Pulmonary Disease/Critical Care Medicine Fellowship Program

WELCOME TO THE UNIVERSITY OF TENNESSEE GRADUATE SCHOOL OF MEDICINE

Pulmonary Critical Care Medicine Fellowship Program

DEPARTMENT OF MEDICINE

Pulmonary Critical Care Medicine Fellowship Program

Leadership Team

Rajiv Dhand, MD, FCCP, FACP, FAARC Chairman and Professor, Department of Medicine

Tina Dudney, MD, D’ABSM, FCCP

Fellowship Program Director Associate Professor Chief, Division Pulmonary Critical Care Medicine Chief, Section of Pulmonary

Francisco Soto, MD, MS, FCCP Associate Program Director –Research Associate Professor

Isaac Biney, MD Associate Program Director – Education Clinical Assistant Professor

3rd year fellow

Chief Fellows

CHIEF FELLOWS

Completed residency at The Wright Center for Graduate Medical Education, Scranton, PA

Shawn Tosonian, M.D.

3rd year fellow

Completed residency at the Eisenhower Medical Center, Rancho Mirage, CA

Elman Urbina

Meneses, MD

3rd year fellow

Completed residency at the MetroWest Medical Center/Tufts School of Medicine, Framingham, MA

Nishant Sharma, M.B.,B.S.

The power of Teamwork

Li J, Liu K, Lyu S, Jing G, Dai B, Dhand R, Lin HL, Pelosi P, Berlinski A, Rello J, Torres A, Luyt CE, Michotte JB, Lu Q, Reychler G, Vecellio L, de Andrade AD, Rouby JJ, Fink JB, Ehrmann S. Aerosol therapy in adult critically ill patients: a consensus statement regarding aerosol administration strategies during various modes of respiratory support. Ann Intensive Care. 2023 Jul 12;13(1):63. doi: 10.1186/s13613-023-01147-4. PMID: 37436585; PMCID: PMC10338422

Terry PD, Dhand R. The 2023 GOLD Report: Updated Guidelines for Inhaled Pharmacological Therapy in Patients with Stable COPD. Pulm Ther. 2023 Jul 20. doi: 10.1007/s41030-023-00233-z. Epub ahead of print. PMID: 37470971

Soto FJ, Biney IN, Akhtar Y, McKeown PP, Turner JF. Abnormal Cardiac Ultrasound Imaging in a Patient With Sudden Neurologic Deficit. Chest. 2022 Sep;162(3):e145-e148. doi: 10.1016/j. Chest.2021.09.043

Fogelson B, Qu D, Bhagat M, Branca PR. Multi-organ system failure secondary to difluoroethane toxicity in a patient "huffing" air duster: a case report. J Addict Dis. 2022 OctDec;40(4):577-582. doi: 10.1080/10550887.2022.2027207. Epub 2022 Jan 19. PMID:35044291

Bhagat M, Singh A, Bazzi T, Green J. Bronchorrhea: a Rare and Debilitating Symptom of Lung Cancer: Case Report and Review of the Treatment. JTO Clinical and Research Reports. 2022 Oct;3(10) https://doi.org/10.1016/j.jtocrr.2022.100398

Olanipekun T, Abe T, Effoe V, Chris-Olaiya A, Biney I, Guru P, Ritchie C, Sanghavi D. Utilization trends and outcomes of catheter-directed thrombolysis for pulmonary embolism in the US by race/ethnicity. J Thromb Thrombolysis. 2022 Nov;54(4):675-685. doi: 10.1007/s11239-022-02710-9. Epub 2022 Oct 11. PMID: 36219337

Pleasants PA, Chan AH, Mosnaim G, Costello RW, Dhand R, Schworer SA, Merchant R, Tilley SL. Integrating digital inhalers into clinical care of patients with asthma and chronic obstructive pulmonary disease. Respir Med. 2022 Dec;205:107038. doi: 10.1016/j.rmed.2022.107038. Epub 2022 Nov 7. PMID: 36446239

