Pulmonary & Critical Care Medicine Fellowship
The Spectrum Health/Michigan State University Pulmonary & Critical Care Medicine Fellowship offers fellows a broad experience in acute and chronic respiratory conditions, critical care and diagnostic and therapeutic procedures in world-class facilities with cutting-edge technology. Trainees get experience in a variety of specialties, including interventional pulmonology, lung transplant, critical care, lung cancer and interstitial lung disease.
From the Program Director
Welcome to the pulmonary and critical care medicine fellowship program at Spectrum Health, in partnership with Michigan State University College of Human Medicine.
Spectrum Health, a not-for-profit, integrated health system, is committed to improving the health and wellness of our communities. Our talented physicians and caregivers are privileged to offer a full continuum of care and wellness services to our communities through 14 hospitals, including Spectrum Health Helen DeVos Children’s Hospital, 150 ambulatory sites and telehealth offerings.
The fellowship program is an ACGME-accredited, three-year program based at Spectrum Health Butterworth Hospital in Grand Rapids, Michigan. Butterworth Hospital is a Level 1 Trauma Center with 679 acute care beds and 80 ICU beds. It is a major referral center for lung cancer, interventional pulmonology, lung and heart transplant, mechanical circulatory support, extracorporeal membrane oxygenation, and adult blood and marrow transplant.
The Division of Pulmonary, Critical Care and Sleep Medicine has 30 specialists and is affiliated with Michigan State University. We are supportive of academic pursuits and the expertise of our faculty have resulted in numerous publications and presentations in peer-reviewed journals and national scientific meetings.
The mission of the fellowship is to improve the health of the communities we serve by training future medical leaders in this field. Our core values are teamwork, accountability, compassion, integrity, respect and excellence. They are key to provide the best care to our patients and foster an environment of learning, collegiality and innovation. Spectrum Health was the first hospital with robotic bronchoscopy in Michigan and center of excellence in robotic bronchoscopy. The Spectrum Health Richard DeVos Heart & Lung Transplant Program has been recognized as having one of the best outcomes in the nation (based on the report by the Scientific Registry of Transplant Recipients).
In support of our goals, the Division of Pulmonary, Critical Care and Sleep Medicine has developed service lines tailored to the needs of our patients. We provide care to the complete range of lung disease, including chronic obstructive pulmonary disease, asthma, interstitial lung diseases and idiopathic pulmonary fibrosis, sarcoidosis, pulmonary hypertension, cystic fibrosis, alpha-1-antitrypsin deficiency, pleural effusion, sleep apnea and lung cancer.
Collaboration is part of our culture and essential in the decision-making processes during multidisciplinary ICU rounds, Multidisciplinary Lung Cancer Conference, Multidisciplinary Interstitial Lung Disease Conference and Lung Transplant Selection Committee.
Our fellows learn to evaluate patients with respiratory symptoms and radiographic abnormalities and interpret pulmonary function tests, cardiopulmonary exercise tests, bronchial challenge testing, exhaled nitric oxide testing and sleep studies. Fellows perform diagnostic and therapeutic interventions like flexible bronchoscopy, endobronchial ultrasound, robotic bronchoscopy, thoracentesis, tunneled pleural catheters; and are exposed to rigid bronchoscopy, tumor laser ablation, stent placement, endobronchial valves for bronchoscopic lung volume reduction for qualified patients with emphysema, bronchial thermoplasty for severe asthma, medical thoracoscopy (pleuroscopy), and percutaneous tracheostomy through our interventional pulmonology service.
Fellows have the important role of teaching residents and medical students. They participate in didactic activities giving lectures, presenting in the Pulmonary and Critical Care Grand Rounds, Morbidity & Mortality and act as instructors in workshops with simulation.
In collaboration with the Spectrum Health Office of Research and Education, fellows receive guidance and core lectures to develop their research projects. Many of our faculty are involved in clinical research, allowing fellows to have many mentors. There are opportunities to collaborate with the Spectrum Health – Michigan State University Alliance Corporation.
As a fellow, you will learn the fundamentals of quality improvement and its applications in an academic environment. All fellows are encouraged to take on a QI project during their fellowship training.
We are committed to developing leadership and expertise to advance patient care and expand the knowledge base of pulmonary and critical care medicine. Our high-volume and clinically diverse program offers a unique experience to shape future specialists in these disciplines.
We invite you to explore our program and consider joining us to further develop our mission.
