto, MD, MS, FCCP Associate Program Director Research Associate Professor
Chairman and Professor, Departmentof Medicine
Chief, Division Pulmonary Critical Care Medicine Chief, Section of Pulmonary
Pulmonary Critical Care Medicine Fellowship Program
Isaac Biney, MD Associate Program Director Education Clinical Assistant Professor
Completed residency at the Eastern Virginia Medical School, Norfolk, VA CHIEF FELLOWS
Chief Fellows
Milind Bhagat, MBBS
NicholasFuerst, MD
3rd year fellow
3rd year fellow
Completed residency at St. Vincent Hospital, Worcester, MA
The Teamworkpowerof
UsmaniOS, Dhand R, Lavorini F, Price D. Whywe should targetsmall airways disease in our managementof chronic obstructive pulmonary disease. Mayo Clin Proc.2021Sep;96(9):2448-2463. Epub 2021 Jun 26. PMID:34183115
Lavorini F, Usmani OS, Dhand R. Aerosoldelivery systems for treating obstructive airway diseases during the SARS-CoV-2pandemic. Intern Emerg Med. 2021Jul30. [Epub aheadofprint]. PMID: 34331192
Fogelson B, Qu D, BhagatM, BrancaPR. Multi-organ systemfailure secondaryto difluoroethane toxicity in a patient "huffing" air duster:a case report. J Addict Dis. 2022 Jan19:1-6. doi: 10.1080/10550887.2022.2027207. Epub aheadof print. PMID:35044291
Li J, Alolaiwat A, Harnois L, Fink JB, Dhand R. Mitigating fugitive aerosols during aerosoldelivery via high-flow nasalcannula devices. Respir Care. 2021Nov17: respcare.09589. [Epub aheadofprint]. PMID:34789564
Harnois L, Alolaiwat A, Jing G, Fink JB, Dhand R, Li J. Efficacyofvarious mitigation devices in reducing fugitive emissions from nebulizers. Respir Care. 2021Nov 9: respcare.09546. [Epub aheadofprint]. PMID:34753815
Chan AHY,Pleasants RA,Dhand R, Tilley SL, Schworer SA, Costello RW, MerchantR. Digital inhalers for asthma or chronic obstructive pulmonary disease:A scientific perspective. Pulm Ther. 2021 Aug 11. [Epub aheadof print]. PMID:34379316
2021 – 2022
AcademicYear
PUBLICATIONS
Li J, A Alolaiwat A, J Harnois L, Fink JB, Dhand R. Mitigating Fugitive Aerosols During AerosolDelivery via High-Flow Nasal Cannula Devices. Respir Care. 2022 Apr;67(4):404-414. doi: 10.4187/respcare.09589. Epub 2021 Nov 17. PMID:34789564
Li J, ScottJB, Fink JB,ReedB, Roca O, Dhand R. Optimizing high flow nasalcannula flow settings in adult hypoxemic patients basedon peakinspiratory flow during tidal breathing. Ann Intensive Care. 2021 Nov 27;11(1):164. PMID:34837553
UsmaniOS, Hickey AJ, Guranlioglu D, RawsonK, Stjepanovic N, Siddiqui S, Dhand R. The impact of inhaler device regimen in patients with asthma or COPD. J Allergy Clin Immunol Pract. 2021 Aug;9(8):3033-3040.e1. Epub 2021 Apr 24. PMID:33901714
AcademicYear PRESENTATIONS
BhagatM, Wong F, Branca P. A Rare Asthma Impostor: An atypical case of granular celltumor in a young patient causing endobronchial obstruction. Presentedat2022 AABIP AnnualConference: Nashville, TN August 13, 2022
MarounR, TreatS, Oakley T, Kravitz J. Managing a rare case ofcongenital atresia ofthe left superior pulmonary vein with associatedatypicalcoronary anatomy in anadult patient with new onsetself-limited chestpain. Presentedat(National) CHEST2021: (Virtual) Orlando, FL October 17 20, 2021
TreatS, MarounR, DePolo J, Dhand R. Whento pull the trigger Persistentupper gastrointestinal bleeding in the setting of splenic arterypseudoaneurysm and cystogastrostomy stentultimately requiring coil embolization. Presentedat(National)CHEST 2021: (Virtual) Orlando, FL October17-20, 2021
