title: Procedural volume and structure of interventional pulmonary fellowships: a survey of fellows and fellowship program directors.
abstract: BACKGROUND
  Current interventional pulmonary (IP) procedural guidelines for competency are based on expert opinion. There are few objective data to support competency metrics for IP procedures. This survey reports procedural volume during IP fellowships to help define new standards in training and curriculum development.
  
  
  METHODS
  A web-based survey was developed to evaluate IP training procedural volume. The survey was administered to all US and Canadian IP fellowship directors and graduates in training from 2006 to 2011. The survey inquired about all diagnostic and therapeutic procedures performed during the specialized year of IP training. Questions regarding the training program structure were collected and analyzed.
  
  
  RESULTS
  There was a 92.5% fellow response rate (37 of 40) and 77% fellowship director response rate (10 of 13) from programs in existence at the time of the survey. Procedural volume was consistent between fellowship directors and graduates (P = .64). Although there was a wide range of procedural volume and types of procedures between different programs, the procedural mean volumes were all significantly higher than the American College of Chest Physicians (ACCP) and American Thoracic Society/European Respiratory Society (ATS/ERS) guideline recommendations (P &lt; .005).
  
  
  CONCLUSIONS
  US and Canadian IP fellowships produce fellows with variable procedural volumes; however, these are significantly higher than ACCP and ATS/ERS guidelines for most programs and procedures. With a uniform training curriculum being adopted by the majority of IP fellowship programs in the United States and Canada, as well as data showing improved core knowledge in IP fellows undergoing a dedicated year of additional training, further metrics examining the impact of advanced IP training on patient outcomes are needed.
authors.affiliation: Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: lyarmus@jhmi.edu.
authors.forename: Lonny
authors.initials: L
authors.lastname: Yarmus
authors.affiliation: Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
authors.affiliation: Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Melhem
authors.initials: M
authors.lastname: Imad
authors.affiliation: Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kim
authors.affiliation: Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D002170:Canada; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008171:Lung Diseases / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008611:Mentors; D010820:Physicians / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D015397:Program Evaluation / Q000379:methods*; D015272:Pulmonary Medicine / Q000193:education*; D012189:Retrospective Studies; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States