Respiratory Medicine
Draft proposed by Professor Simon Lam
Reviewed by Dr YK Shiu
Essential Skills
Domain 1 Professional Values & Behaviour
Domain 2 Communication
Domain 3 Procedural skills
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Airway management and resuscitation
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Face-mask seal and positive pressure ventilation
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Intubation (direct laryngoscopy)
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Use of laryngeal mask airway
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Use of oropharyngeal/ nasopharyngeal airway
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Replacing tracheostomy tube
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Measuring peak flow rate
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Thoracocentesis and chest drain insertion
Domain 4 Patient Management
Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises
Basic Training
Pulmonary physiology and anatomy
Basic knowledge of pulmonary embryology and its clinical relevance
Understanding of normal and abnormal anatomy of paediatric upper airway and lower airway
Basic knowledge of pulmonary physiology and variations according to age group and disease status
Understanding respiratory failure: clinical features and management strategies
Knowledge of normal sleep physiology
Pulmonary diagnostic tests
Understanding of indications for pulmonary function, sleep assessment, lung imaging and endoscopy
Understanding modality of pulmonary function and sleep assessment
Interpretation of simple spirometry results
Interpretation of arterial and capillary blood gas results
Interpretation of chest radiographs
Common respiratory presentations
Know how to approach, investigate and initiate management in a wide range of common respiratory presentations:
Chronic cough
Stridor
Hoarseness
Choking
Cervical lymphadenopathy
Acute infective respiratory diseases
Understanding of respiratory infections with or without complications
Acute bronchiolitis
Community acquired pneumonia
Acute epiglottitis, severe croup, tracheitis
Mycobacterial and non-tuberculous mycobacterial infections with focus on pulmonary tuberculosis, TB pleural effusion, TB lymph node and latent TB infection
Chronic suppurative lung disease
Bronchiectasis
Lung abscess
Pleural empyema
Allergic respiratory conditions
Asthma
Pre-school wheeze
Allergic rhinitis
Common/important respiratory conditions in newborn term and/or preterm infants
(Please refer to neonatology syllabus for details)
Chronic lung disease (in paediatric age group)
Pulmonary complications on the intensive care unit
Please refer to the PICU syllabus
Pleural diseases (pneumothorax and pleural effusion)
Know how to recognise, diagnose and manage pleural conditions which include:
Pneumothorax
Pleural effusion
Chylothorax
Haemothorax
Respiratory manifestations of diseases of non-respiratory systems
Connective tissue diseases
Cor pulmonale
Sudden infant death syndrome and apparent life-threatening events
Foreign body aspiration and chronic aspiration syndrome
Gastro-oesophageal reflux related lung disease
Sleep medicine
Knowledge of sleep disordered breathing including obstructive sleep apnoea syndrome
Recognises importance of sleep routine and sleep hygiene
Desirable skills
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Assisted ventilation
Use of different modes of invasive mechanical ventilation
Use of different non-invasive ventilatory support and different choices of interface
Assess the need to initiate ventilator support
Higher Training
Pulmonary diagnostic tests
Ability to conduct and interpret simple spirometry
Basic interpretation of polysomnography and recognise when to refer
Interpretation of CT scans
Behavioural aspects of respiratory lung disease
Functional cough
Hyperventilation syndrome
Environmental lung disease
Knowledge of hypersensitivity pneumonitis
Understanding the effects of active and passive smoking
Knowledge of the effects of toxin inhalation
Knowledge of common indoor/outdoor pollutants
Rare respiratory conditions
Cystic fibrosis
Obliterative bronchiolitis
Interstitial lung disease
Primary ciliary dyskinesia
Bronchiolitis obliterans
Bronchiolitis obliterans organizing pneumonia
Pulmonary haemorrhage syndrome
Respiratory malignancy
Congenital central hypoventilation syndrome
Narcolepsy
Pulmonary vascular disease
Pulmonary complications of children with complex medical conditions
Complex disabilities
Neuromuscular disorders
Musculoskeletal disorders
Haematological or oncological conditions
Respiratory and ventilatory care of children with complex medical conditions/needs
Peri-operative respiratory care
Long-term respiratory management
Long-term mechanical ventilation
Multidisciplinary approach
Discharge planning for chronic disease management
Multidisciplinary support
Assessment for need of maintenance/prophylactic therapy
Home oxygen therapy and/or respiratory support
Follow-up planning
Sleep medicine
Other sleep disorders including:
Behavioural sleep problems
Parasomnias
Desirable skills
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Advanced procedures
Chest physiotherapy for collapsed lung
Ultrasound assessment of pneumothorax, pleural effusion
Care and assessment of tracheostomy, change of tracheostomy tube