Zhou CY, Sahay S, Shlobin O, Soto F, Mathai S, Melendres-Groves L, Mullin CJ, Levine DJ, Kay D, Highland K, Bossone E, Poms A, Memon H, Balasubramanian V, Farmer MJS, Rahaghi

F, Elwing JM. Effects of COVID-19 pandemic on the management of pulmonary hypertension. Respir Med. 2023 Jan;206:107061. doi: 10.1016/j.rmed.2022.107061. Epub 2022 Nov 26. PMID: 36493604

PUBLICATIONS

Wong F, Doyle-McClam M, Pugh S, Dudney T, McCormack M, Kravitz J. Diagnostic and treatment dilemma during the coronavirus disease 2019 pandemic: a primary pulmonary lymphoma presenting as a cavitary mass in a patient with coronavirus disease 2019: a case report. J Med Case Rep. 2023 Jan 13;17(1):12. doi: 10.1186/s13256022-03745-5. PMID: 36635758; PMCID: PMC9836925

Hamilton M, Anderson M, Dhand R, Patmore O, Prime D, Taylor E. In Vitro Drug Delivery of a Fixed-Dose Combination of Fluticasone Furoate/Umeclidinium/Vilanterol from a Dry Powder Inhaler. J Aerosol Med Pulm Drug Deliv. 2023 Feb;36(1):34-43. doi: 10.1089/jamp.2021.0061. Epub 2023 Jan 25. PMID: 36695722; PMCID: PMC9942181

Zhou CY, Sahay S, Shlobin O, Soto FJ, Mathai SC, Melendres-Groves L, Mullin CJ, Levine DJ, Kay D, Highland K, Bossone E, Poms A, Memon H, Balasubramanian V, Farmer MJS, Rahaghi F, Elwing JM. Effects of COVID-19 pandemic on the management of pulmonary hypertension. Respir Med. 2023 Jan;206:107061. doi: 10.1016/j.rmed.2022.107061. Epub 2022 Nov 26. PMID: 36493604; PMCID: PMC9699715

Street NG, Assaf SN, Tosonian S, Urbina Meneses E, Edwards MD. Severe Legionella and Histoplasma Pneumonia Acquired From Spring Water. Cureus. 2023 Feb 8;15(2):e34765. doi: 10.7759/cureus.34765. PMID: 36909126; PMCID: PMC10005854

Olanipekun T, Ritchie C, Abe T, Effoe V, Chris-Olaiya A, Biney I, Erben YM, Guru P, Sanghavi D. Updated Trends in Inferior Vena Cava Filter Use by Indication in the United States After Food and Drug Administration Safety Warnings: A Decade Analysis From 2010 to 2019. J Endovasc Ther. 2023 Mar 1:15266028231156089. doi: 10.1177/15266028231156089. Epub ahead of print. PMID: 36859812

Rowe SM, Zuckerman JB, Dorgan D, Lascano J, McCoy K, Jain M, Schechter MS, Lommatzsch S, Indihar V, Lechtzin N, McBennett K, Callison C, Brown C, Liou TG, MacDonald KD, Nasr SZ, Bodie S, Vaughn M, Meltzer EB, Barbier AJ. Inhaled mRNA therapy for treatment of cystic fibrosis: Interim results of a randomized, double-blind, placebo-controlled phase 1/2 clinical study. J Cyst Fibros. 2023 Apr 28:S1569-1993(23)00112-1. doi: 10.1016/j.jcf.2023.04.008. Epub ahead of print. PMID: 37121795

Terry PD, Heidel RE, Dhand R. The association of preexisting severe asthma with COVID-19 outcomes. Curr Opin Pulm Med. 2023 May 1;29(3):215-222. doi: 10.1097/MCP.0000000000000954. Epub 2023 Mar 17. PMID: 36928032; PMCID: PMC10090339

