Respiratory Medicine is one of the two major specialties of acute General Internal Medicine (GIM). Approximately 30% of all acute admissions in GIM are for a primary respiratory problem. Respiratory physicians are essential and major contributors to the acute medical take in all acute hospital trusts. Respiratory Medicine also has a close relationship with Intensive Care Medicine.
Most respiratory physicians supervise non-invasive ventilation in the support of patients with acute respiratory failure in an High Dependency Unit environment, and many have sessions helping to run Intensive Care services and expertise in the management of the Adult Respiratory Distress Syndrome. Respiratory physicians have considerable technical skill; they undertake bronchoscopy, pleural procedures, medical thorascopy and have expertise in cardiopulmonary physiology and run lung function laboratories in most hospitals for the interpretation of complex lung function testing, a cornerstone of respiratory diagnosis.
In the outpatient setting, respiratory physicians run the services for asthma, COPD, lung cancer, sleep medicine and tuberculosis in most trusts. They are referred patients with a vast range of pulmonary and non-pulmonary condition;, the latter since the lung is involved in many non-pulmonary systemic conditions. A large percentage of their outpatient work involves the investigation, diagnosis and management of patients referred with the non-specific complaints of chest pain, cough and breathlessness of unknown cause such that most respiratory physicians have considerable expertise in dealing with diagnostic uncertainty. For this reason, they are often a port of call for other medical practitioners when there are other more general non-specific symptoms for which a diagnostic explanation is elusive.
Entry into Respiratory Medicine training is possible following successful completion of both a foundation programme and a core training programme. The two core programmes for Respiratory Medicine are:
- Core Medical Training (CMT)
- Acute Care Common Stem - Acute Medicine (ACCS-AM)