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2017 Nov: Credentialing in Respiratory Medicine


Local Colleges have been requested by Hong Kong Academy of Medicine (HKAM) to formulate individual credentialing mechanisms.  Hong Kong College of Physicians (HKCP) had formed a Credentialing Committee with representatives from all Specialty Boards in 2016, under the Chairmanship of Prof. TM Chan, Chairman of HKCP E&AC.

The credentialing process is targeted towards Specialists (i.e. not related to the training requirements for Higher Physician Trainees).

At the initial phase, only 'entrance requirements' (and not re-credentialing) would be considered. 

Flexible bronchoscopy, EBUS-TBNA and Pleuroscopy had been chosen by HKCP Respiratory Specialty Board to be the first batch of procedures to be credentialed.

Although international guidelines have been taken as reference, considerations would also be made from recommendations from Respiratory Board and local Respiratory Professional Societies, based on local scene and practice. 

The draft criteria had been discussed in Special Interest Group of Bronchology and Interventional Pulmonology (under HKTS/CHEST Delegation HK and Macau), HKCP Respiratory Specialty Board and the Council Meetings of the 3 Respiratory Societies held on 21 Sept 2017.

The criteria would eventually be submitted by the Respiratory Specialty Board to the HKCP Credentialing Committee.

1. Flexible bronchoscopy (FB)

A. Pre-requisite requirements: fulfilled the basic requirements of having performed >=100 procedures under supervision before attaining specialist status.

B. Required no. of bronchoscopic skills within the >=100 procedures in (A) as credentialing criteria

- >=10 each: bronchial aspirate/wash, bronchial brush, endobronchial biopsy, transbronchial biopsy

- >=3 FB in mechanical ventilated patients


2.  Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA)

A. Pre-requisite requirements:

Fulfilled the basic requirements of having performed >=100 flexible bronchoscopic procedures under supervision before attaining the specialist status.

B. Required no. as credentialing criteria:

40 cases under supervision, with >= 20 transbronchial needle aspirations performed in these 40 procedures


3.  Pleuroscopy (Medical Thoracoscopy)

A. Pre-requisite requirements:

Being a Respiratory Specialist (and hence satisfied the HPT training curriculum, which contains the required knowledge in pleural procedures such as pleural aspiration, closed pleural biopsy, intercostal drain insertion and utilization of ultrasonography in such procedures if necessary)

B.  Required no. as credentialing criteria

20 cases under supervision, with >=10 parietal pleural biopsies performed in these 20 case


Ernst A, Silvestri G and Johnstone D et al.  Interventional Pulmonology Procedures: Guidelines from the American College of Chest Physicians.  CHEST 2003; 123: 1693-1717

Bolliger CT, Mathur PN, et al.  ESR/ATS Statement on Interventional Pulmonology.  Eur Respir J 2002; 19: 356-373.

Fielding D, Phillips M, Robinson P et al.  Advanced interventional pulmonology procedures: Training guidelines from the Thoracic Society of Australia and New Zealand.  Respirology 2012; 17: 1176-1189.

Rahman NM, Ali NJ, Brown G, et al. Local anaesthetic thoracoscopy: British Thoracic Society pleural disease guideline 2010.  Thorax 2010;65(Suppl 2): ii54-ii60