2021 – 2022
BhagatM,BevillB. Cavitationdue to Covid 19: A case ofsecondaryatypical mycobacterialinfection post Covid 19. Presentedat(National)CHEST 2021: (Virtual) Orlando, FL October17 20, 2021
PurkeySC, Alexander M, Doyle-McClamM,Rasnake MS. Histoplasmosis, the greatimitator of COVID-19pneumonia? Presentedat(Regional) 21st Southern Hospital Medicine Conference. Atlanta,GA October14-16, 2021
Bhagat MK,MowerySR, DudneyTM, BrancaP, McCormack MT, DhandR,HeidelRE, Soto FJ. High-flow nasalcannula requirements in hypoxemic respiratory failure secondaryto COVID-19:Identifying FIO2 cutoffs thatpredict a higher risk for ICU admission, mechanicalventilation, and death. Presentedat(International) CHEST2021: (Virtual) Orlando, FL October 17-20, 2021
Awards
Dr. Megan Doyle McClam received the Fellow of the Year Award for exceptional clinical skills and dedication to teaching as chosen by her peers and Medicine Chief Residents
In 2018, the Department of Medicine created the Jim Neutens Award for Best Teaching Division of the Year in honor of Dr. Jim Neutens, who retired in 2018 after many years of serviceas the Dean of the Graduate School of Medicine. Graduating internal medicine residents select the department that made the most impact upon them during three years of residency training. For the fifth year in a row, this honor went to the Division of Pulmonary and Critical Care Medicine
Dr. Shawnt Tosonian, MD received the Certificate of Academic Excellence for the APCCMPD highest performance In ServiceExam for Pulmonary Disease and Critical Care Medicine
Jim Neutens Award for Best Teaching Division of the Year
Who you’ll meet on Interview Day: (next four slides) Tina Dudney, MD, DABSDM, FCCP • Program Director • Division Chief, Pulmonary Critical Care Medicine • Undergraduate: Tennessee Technological University • Medical School : University of Tennessee Memphis • Residency: University of Tennessee Medical Center • Fellowship:University of Utah School of Medicine • Enjoys gardening, animal rescue, cooking and swimming
•
Francisco Soto, MD, MS, FCCP
Associate Program Director - Research
Medical School: Universidad del Valle,Cali, Colombia • Residency: University of Illinois at Chicago, Chicago,IL • Fellowship:Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine,Houston, TX • Enjoys Latin dancing, hiking, country music and soccer/football
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Isaac Biney, MD • Associate Program Director – Education • Medical School: University of Ghana School of Medicine and Dentistry • Residency: Howard University Hospital • Fellowship:University of Tennessee GraduateSchool of Medicine– Knoxville • Enjoys playingand watching tennis
Arseniy Tsapenko, DO, MD • DO: New York College of OsteopathicMedicine • MD: Ukrainian State Medical University • Residency: Kyiv University Hospital #12; Albert Einstein College of Medicine • Critical Care Fellowship: Brown University • Pulmonary Fellowship: University of Tennessee Knoxville • Sleep Fellowship:Dartmouth-HitchcockMedical Center • Enjoys fishing and travelling
•
•
Bhagat,
Milind MBBS Medical Vincent Hospital,Worcester, Fuerst, MD Medical School: Virginia UniversityCommonwealthSchool of Medicine Residency: Eastern Virginia Medical School
College • Residency: St.