PUBLICATIONS

Swanson CS, Dhand R, Cao L, Ferris J, Elder CS, He Q. Microbiome-scale analysis of aerosol facemask contamination during nebulization therapy in hospital. J Hosp Infect. 2023 Apr;134:80-88. doi: 10.1016/j.jhin.2023.01.008. Epub 2023 Jan 20. PMID: 36690253

Kourouni I, Suguness A, Finley J, Josan ES, Dutton K, Tarabichi Y. Reducing Racial Disparities in the Timeliness of Potential Lung Cancer Evaluation With a Novel Application-Supported Rapid Outpatient Diagnostic Program: An Interrupted Time Series Analysis. Clin Lung Cancer. 2023 Jun;24(4):339-346. doi: 10.1016/j.cllc.2023.02.008. Epub 2023 Mar 4. PMID: 37002154; PMCID: PMC10225315

PRESENTATIONS

Bhagat M, Wong F, Branca P. A Rare Asthma Impostor: An atypical case of granular cell tumor in a young patient causing endobronchial obstruction. Presented at 2022 AABIP Annual Conference: Nashville, TN August 13, 2022

Branca P. Update on Endobronchial Therapies for Central Airway Obstruction. Presented at John W. Whittington MD Endowed Lecture: Lung Cancer: Knoxville, TN September 30, 2022

Bevill B. Endobronchial Staging for Lung Cancer and Robotic Bronchoscopy. Presented at John W. Whittington MD Endowed Lecture: Lung Cancer: Knoxville, TN September 30, 2022

Fuerst N. Case Presentations. Presented at John W. Whittington MD Endowed Lecture: Lung Cancer: Knoxville, TN September 30, 2022

Bhagat M. Case Presentations. Presented at John W. Whittington MD Endowed Lecture: Lung Cancer: Knoxville, TN September 30, 2022

Sharma N, McCormack M, Bhagat M. Crossing the Rubicon: Subdiaphragmatic abscess fistulizing into the lung. Presented at (National) CHEST 2022: Nashville, TN October 17-19, 2022

Bhagat M, Urbina E, Bevill B, Soto F. A Giant Left Atrium Causing Extrinsic Compression of the Left Lower Lobe in a Patient with Pulmonary Hypertension and Mitral Valve Disease. Presented at (National) CHEST 2022: Nashville, TN October 17-19, 2022

Gutierrez A, Alexander W, Treat S, Purkey J. A Reminder of the Immunosuppression Conferred by Prolonged Hyperglycemia: A Case of Nocardia Farcinica Pneumonia. Presented at (National) CHEST 2022: Nashville, TN October 17-19, 2022

2022 – 2023

Academic Year

PRESENTATIONS

Thomas A, Dalabah R. Rare Presentation Of Thymoma At An Infrequent Location. Presented at (National) CHEST 2022: Nashville, TN October 17-19, 2022

Thomas A, Dalabah R. A Case Of Metastatic Synovial Sarcoma. Presented at (National) CHEST 2022: Nashville, TN October 17-19, 2022

Treat S, Venero C, Goodwin E, Barton B, Soto F. Tricuspid Valve Endocarditis History and Acute Hypoxemic Respiratory Failure: POCUS, Bubbles, and More. Presented at (National) CHEST 2022: Nashville, TN October 1719, 2022

Josan E. Novel Aids in the Diagnosis of Lung Cancer: Rules and Robots. Moderator at (National) CHEST 2022: Nashville, TN October 17-19, 2022​

Josan E. The Cardiac Intensivist I. Moderator at (National) CHEST 2022: Nashville, TN October 17-19, 2022​

Dudney T, Josan E. Everything You Need to Know to be a Chief Fellow. Panelist at 2022 CHEST Annual Meeting; Nashville, TN. October 17-19, 2022​

Soto FJ. Right Heart Catherization in Pulmonary Hypertension: Interpretation, Troubleshooting & Pitfalls. Presented at 2022 CHEST Annual Meeting: Nashville, TN. October 17-19, 2022​

