Division of Pulmonary, Critical Care & Sleep Medicine

Curriculum

The goal is to train MDs and PhDs committed to an academic career in pulmonary biology. All trainees participate in core sessions to establish a common identity and knowledge base, and then focus in one of three research scientific themes: Airway Inflammation and Immunology, Pulmonary Vascular Biology and Disease, or Hypoxia and Sleep. Courses occur in parallel to classes and/or laboratory work on problems within one of the three scientific themes. Program-wide activities continue throughout the trainee’s tenure to develop breadth and reinforce integration and translation.

Predoctoral Training

Predoctoral trainees will be recruited from the Biomedical Sciences (BMS) Graduate Program. Students are encouraged to participate in the “Med-into-Grad” (MIG) Program.

After completing BMS Research Proposition requirements, students may apply for support by the training grant. At this point, PhD students focus on research in their research mentor’s laboratory, where the Scientific Theme provides structure for laboratory training and direction for further BMS course requirements. MIG trainees will attend medical case conferences during their years of thesis research to continue reinforcing the integration between their research and medical experiences. All predoctoral trainees also attend the Core Training activities (Research meetings, Journal Clubs, Career Development Course, and Ethics Courses described below) with the postdoctoral trainees.

Postdoctoral Training

Postdoctoral trainees select a Scientific Theme, based on their selection of a primary research mentor, and work with their primary research mentor and secondary faculty advisor (assigned by the Executive Committee) to design a training program for their concentration with a Fundamental or Clinical Approach. They will then embark on a theme-specific mentored research project, supplemented with didactic Core Training activities and concentration-specific coursework over the intensive one to two year training period.

Details for these three levels of training are provided below.

Core Training

Core Training experiences are common to all trainees – predoctoral and postdoctoral -- and cover the “how” of academic research training and professional development. Activities include:

  • Scholarly Activities Meetings (SAMs) are monthly informal conferences that will provide ample opportunities for each trainee to present research progress to the entire group of trainees and faculty in a critical, but supportive atmosphere.
  • Journal Club to critically review current literature, both basic and clinical.
  • Career Development Course focusing on critical areas relative to professional development. Topics include “Grant Writing 101,” “Grant Writing 201,” “Academic Tools: Reviewing and Writing Manuscripts,” “Survival Skills for an Academic Career,” and “How to Give a Presentation”.
  • An Ethics Course in the second year will introduce critical principles for appropriate reporting, sharing, and use of data, interpersonal interactions, and ethical investigative behavior.

Scientific Themes

Faculty research interests are organized into three scientific themes, which provide the structure for laboratory training. These include:

Airway Inflammation and Immunology: The overall goal of the airway inflammation and immunology scientific theme is to train scientists in the mechanisms and phenotypes of pulmonary responses in inflammatory and immunological processes. This theme will emphasize normal and pathological mechanisms of airway cell responses that defend or challenge airway patency. A major focus is to develop the trainee’s ability to translate innovative results from studies of airway cells and tissues into respiratory clinical medicine and care. The successful trainee will have the opportunity to emerge from this theme with a strong background in mechanisms of innate and adaptive immunity, fluid and electrolyte management, mucociliary clearance, and experience in the design and execution of clinical studies related to lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). The airway inflammation and immunology theme is supported by faculty with proven expertise in each of these fundamental components. The trainees will be innovatively educated in an integrated course of instruction to become leaders in translating new learning and understanding into better medical care. Opportunities for applying systems biology approaches to any of these areas are available. The airway inflammation and immunology theme is especially suited to integration with the other research themes, given the importance of inflammation in pulmonary vascular disease and the recent interest in common signaling and effector pathways between hypoxia and innate immunity.

Pulmonary Vascular Biology: The pulmonary vascular biology scientific theme emphasizes laboratory training that examines the scientific basis of pulmonary vascular physiology and pathological mechanisms involved in pulmonary vascular disease. Historically, UCSD has been a home and “crossroads” for unique avenues investigating pulmonary vascular disease at multiple levels, including anatomy, physiology, and pathology. The faculty guiding these efforts include leaders in pulmonary physiology, endothelial biology, and pulmonary vascular disease. In addition, our clinical and basic research expertise in the areas of pulmonary embolism, idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension continues to grow rapidly. Biomedical Informatics approaches lend themselves to understanding a critical problem within a larger patient population. Trainees will gain state-of-the-art education in basic pulmonary vascular physiology, the biology of endothelial growth control and remodeling, and a comprehensive understanding of pulmonary hypertensive pathophysiology.

Hypoxia and Sleep: This scientific theme is organized around on-going collaborations between faculty and trainees studying the physiological and medical consequences of chronic hypoxemia from respiratory diseases. The theme includes lines of research that can be categorized according to the pattern of hypoxemia: chronic intermittent hypoxia, which is typical of sleep disordered breathing, and chronic sustained hypoxia, e.g., COPD and in obesity and central hypoventilation syndromes. Clinical approaches also include, but are not limited to, pulmonary fibrosis and biomarker assessment. An objective of the theme is to define the fundamental mechanisms responsible for tolerance and susceptibility to hypoxic injury, control of breathing and normal systemic responses or complications to chronic hypoxia.

Research Approach Tracks

Trainees from any Scientific Theme may pursue research with a Fundamental or Clinical Approach as described here.

Fundamental Approaches: This track provides specialized instruction in methodology and applications for laboratory-based investigation. A series of specialized courses are provided to ensure that all trainees have a strong base in cell-to-systems physiology, basic research methodology, and biostatistics. These training modules provide knowledge in basic molecular-, cell-, and systems biology together with an array of practical laboratory-based tools from which trainees may both strengthen their basic biology and pathophysiology knowledge base, as well as supplement their hands-on mentored research experience with state-of-the-art tools.

Clinical Approaches: This track offers formal instruction in the theory and practice of clinically applied research. An introductory workshop, “Epidemiology and Biostatistics Introductory Workshop,” provides an overview of the basic concepts of patient-oriented research. Topics will include: conception of research questions; study designs; sampling and recruitment; questionnaire development; data collection; descriptive, bivariate, and regression analyses; sample size and power calculations; and institutional review board approval for animal and human subjects research.

One option for continued training in clinical research is the Clinical Research Enhancement through Supplemental Training (CREST) program of the UCSD Clinical Investigation Institute. The CREST program covers a comprehensive core of didactic instruction in the methodology required for clinically applied research. The objectives of the CREST program are to provide training in the techniques of clinical research including epidemiology and biostatistics, behavioral medicine, and outcomes research. Completion of the eight core modules in CREST leads to a Certificate in Clinical Research. Trainees interested in obtaining a Master’s degree following CREST may enroll in the Master of Advanced Studies (MAS) degree program at UCSD during an additional year.

A trainee interested in obtaining a Master of Public Health (MPH) degree within the Clinical Approaches concentration of this training program has the option to enroll in the MPH Program in the Graduate School of Public Health (GSPH) at San Diego State University (SDSU). Most GSPH classes meet once weekly in the late afternoon/evening to accommodate working students, so these classes can easily be incorporated into the training program. Additional coursework required to complete the MPH degree can be taken in one additional full-time (or two part-time) semester(s) following this two year training program.