• School:MedicalPramukhswami
MA Nicholas
Chief Fellows
Didactics Difficult Case Basic Science UltrasoundAdvanced Clinical ConferenceCase Boot Camp Lecture SeriesState)(Disease InterstitialDiseaseLung PulmonaryBoardTumor Research/QualityImprovement Chest X Ray Ethics Board Review Pulmonary Journal Club HypertensionPulmonary M & M CriticalMedicineCare Financial/Business
Bronchoscopy Bootcamp Didactic Conference
Megan Doyle McClam, MD
Isaac Biney, MBBCh Academic Knoxville,TN
Private Practice Knoxville,TN
Spencer Pugh, MD Private Practice Knoxville,TN
Class of 2022
Bimaje Akpa, MBBS
Class of 2021
Private Practice Anderson, SC
Swati Baveja,MBBS
Class of 2019
Sleep Fellowship
Private Practice
Ashish Thakkar,MD Academic Knoxville,TN
Raakesh Sathya,MBBS
Class of 2020
Naveed Sheikh, MBBS Private Practice
PulmonologyFellowship
Ralph Maroun,MD
Victorville,CA
Oak Ridge, TN
Fatima Wong, DO Interventional Cooper University Hospital Camden, NJ
Class of 2018
Sameh Attia, MBBCh Academic Knoxville,TN
Private Practice Los Angeles, CA
University of Chicago Chicago, IL
Post-Fellowship Placement
Class of 2017
Anil Singh, MBBS Private Practice Dallas, TX
Syed Naqshbandi,MBBS
Rafael Alba-Yunen,MD Private Practice Brunswick, GA
Class of 2014
Naveed Sheikh, MBBS
(continued)
VanderbiltUniversity Medical Center Nashville,TN
Victor Gordon, MD Private Practice
Sleep Fellowship
Critical Care Fellowship
Class of 2016
MontefioreMedical Center Bronx, NY
Rishi Sehgal, MD
Farhan Khan, MBBS Critical Care Fellowship
Orlando Health Orlando,FL
Oak Ridge, TN
Post-Fellowship Placement
Saginaw, MI
Class of 2015
Dipaben Modi, MBBS Academic Houston, TX
Private Practice
Kashif Aslam, MBBS Critical Care Medicine
University of New Mexico Albuquerque,NM
Dartmouth-HitchcockLebanon, NH
Private Practice
Class of 2013
Kinnaresh Patel, MBBS Critical Care Fellowship
Syed Gilani, MBBS
Private Practice
Muhammad Mir, MD
(continued)
Class of 2012
Mesquite, TX
Private Practice
Crossville, TN
Columbia,SC
Wake Forest School of Medicine Winston-Salem,NC
Paramveer Bhugra, MD Critical Care Fellowship
Peoria, AZ
Brown University Providence, RI
Dartmouth-HitchcockLebanon, NH
Class of 2011
Kamran Manzoor, MBBS Critical Care Fellowship
Adeel Shibli, MD
Amit Dhingra, MD
Post-Fellowship Placement
Class of 2010
Arseniy Tsapenko,DO, MD Sleep Fellowship
Private Practice
Pulmonary Critical Care FellowshipMedicineProgram • 9 fellows • 3 per year • All fellow training is at this facility except 6 weeks at Vanderbilt for Lung Transplant and Burn ICU • University Pulmonary Critical Care • 14 Pulmonary/Critical Care Physicians with varied area of focus in: • Sleep Medicine • Pulmonary Hypertension • Cystic Fibrosis • Interstitial Lung Disease • Thoracic Oncology • Interventional Pulmonology • General Pulmonary Medicine • Critical Care Medicine • Ultrasonography
Pulmonary Critical MedicineCareBlock Schedule (two-week blocks) Block PGY4 PGY5 PGY6 Block PGY4 PGY5 PGY6 1 Pulmonary Pulmonary Flex 14 Pulmonary Night Float Flex 2 Applied Physiology Elective Pulmonary 15 Procedures ICU Elective 3 Anesthesia Pulmonary Night Float 16 Research Pulmonary ICU 4 Cardiothoracic Surgery Procedures ICU 17 ICU Procedures Night Float 5 ICU Night Float Research 18 Night Float Research Flex 6 Night Float ICU Pulmonary 19 Procedures Echo Lung Transplant(Vandy) 7 Chest Radiology Research Procedures 20 Research Research Lung Transplant(Vandy) 8 Chest Radiology Echo Flex 21 Sleep Pulmonary Burn (Vandy) 9 Pulmonary NICU Procedures 22 Sleep Flex Research 10 Pulmonary Rehab NICU Elective 23 Pulmonary SICU Acting Attending 11 Night Float Flex Research 24 ICU SICU Procedures 12 ICU Procedures Pulmonary 25 Night Float NF Flex 13 Holiday Holiday Holiday 26 Pulmonary ICU Elective
Despite the limitations imposed on pulmonary procedures by the pandemic, the volume of interventional procedures and inpatient consultations performed by our group at UTMC in 2021 remained substantial, including:
PLEURAL
• 1,232 Bronchoscopies (there is close to 95% fellow participation in these procedures based on monthly rotation availability)
• 28 Comprehensive Shunt Run Evaluations