Gardner K. First Line and Advanced Treatment. Presented at Heart, Lung, Vascular Update for Primary Care Providers: Knoxville, TN. November 5, 2022

Dudney T. Obstructive Sleep Apnea: Who needs tested and benefits of treatment. Presented at Heart, Lung, Vascular Update for Primary Care Providers: Knoxville, TN. November 5, 2022​

​Dudney T, Gardner K, Josan E. Panel Discussion. Presented at Heart, Lung, Vascular Update for Primary Care Providers: Knoxville, TN. November 5, 2022

Josan E. COPD: Inhaler and More. Presented at Heart, Lung, Vascular Update for Primary Care Providers: Knoxville, TN. November 5, 2022

Awards

Dr. Milind Bhagat received the Fellow of the Year Award for exceptional clinical skills and dedication to teaching as chosen by her peers and Medicine Chief Residents

Drs. Shawnt Tosonian and Akesh Thomas received the Certificate of Academic Excellence for the APCCMPD

highest performance In-Service Exam for Critical Care Medicine

Dr. Milind Bhagat received the Certificate of Academic Excellence for the APCCMPD

highest performance In-Service Exam for Pulmonary Disease

Who you’ll meet on

Interview Day:

(next four slides)

Tina Dudney, MD, DABSDM, FCCP

• Program Director

• Division Chief, Pulmonary Critical Care Medicine

• Undergraduate: Tennessee Technological University

• Medical School : University of Tennessee Memphis

• Residency: University of Tennessee Medical Center

• Fellowship: University of Utah School of Medicine

• Enjoys gardening, animal rescue, cooking and swimming

Francisco Soto, MD, MS, FCCP

• Associate Program Director - Research

• Medical School: Universidad del Valle, Cali, Colombia

• Residency: University of Illinois at Chicago, Chicago, IL

• Fellowship: Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX

• Enjoys Latin dancing, hiking, country music and soccer/football

Isaac Biney, MD

• Associate Program Director – Education

• Medical School: University of Ghana School of Medicine and Dentistry

• Residency: Howard University Hospital

• Fellowship: University of Tennessee Graduate School of Medicine – Knoxville

• Enjoys playing and watching tennis

Arseniy Tsapenko, DO, MD

• DO: New York College of Osteopathic Medicine

• MD: Ukrainian State Medical University

• Residency: Kyiv University Hospital #12; Albert Einstein College of Medicine

• Critical Care Fellowship: Brown University

• Pulmonary Fellowship: University of Tennessee Knoxville

• Sleep Fellowship: Dartmouth-Hitchcock Medical Center

• Enjoys fishing and travelling

Elman Urbina

Meneses, MD

• Medical School: Universidad

Americana (UAM) Facultad de Medicina , Nicaragua

• Residency: MetroWest Medical Center/Tufts Schoo of Medicine, Framingham, MA

Chief Fellows

Nishant Sharma, MBBS

Medical School: Kakatiya

Medical College, India

Residency: The Wright Center for Graduate Medical Education, Scranton, PA

Shawnt Tosonian, MD

• Medical School: St. George's University School of Medicine, Grenada

• Residency: Eisenhower Medical Center, Rancho Mirage, CA

Didactic Conference

Post-Fellowship Placement

Class of 2023

Nicholas Fuerst, MD Academic Greenville, SC

Milind Bhagat, MBBS Academic

Class of 2022

Megan Doyle McClam, MD Private Practice

Ralph Maroun, MD Private Practice

Class of 2021

Spencer Pugh, MD Private Practice

Minneapolis, MN

Anderson, SC

Knoxville, TN

Knoxville, TN

Fatima Wong, DO Interventional Cooper University Hospital Camden, NJ

Pulmonology Fellowship

Class of 2020

Swati Baveja, MBBS Private Practice

Isaac Biney, MBBCh Academic

Victorville, CA

Knoxville, TN

Post-Fellowship Placement (continued)

