Lung Rotation
Residents will rotate with Dr. Mehta to evaluate adult patients with thoracic conditions, including benign and malignant tumors, and non-tumor conditions treated with radiotherapy, such as thoracic organ transplant rejections, sarcoid, chest wall hemangiomas, etc. These patients will be seen primarily in a multidisciplinary context, together with adult cardiothoracic surgeons, medical oncologists, and radiologists and pulmonologists as necessary. Patients will be seen and evaluated as inpatients at UW Hospital and occasionally at Meriter Hospital and the VA. The rotation will provide opportunities in enhancing the multidisciplinary knowledge in the management of these conditions. In addition residents will have ample opportunity, and are highly encouraged, to become proficient in the application of advanced radiotherapy techniques such as 3-D radiotherapy, endobronchial brachytherapy, etc. In order to truly appreciate the multidisciplinary management of these patients, all patients with new cardiothrocacic tumors seen at UWHC are discussed at the weekly combined modality Thoracic Conference, attendance at which is highly recommended; this will include cardiothoracic radiology review every week. Additional optional learning opportunities include participation and/or observation at the monthly Clinical Research in Lung Cancer Meeting through the Lung Disease Oriented Working Group and observation of cardiothoracic procedures with Dr. Pellett.
Typically, in an average 3-month rotation, residents will have contact with approximately 30-50 new cardiothoracic problems, and over 50-70 follow-up contact opportunities. In addition, in an average 3-month time span, residents will have the opportunity to participate in approximately four to six endobronchial brachytherapy procedures.
Goals and Objectives
Observe and understand the etiology, epidemiology, molecular genetics, pathophysiology, clinical presentation, natural history, treatment options, risks and benefits of various options and long-term sequalae of treatment, including pulmonary functional outcome for patients with various cardiothoracic conditions as listed above. Acknowledge, appreciate and act upon the recognition of a unique physician opportunity and obligation to assist patients, family members and society in dealing with the most common etiologic association known to us, i.e. smoking; specifically understand the value of providing appropriate resources to achieve smoking cessation in appropriate patients, and when requested, for family members. Recognize the clinical research opportunities for chemoprevention in this cohort of patients. Understand the educational, social, societal, quality of life and cost-effectiveness issues surrounding the management of the above patients. Understand the multimodality approaches to these conditions, and learn an appropriate physician behavior pattern that optimizes multidisciplinary interaction. Become proficient in the technical aspects of radiotherapeutic management of cardiothoracic conditions, including routine radiotherapy, as well as specialized applications such as 3-D radiotherapy, the use of endobronchial radiotherapy and Tomotherapy (once implemented). It is also expected that a basic foundation in the radiobiologic concepts underpinning these approaches will be developed. Understand and appreciate the opportunities for clinical and translational research in this patient population.