Pediatric Respirology

Program Director
Dr. Marielena DiBartolo
Alberta Children's Hospital
2888 Shaganappi Trail NW
Calgary  AB  T3B 6A8
Phone: (403) 955-7974
Fax: (403) 955-2922
e-mail: marielena.dibartolo@albertahealthservices.ca

Program Administrator
Brenda Greig
e-mail: Brenda.Greig@albertahealthservices.ca

For further information see also:
http://www.calgaryhealthregion.ca/clin/child/paed  (click on Directory)

Prerequisite
Candidates wishing to enter the program must have successfully completed three years of pediatric training.

Program Outline
We have a 2-year clinical fellowship program, which can be extended towards a research career if desired. We have 5 staff respirologists, all with general training and each with their individual fields of expertise. There is space for 2 fellows per program year. Most of the clinical work is accomplished in the first year, although there is an expectation that the primary research project will be developed and initiated during this time as well. The main focus of the second year of training is completion of the project. There are components of the program that can be tailored to each individual interest.

Funding
Candidates from out of the province of Alberta must come with their own funding, or enter the Alberta Children's Hospital Foundation competition in the early fall of the year prior to beginning. The competition is based upon a proposed clinical research project. Information can be obtained from the program director. (NOTE: deadline for this competition is in the Spring, ONE YEAR prior to the anticipated program start date). The detailed research proposal would be prepared during the program as outlined above.

Basic Rotations
Rotations are on a 4 weekly basis (13/year). One month with the adult respirologists and 2 months in the PICU are part of the program. These months will be planned according the objectives of the fellow in conjunction with the respiratory residency training director in collaboration with other associated programs. There is a further month of elective time allowed which may include such areas as infectious disease, gastroenterology, allergy/immunology, and ENT. Most of the remainder of the first year is made up of in-patient and out-patient pediatric respirology. As both components are fairly busy, the two are generally not mixed.

Bronchoscopy
We have 2 half days a week for elective bronchoscopies and perform about 150 of them per year. The fellows in the first year are prioritized to perform these, and are expected to be proficient at flexible bronchoscopy by the end of the first year. They are encouraged to continue this training throughout the second and further years as well.

Laboratories
Standard laboratory - spirometry, body plethysmography (volumes, resistances), broncho-provocation are routine. Full opportunity to become proficient at interpretation is made available. Fellows will have ample opportunity to develop a full theoretical and practical understanding of all of the laboratory equipment, techniques, and interpretation, so that they will be able to set up their own laboratory.

1. Standard laboratory - spirometry, body plethysmography (volumes, resistance), broncho-provocation are routine. Full opportunity to become proficient at interpretation is made available. Fellows will have ample opportunity to develop a full theoretical and practical understanding of all of the laboratory equipment, techniques, and interpretation, so that they will be able to set up their own laboratory.
2. Exercise - cardio-respiratory testing as well as exercise broncho-provocation is available.
3. Sleep laboratory - the laboratory offers complete polysomnography. Services include full diagnosis and treatment of all respiratory related problems. Exposure to the basics of interpretation of sleep studies is part of the curriculum. 

Clinics
We have a full range of pediatric respiratory out-patient clinics. These include: 

1. Asthma clinic: about 1000 new referrals/year. 5 half days/week in a multidisciplinary setting.
2. Sleep clinic: 1 half day/week. Priority is given to seeing patients with respiratory-related problems but non-respiratory sleep disorders are also managed through this clinic.
3. Respiratory home care clinic: multidisciplinary care of oxygen dependent, tracheotomy, and complex respiratory patients. 3 half days/week. About 150 new patients/year.
4. Pulmonary clinic: 1 half day/week - new undiagnosed problems
5. Cystic Fibrosis clinic: 1 half day/week - 100 patients in a multidisciplinary setting
6. Neuromuscular clinic: ½ day/month. - Also a multidisciplinary clinic with a full program of respiratory interventions including noninvasive ventilation.
7. Bone marrow transplant/oncology: ½ day per week.
8. Longitudinal "Fellows' Clinic" - The trainees follow their own patients on a long-term basis under the supervision of the staff respirologists

In-patient Service
Our in-patient service looks after about 15-20 patients at any one time, half being on a consultative basis, and half as the treating physician. Call from home is ¼. We often have a pediatric resident or medical student with us, which permits you to both teach and have service assistance.

Research
The second year is split between further clinical training and research. The research project will be initiated in the second month of the first year, which will be dedicated to writing a full proposal under the supervision of a staff respirologist. It is anticipated that the project will be of the quality for submission for funding and publication. Opportunities exist to pursue advanced education at the University of Calgary in clinical epidemiology, statistics, or other courses of interest.

Teaching
The fellow will also be expected to participate in our medical school teaching, mostly in terms of small group teaching. Generally fellows present one seminar per month to our weekly academic group meetings, as well as some journal clubs and case presentations. You will have the unique opportunity to present a case and/or journal club to all the fellows and staff in training programs across Canada via our monthly videoconference.