• 298 EBUS (endobronchial ultrasound)
• 70 Navigational Bronchoscopies (as of Aug ’22, we have performed 94 navigational bronchoscopies, including 64 robotic bronchoscopies)
• 1,177 Pulmonary Consultations/Admissions
• 126 Transbronchial Biopsies
PULMONARY FUNCTION LAB
• 31 Vasodilator Challenge Studies
• >500 Central Venous Lines (does not include overnight procedures)
• 14,425 Medical ICU Admissions
• 56 Radial EBUS
• 33 Exercise Challenge Studies
• 241 ROSE (rapid on-site evaluation)
• 97 Chest Tubes
RIGHT HEART CATHETERIZATIONS
• >200 Thoracentesis
PROCEDURES
• 184 Endotracheal Intubations
• 5 Fluid Bolus Challenge Studies
• 4,737 PFTs (pulmonary function tests)
Procedures-
ICU-RELATED
INPATIENT CONSULTATIONS AND ADMISSIONS
BRONCHOSCOPY
• 87 CPET (cardiopulmonary exercise test)
• 95 Therapeutic/Interventional Bronchoscopies
• 61 Right Heart Catheterizations (performed in the Cath Lab; number does not include pulmonary artery catheters placed at beds ide)
Bedside
Swan Ganz Right Heart Cath-Cath Lab Robotic Bronchoscopy
The University of Tennessee Medical Center • Opened August 1956 • 685 bed acute care teaching hospital • Region’s only Academic Medical Center • 17 ACGME accredited specialty and subspecialty programs • Level 1 Trauma Center • Regional Referral Center • Certified Primary Stroke Center • Aeromedical Service Base • Magnet recognition for excellence in nursing • Clerkships for M3 and M4 students • Health Information Center – Preston Medical Library • LIFESTAR • Area’s first emergency response helicopter • 2010 – East TN’s first dedicated heart hospital • Medical Simulation Center
The Facility – Heart Lung Vascular Institute • Outpatient office • Connected to hospital via walkway • Fellow parking attached to HLVI • in garage • Shared fellow’s office with individual desks, call room adjacent to hospital
Bronchoscopy Lab • Two dedicated rooms with EBUS and Interventional capability • Navigational Bronchoscopy • Radial Probe bronchoscopyUltrasound • OR availability with combined CT surgery/Pulmonologist cases • Close working relationship with Thoracic Surgery
The Facility - Academics • Health Information Center • In hospital – access 24/7 • Patient access area separate from resident / fellow study area • Conference rooms • Computers • Stacks • Magazines • Access to thousands of books / electronic resources through UT Memphis
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• UT Center for Advanced Medical Simulation • 6500 Sq ft • 1 of 68 in the world (only one in TN) to earn accreditation as Level 1 Comprehensive Accredited Education Institute from American College of Surgeons
The Facility Academics
• Anesthesia ➢ Fellowshipsin Pain Medicineand PerioperativeMedicine Graduate School of Medicine – Residencies and Fellowships • Family Medicine ➢ Fellowshipsin Emergency Medicine,Hospice and PalliativeMedicineand Sports Medicine • General Dentistry ➢ Fellowship in Dental Operating Room • Internal Medicine ➢ Fellowshipsin Cardiovascular Diseases, Disease/Cardiology,InterventionalandPulmonaryCriticalCareMedicineandHematology/Oncology • Transitional Year • Obstetrics & Gynecology ➢ Fellowship in Maternal-Fetal Medicine • Oral & Maxillofacial Surgery ➢ Fellowship in Oral/Head and Neck Oncologic Surgery • Pathology ➢ Fellowship in OncologicSurgical Pathology • Radiology • Surgery ➢ Fellowshipsin Advanced GI MIS/Bariatric, Surgical Critical Care and Vascular Surgery • Urology
The City - Knoxville • Est population 193,114 • Knoxville Metropolitan Statistical Area (Knox, Blount, Anderson, Loudon, and Union counties) is 1 ,156,861 million • Economics • No state income tax • 17.8% below the national cost-of-living average • Median household income $58,801 • Demographics • Median age 32.7 • 31.5 Male / 34.1 Female • 75.63% Caucasian, 16.94% Black, 0.28% Native American, 1.68% Asian, 0.05% Pacific Islander, Two or more races 3.86%, other race 1.56%
FELLOW HOSPITALTHEOUTSIDELIFE
Travelling to / from Knoxville
Two interstatesmajor– I-40 and I-75 make car from(aboutflightwithgetAirportMcGheeconvenienttravelTysoniseasytoin/outofreasonablerates15minhospital)
Fellowship Photos
