Pulmonary Disease and Critical Care Medicine fellowship interview questions
Pulmonary and critical care interviewers listen for calm in the ICU: how you notice a patient getting worse, act in time and keep the team and family informed. They also want to know how you see the balance between the unit, pulmonary clinic and procedures, and which side draws you more.
- Calm when patients deteriorate
- Honest talk with families
- Interest in clinic and ICU
What pulmonary disease and critical care medicine programs ask
Questions about the specialty itself, beside the ones every program asks.
Some fellows are drawn mainly to the ICU, others to pulmonary clinic and procedures. Where do you see yourself?
- What they're listening for
- Whether you want the whole combined training, and what kind of career you are building toward.
- How to answer
- Say which side draws you more and why, what you value in the other side, and the practice you picture (an intensivist, a pulmonologist who also works in the ICU, interventional pulmonology, a disease focus such as interstitial lung disease).
- Where it goes wrong
- Saying you only want the ICU and have no interest in lung disease.
A ward patient with pneumonia is more short of breath and needs more and more oxygen. You are the resident. What do you do?
- What they're listening for
- Whether you recognize respiratory failure early and escalate in time.
- How to answer
- Go to the bedside, assess work of breathing and mental status, get a blood gas and chest imaging, increase oxygen support, and call the rapid response team or the ICU early rather than late. Confirm the patient's code status and wishes along the way.
- Where it goes wrong
- Turning up the oxygen and waiting to see, with no plan for who to call.
A family wants everything done for a patient you believe will not survive this ICU stay. How do you approach the conversation?
- What they're listening for
- Whether you can hold an honest, compassionate conversation when medicine and hope pull apart.
- How to answer
- Prepare with the team, find out what the family understands and what the patient valued, explain the situation plainly, and recommend a plan based on those values. Involve palliative care or ethics when it helps, and expect it to take more than one meeting.
- Where it goes wrong
- Repeating the medical facts until the family gives in.
A patient with COPD keeps coming back to the hospital with flares. What would you look at in clinic?
- What they're listening for
- Whether you see pulmonology as long-term care, not only acute care.
- How to answer
- Confirm the diagnosis with spirometry, then review inhaler technique and adherence, smoking and other exposures, vaccinations, pulmonary rehabilitation and the patient's own goals before adding treatment.
- Where it goes wrong
- Adding medications without checking how the patient uses the ones they have.
Tell me about a procedure in the ICU that did not go as planned. What did you do?
- What they're listening for
- Honesty about complications and your own limits, which the ICU depends on.
- How to answer
- Describe the procedure, the moment it went off course, how you kept the patient safe and called for help, and what you changed afterward (preparation, ultrasound guidance, a checklist).
- Where it goes wrong
- A story where nothing really went wrong, or where someone else was to blame.
What would you like to study in pulmonary or critical care medicine, and why does it matter to patients?
- What they're listening for
- Whether your scholarly interest comes from patients you have cared for.
- How to answer
- Name one specific question (in sepsis, mechanical ventilation, recovery after the ICU, a chronic lung disease), where it came from, and a realistic first project with a mentor.
- Where it goes wrong
- A topic so broad it could never become a project.
The questions every program asks
Expect these too. Each is explained in full on the main questions page.
- Tell me about yourself.
- Why do you want to do a fellowship in pulmonary disease and critical care medicine?
- Tell me about your research.
- Do you see yourself in academic medicine or in clinical practice?
- Tell me about a case from residency that you still think about.
- How do you like to teach residents and students?
- That's everything from me. What questions do you have for us?
Questions to ask pulmonary disease and critical care medicine programs
Ask what their website doesn't answer. These show you have thought about training there.
- How is time divided between the ICU, pulmonary clinic and procedures across the fellowship?
- How are fellows supervised overnight in the ICU?
- How do fellows get exposure to areas such as interstitial lung disease, pulmonary hypertension, sleep and interventional pulmonology?
- What support is there for fellows after a hard death or a difficult run of ICU weeks?
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