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 and respiratory physicians are essential and major contributors to the acute medical take in all acute hospital trusts. Respiratory Medicine has a close relationship with Critical Care Medicine.
Most respiratory physicians supervise non-invasive ventilation in the support of patients with acute respiratory failure in the 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 and have expertise in cardiopulmonary physiology. They also 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 lung cancer and tuberculosis in most Trusts. They are referred patients with a vast range of pulmonary and non-pulmonary conditions, 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 non-specific complaints of chest pain, cough and breathlessness. Given these unknown causes, 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 and 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:
- Internal Medicine Training (IMT)
- Acute Care Common Stem - Internal Medicine (ACCS-IM)
A new curriculum for dual training in Respiratory Medicine and Internal Medicine was implemented in August 2022. Trainees already in training in 2022 will need to transfer to the new curriculum unless in their final year of training. Please see our transition page for further information.
The curriculum for each specialty defines the process of training and the capabilities needed for the award of a certificate of completion of training (CCT). The curriculum includes the assessment system for measuring trainees’ progress, comprising workplace based assessment and knowledge based assessment. Information on the Specialty Certificate Examination (SCE) in Respiratory Medicine can be found on the MRCP(UK) website.
A new curriculum has been approved by the GMC and implemented in August 2022.
The previous curriculum for Respiratory Medicine appears below. Earlier versions of the curriculum are no longer available online but copies can be requested from firstname.lastname@example.org.
The ARCP decision aid for each specialty defines the targets that have to be achieved for a satisfactory ARCP outcome at the end of each training year. This is the ARCP decision aid for the new 2022 curriculum:
The decison aid below should be used for trainees remaining on the previous curriculum.
The SAC has produced the following guide for training programme directors, supervisors and trainees to support the implementation of the new curriculum.
The guidance below provides information on the minimum training requirements for acquiring competencies in pulmonary hypertension, lung transplantation and cystic fibrosis in the 2010 curriculum.