Division of Respirology

Acute Care Service

Medical Expert

  1. Demonstrate expertise in the role of Junior Consultant in Respirology.
  2. Consolidate skills in the role of Most Responsible Physician in a Respiratory patient.
  3. Perform an appropriate history and physical examination on a patient presenting with respiratory symptoms or an abnormal laboratory test.
  4. Generate a provisional diagnosis and differential diagnosis to guide the investigative process.
  5. Order appropriate investigations to establish the diagnosis and to assess the severity of physiologic impairment.
  6. Discuss the natural history of any respiratory disease with and without treatment.
  7. Develop expertise in the pharmacologic and non-pharmacologic aspects of treatment.
  8. Recognize the interaction of co-morbid conditions on the management and prognosis of respiratory diseases.
  9. Develop competence in the management of chronic respiratory diseases such as:
    • COPD
    • Corpulmonale and pulmonary heart disease
    • Asthma
    • Bronchiectesis
    • Cystic fibrosis
    • Pulmonary fibrosis and interstitial lung disease
    • Pulmonary fibrosis and interstitial lung disease
    • Sarcoidosis
    • Pneumoconiosis
    • Neuromuscular disease
    • Pleural disease
    • Lung malignancy
    • Sleep disorders
  10. To develop competence in the management of acute respiratory exacerbations and diseases such as:
    • Pulmonary infections
    • Acute exacerbation of COPD
    • Acute asthma/bronchospasm
    • Aspiration
    • Acute lung injury including ARDS, smoke inhalation
    • Lung malignancy
    • Upper airway obstruction
    • Pneumothorax
    • Pleural effusion
    • Pulmonary embolus
    • Pulmonary edema
    • Pulmonary hemorrhage
  11. Have knowledge and skill in assessment and management of the pulmonary complications associated with:
    • Immunosuppression, including HIV infection
    • Exposure to medications and chemical known to have potential lung toxicities or side effects
  12. To have knowledge and skill in assessment and management of pulmonary manifestations of systemic diseases.
  13. To develop expertise in the assessment and management of acute and chronic respiratory failure with:
    • timely and safe application of oxygen therapy with awareness of principles of controlled oxygen
    • knowledge of indications for and management of techniques such as CPAP, BIPAP and mechanical ventilation
    • awareness of physiological effects of the above therapies on normal and abnormal pulmonary function
    • identification and treatment of precipitating causes
    • selection of appropriate environment for monitoring
  14. To have expertise in the use of home oxygen by having knowledge of:
    • criteria for home oxygen
    • evidence for benefits and risks of home oxygen therapy
    • available modalities for the administration of home oxygen
  15. To recognize dangerous situations relating to the control and mechanics of breathing such as impaired respiratory drive, respiratory muscle fatigue and disorders of respiratory control.
  16. To master skills and recognize complications of procedures such as:
    • Fiberoptic bronchoscopy
    • Transbronchial biopsies
    • transbronchial needle aspirate
    • Thoracentesis
    • Intubation with laryngoscope
    • Intubation over bronchoscope
    • Pleurodesis
    • Chest tube insertion
    • Closed pleural biopsy
    • ABG
    • Tracheostomy tube management and tube change

 

Communicator

  1. Communicate the clinical impression in a clear and concise fashion in both the written and oral forms to the referring physician and to other medical personnel.
  2. Communicate the clinical impression to the patient family in a clear and compassionate way that takes into account the patient’s cultural values and education.
  3. Extract the relevant clinical question(s) posed when approaching a Respirology consultation

Collaborator

To be able to liaise with primary care physicians and related health care professionals in order to ensure efficient and safe discharge to the community.

Manager

  1. Demonstrate the ability to triage the management of multiple acute patients who present at any given time, and to prioritize the management of multiple problems occurring with one individual patient at any given time.
  2. Demonstrate knowledge of the cost of investigations performed and the limitations of finite health care resources.
  3. Formulate a plan of investigation with consideration of the costs of testing, the positive predictive value and negative predictive value.
  4. Balance the demands of caring for hospitalized patients with other lifetime priorities such as Continuing Medical Education, personal health and home life.

Health Advocate

  1. Recognize the importance of smoking cessation as it applies to the individual, community and nation.
  2. Assist patients in understanding the importance of preventative health strategies, such as smoking cessation and vaccination.
  3. Provide the opportunity for patients to seek other treatment options for which the patient may need encouragement to do so, such as pulmonary rehabilitation or treatment of depression.
  4. Recognize when end-stage respiratory failure or late-stage lung malignancy is present, and to be able to arrange for appropriate palliative care when further active interventions have no reasonable possibility of benefit.
  5. Recognize hazards posed by infections such a TB, HIV, influenza and febrile respiratory illness; and
  6. Utilize personal protective equipment and environmental control measures to protect oneself, the health care team and other patients.

Scholar

  1. To incorporate evidence based medicine and ethical and legal principles in planning investigations and formulating treatment plans.
  2. To commit to lifelong Continuing Medical Education in Respirology and other related fields.
  3. To provide teaching about respiratory diseases to clinical clerks, residents, attending physicians and other related health care professionals.

Professional

  1. Consistently demonstrate appropriate professional and personal behavior.
  2. Understand to principles of ethics and to apply these in clinical situations.
  3. To be punctual, and to meet deadlines appropriately.