Class of 2019

Bimaje Akpa, MBBS Sleep Fellowship

Sameh Attia, MBBCh Academic

Ashish Thakkar, MD Academic

Class of 2018

Raakesh Sathya, MBBS Private Practice

Naveed Sheikh, MBBS Private Practice

Class of 2017

Rishi Sehgal, MD Sleep Fellowship

Anil Singh, MBBS Private Practice

Class of 2016

Rafael Alba-Yunen, MD Private Practice

Victor Gordon, MD Private Practice

Class of 2015

Farhan Khan, MBBS Critical Care Fellowship

Dipaben Modi, MBBS Academic

University of Chicago Chicago, IL

Knoxville, TN

Knoxville, TN

Los Angeles, CA

Oak Ridge, TN

Vanderbilt University Medical Center Nashville, TN

Dallas, TX

Brunswick, GA

Saginaw, MI

Orlando Health Orlando, FL

Houston, TX

Post-Fellowship Placement (continued)

Class of 2014

Syed Naqshbandi, MBBS Critical Care Fellowship

Montefiore Medical Center

Naveed Sheikh, MBBS Private Practice Oak Ridge, TN

Kashif Aslam, MBBS Critical Care Medicine University of New Mexico

Class of 2013

Syed Gilani, MBBS Private Practice

Arseniy Tsapenko, DO, MD Sleep Fellowship

Class of 2012

Kamran Manzoor, MBBS Critical Care Fellowship

Muhammad Mir, MD Private Practice

Class of 2011

Adeel Shibli, MD Private Practice

Amit Dhingra, MD Private Practice

Class of 2010

Paramveer Bhugra, MD Critical Care Fellowship

Kinnaresh Patel, MBBS Critical Care Fellowship

Bronx, NY

Albuquerque, NM

Columbia, SC

Dartmouth-Hitchcock Lebanon, NH

Dartmouth-Hitchcock

Crossville, TN

Lebanon, NH

Mesquite, TX

Peoria, AZ

Brown University

Providence, RI

Wake Forest School of Medicine

Winston-Salem, NC

Pulmonary Critical Care Medicine Fellowship Program

• 9 fellows

• 3 per year

• All fellow training is at this facility except 6 weeks at Vanderbilt for Lung Transplant and Burn ICU

• University Pulmonary Critical Care

• 15 Pulmonary/Critical Care Physicians with varied area of focus in:

• Sleep Medicine

• Pulmonary Hypertension

• Cystic Fibrosis

• Interstitial Lung Disease

• Thoracic Oncology

• Interventional Pulmonology

• General Pulmonary Medicine

• Critical Care Medicine

• Ultrasonography

Procedures

- The volume of interventional procedures and inpatient

consultations performed by our group at UTMC in 2022

INPATIENT CONSULTATIONS AND ADMISSIONS

• 1,157 Pulmonary Consultations/Admissions

• 11,644 Medical ICU Admissions

BRONCHOSCOPY

• 1,347 Bronchoscopies (there is close to 95% fellow participation in these procedures based on monthly rotation availability)

• 430 EBUS (endobronchial ultrasound)

• 181 Radial EBUS

• 126 Transbronchial Biopsies

• 168 Navigational Bronchoscopies (including 132 robotic bronchoscopies)

• 228 Therapeutic/Interventional Bronchoscopies

• 377 ROSE (rapid on-site evaluation)

PULMONARY FUNCTION LAB

• 5,287 PFTs (pulmonary function tests)

• 89 CPET (cardiopulmonary exercise test)

PLEURAL PROCEDURES

• >200 Thoracentesis

• 97 Chest Tubes

RIGHT HEART CATHETERIZATIONS

• 38 Right Heart Catheterizations (performed in the Cath Lab; number does not include pulmonary artery catheters placed at bedside)

