1992 - POST-GRADUATE TRAINING IN RESPIRATORY MEDICINE
Published in the HKTS/ACCP Newsletter, v2, n2, Oct 1992
The following is the proposed outline of local post-graduate training in the subspecialty of respiratory medicine. All members are invited to send in their comments before 30 October, 1992 so that modifications can be made before submission to the Hong Kong College of Physicians.
AIM
The primary goal is to provide post-graduate clinical training in the subspecialty of respiratory medicine. At the end of the training, the trainee should have scientific knowledge, clinical competence and technical skills in respiratory medicine. He/she should be able to provide consultative specialist care in diseases relating to the respiratory system. The training should lay the groundwork for future in-depth commitment to scientific research in this field.
RESPONSIBLE BODY
The Subcommittee on Post-graduate Training and Accreditation in Respiratory Medicine will be under the auspices of the Hong Kong Thoracic Society and the Hong Kong Chapter, American College of Chest Physicians. The Subcommittee will be responsible for 1) Accreditation of training institutes and trainer. 2) Training programme syllabus, approval of individual trainee's programme, coordination of institutes for placement of trainees. 3 ) Attending to complaints or appeals from trainees. 4) Evaluation of trainees and final accreditation of specialist status.
ENTRANCE REQUIREMENT
3 years training in general internal medicine. Part of this training (maximum duration to be specified) may be acquired from chest hospitals. MRCP(UK) or equivalent qualifications
STRUCTURE OF PROGRAMME
Total of 3 years, of which a minimum of 4 months should be spent in critical
care, and a maximum of 6 months may be spent in research.
Minimum of two training institutes to ensure adequate scope of exposure for
trainee.
Part of the training may be acquired from institutes abroad.
TRAINING INSTITUTE
A training institute may comprise of a medical unit within a general hospital or a chest hospital. Criteria for becoming a training institute will be laid down by the subcommittee and reviewed periodically. Any unit that satisfies the criteria will be given full or partial "accreditation" (in terms of years) so that it can receive trainees. Any training institute may receive trainees at a maximum trainee to trainer ratio of 2: 1 at one time.
TRAINER
Qualification: currently practising respiratory physician with at least two years of full time clinical experience in respiratory medicine (with or without commitments to general internal medicine) after specialist accreditation. Approval will be subject to evaluation by Subcommittee.
CLINICAL ENTITIES TO BE COVERED IN TRAINING
Mandatory: Chronic bronchitis and emphysema Asthma and allergic rhinitis Carcinoma of lung Pulmonary infections:
Immunocompetent and immunocompromised hosts Tuberculosis Bronchiectasis Respiratory failure Respiratory critical care, including mechanical ventilation Interstitial lung diseases Restrictive lung diseases from chest wall or neuromuscular problems Pulmonary vascular disease Lung manifestaions of systemic diseases Occupational, environmental, and drug-induced lung diseases Disorders of the pleura and mediastinum Pre-operative pulmonary assessment and post-operative care for general
surgery Sleep-related breathing disorders Pulmonary rehabilitation
Desirable, subject to availability of training facilities: Chest radiology Palliative medicine Microbiology Pathology/immunology/molecular biology Anaesthesia
TECHNICAL PROCEDURES
Mandatory:
Lung function tests (Interpretation) including spirometry, static lung volumes, diffusing capacity, flow-volume loops, airway resistance and lung compliance (Body plethysmograph)
Exercise lung function tests (Supervision and interpretation) Fibreoptic bronchoscopy and related procedures Pleural tap and biopsy Pleural drain for pneumothorax and pleural effusion Medical pleurodesis Endotracheal intubation Mechanical ventilation (including set-up, monitor, weaning) Central venous line insertion Arterial punctures Arterial line insertions Pulmonary arterial line insertion and pressure monitorings Nasal mask ventilation
(For certain procedures, those done during general internal medicine training may be counted as well)
Highly desirable but not mandatory: Bronchial challenge tests Skin tests Percutaneous needle lung aspiration
Desirable, subject to availability of training facilities:
Rigid bronchoscopy Thoracoscopy Endobronchial therapy
EVALUATION
Evaluation will be based on reports from trainers and log-books. The Subcommittee will be responsible for evaluation at yearly intervals and recommendations will be given for any deficiency noted. Final evaluation at the end of the three years training may include an interviw or examination, final format pending on "standardization" with other subspecialties. Accreditation of subspecialty training in respiratory medicine will be granted to trainees who have satisfactorily completed their training.