Maximiliano Tamae Kakazu, MD, FCCP
Program Director, Pulmonary and Critical Care Medicine Fellowship
Assistant Professor of Medicine, Spectrum Health / Michigan State University College of Human Medicine
- Mastery of the knowledge base
- Excellence in patient care
- Acquiring skills in teaching and mentoring
- Procedural expertise
- Clinical research
The program is based at Spectrum Health Butterworth Hospital in the intensive care unit and lung transplant clinic with the following complementary experiences:
- Spectrum Health Cancer Center at Lemmen-Holton Cancer Pavilion (multidisciplinary lung cancer clinic)
- 4100 Lake Drive outpatient office (for general pulmonary continuity clinic)
- Pulmonary hypertension clinic
- Sleep disorder clinic
- Cystic fibrosis clinic
- Interstitial lung disease clinic
- Interventional pulmonology
- Spectrum Health Blodgett Hospital (outpatient bronchoscopies and Long-Term Acute Care Hospital)
- Simulation laboratories are available from the vascular training program
Each year starts with an intensive fellow boot camp that includes a daily conference series covering topics in pulmonary and critical care medicine. These conferences then transition to morning report, pulmonary and critical care grand rounds, multidisciplinary interstitial lung disease conference, research conference/journal club, critical care morbidity and mortality, and during determined rotations will have specific conferences (i.e. lung transplant selection committee, multidisciplinary interventional pulmonology conference, multidisciplinary lung cancer conference).
This service allows learning basic and advanced diagnostic procedures and exposure to advanced therapeutic procedures during the three years of training. Our associate program director, Gustavo Cumbo-Nacheli, MD, is one of two board-certified interventional pulmonologists at Spectrum Health in western Michigan. Watch the program video to learn about the many procedure fellows can assist with. Get to know Gustavo Cumbo-Nacheli, MD.
Our institution has performed more than 200 lung transplants over the past five years. This gives fellows experience in the evaluation of patients considered for transplantation and in the management of post-transplant patients. Fellows participate in rounds at the Spectrum Health Fred and Lena Meijer Heart Center and at Spectrum Health Butterworth Hospital. Clinic is completed at the Spectrum Health Richard DeVos Heart & Lung Transplant Clinic.
There are 80 beds at Spectrum Health Butterworth Hospital allowing exposure to complex patients in the medical intensive care unit, neuro intensive care unit, surgical intensive care unit, and cardiothoracic intensive care unit including mechanical circulatory devices and ECMO. An attending physician is present 24 hours a day and 7 days a week allowing direct and indirect supervision. During this rotation, fellows learn airway management, resuscitation in patients with shock, insertion of central venous catheters and arterial lines, chest tubes and mechanical ventilation management.
The lung mass and cancer clinic at Spectrum Health Lemmen-Holton Cancer Pavilion provides a rapid evaluation of patients with lung nodules and suspicion of malignancy. Fellows can see patients and participate in discussion in the tumor board that includes pulmonologists, oncology, thoracic surgery, pathology, interventional radiology, interventional pulmonology and radiation oncology.
Interstitial Lung Disease
Fellows can see patients at the dedicated interstitial lung disease and sarcoid clinics and be part of the interstitial lung disease conference where multidisciplinary discussions are done to decide on a consensus diagnosis for most of the patients.
Affiliation with Michigan State University College of Human Medicine
Fellows supervise and are expected to teach residents, medical students, and other learners during their rotations.
Medical Intensive Care Unit Team A and Medical Intensive Care Unit Team B
Fellows in each team are responsible for coordinating rounds and consultations in the medical intensive care unit and interacting with consulting services. Fellows will interact and coordinate care with nursing, respiratory therapy, pharmacy, social work, nutrition, and physical therapy. They will also supervise and teach residents and medical students.
The fellow will provide night coverage in the medical intensive care unit and urgent consultations in the medical floor. The fellow will also supervise and teach residents and medical students during the night shift.
The fellow will gain experience in the workup, evaluation and management of patients with pulmonary disorders while hospitalized. The fellow will supervise and teach residents during this rotation and facilitate rounds.
The fellow will be instructed in procedures such as fiberoptic bronchoscopy, endobronchial ultrasound, radial endobronchial ultrasound, thoracentesis and assist the attending physician in procedures like electromagnetic navigation or therapeutic bronchoscopy. The fellow will also participate in the multidisciplinary lung cancer clinic conference.
In addition to the continuity clinic, the fellow will be responsible for the reading of all PFT’s and cardiopulmonary exercise tests. The fellow will participate in sleep studies interpretation and assess patients for pulmonary rehabilitation.
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