• 28 Comprehensive Shunt Run Evaluations

• 31 Vasodilator Challenge Studies

• 89 Exercise Challenge Studies

• 5 Fluid Bolus Challenge Studies

ICU-RELATED

• 133 Endotracheal Intubations

• 222 Central Venous Lines (does not include overnight procedures)

The University of Tennessee Medical Center

• Opened August 1956

• 710 bed acute care teaching hospital

• Region’s only Academic Medical Center

• 19 ACGME accredited specialty and subspecialty programs

• Level 1 Trauma Center

• Certified Comprehensive Stroke Center

• Aeromedical Service Base

• Magnet recognition for excellence in nursing

• Clerkships for M3 and M4 students

• Health Information Center – Preston Medical Library

• LIFESTAR

• Area’s first emergency response helicopter

• Medical Simulation Center

Designated Level III

Neonatal Intensive Care Unit

The Facility – Heart Lung Vascular Institute

• Outpatient office

• Connected to hospital via walkway

• Fellow parking attached to HLVI

• in garage

• Shared fellow’s office with individual desks, call room adjacent to hospital

Bronchoscopy Lab

• Two dedicated rooms with EBUS and Interventional capability

• Navigational Bronchoscopy

• Radial Probe Ultrasound bronchoscopy

• OR availability with combined CT surgery/Pulmonologist cases

• Close working relationship with Thoracic Surgery

The Facility - Academics

• Health Information Center

• In hospital – access 24/7

• Patient access area separate from resident / fellow study area

• Conference rooms

• Computers

• Stacks

• Magazines

• Access to thousands of books / electronic resources through UT Memphis

The Facility - Academics

• UT Center for Advanced Medical Simulation

• 6500 Sq ft

• 1 of 68 in the world (only one in TN) to earn accreditation as Level 1

Comprehensive Accredited Education Institute from American College of Surgeons

Graduate School of Medicine – Residencies and Fellowships

• Anesthesia

 Fellowships in Pain Medicine and Perioperative Medicine

• Family Medicine

 Fellowships in Emergency Medicine, Hospice and Palliative Medicine and Sports Medicine

• General Dentistry

 Fellowship in Dental Operating Room

• Internal Medicine

 Fellowships in Cardiovascular Diseases, Interventional Cardiology, and Pulmonary Disease/ Critical Care Medicine and Hematology /Oncology

• Transitional Year

• Obstetrics & Gynecology

 Fellowship in Maternal-Fetal Medicine

• Oral & Maxillofacial Surgery

 Fellowship in Oral/Head and Neck

Oncologic Surgery

• Pathology

 Fellowship in Oncologic Surgical

Pathology

• Radiology

• Surgery

 Fellowships in Advanced GI

MIS/Bariatric, Surgical Critical Care and Vascular Surgery

• Urology

ABOUT KNOXVILLE

We’re a nature-lovingadventure-seeking-artsykinda-town

• Lower cost of living than the national average

• 4 general seasons

• Multiple festivals and weekly concerts

• Exciting Craft Beer Scene with Knoxville Ale Trail

• Food Truck Parks

• Small local airport with access to major airlines and cities

• Multiple farmer’s markets

• www.visitknoxville.com

The City - Knoxville

• Est population 196,823

• Knoxville Metropolitan Statistical Area (Knox, Blount, Anderson, Loudon, and Union counties) is 1 ,156,861 million

• Economics

• No state income tax

• 15% below the national cost-of-living average

• Median household income $64,650

• Demographics

• Median age 33.5

• 32.3 Male / 34.7 Female

• 74.95% Caucasian, 16.44% Black, 0.15% Native American, 1.68% Asian, 0.02% Pacific Islander, Two or more races 5.09%, other race 1.67%

FELLOW LIFE OUTSIDE THE HOSPITAL

Travelling to / from Knoxville

Two major interstates – I-40 and I-75 make car travel convenient

McGhee Tyson

Airport is easy to get in /out of with reasonable flight rates (about 15 min from hospital)

Fellowship Photos