Thoracic and Sleep Medicine

Thoracic Medicine

Components of Training

Core Training
A minimum of two years in clinical paediatric thoracic medicine is required. The major portion of this should be spent in in-patient and out-patient care of children and adolescents at a hospital with the facilities outlined below. A portion of this time could be spent in an adult thoracic medicine unit. Three months training in paediatric sleep medicine is strongly recommended.

You will be expected to:

• become conversant with diagnostic procedures relevant to paediatric medicine
  
• become conversant with the current literature and research in the field of respiratory medicine and related disciplines such as immunology, allergy, pathology and pharmacology
  
• develop significant expertise in the performance and interpretation of lung function tests in children
  
• develop consultation skills for management of children and adolescents with complex diseases which impact upon the respiratory system, in a multi-disciplinary setting
  
• develop communication skills to ensure effective consultation, counselling, teaching and collaboration with other agencies.

You are also encouraged to pursue knowledge and training in paediatric sleep medicine and performance of bronchoscopy in children.

You will not necessarily be expected to become an expert in all branches of paediatric thoracic medicine nor in all investigational techniques.

Three months of training in paediatric sleep medicine is strongly recommended. The aim is to achieve:

• an understanding of the changes in normal sleep physiology (sleep patterns, sleep states and EEG) that occur with growth and maturation
  
• knowledge of the changes in normal respiratory physiology, including ventilatory control, gas exchange and mechanics during sleep
  
• skills in the diagnosis and management (including the use of CPAP and pressure-& volume-cycled non-invasive ventilation) or respiratory disorders that are either exclusively sleep-related, or exacerbated by sleep
  
• preliminary knowledge of the symptomatology and management of non-respiratory sleep disorders, particularly those that are encompassed in the differential diagnosis of sleep apnoea
  
• a basic understanding of polysomnography techniques, and interpretation of polysomnography in children.

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Complementary (Elective) Training
The SAC may approve a maximum of one year of complementary (elective) training which may be spent in related clinical medicine, respiratory research or laboratory work.

Clinical complementary training will be restricted, in general, to related disciplines such as intensive care, infectious diseases and immunology. Complementary training should normally be approved by the SAC before commencement. Usually at least six months of core training must be undertaken before complementary training is begun.

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