Education and training
Every hospital should have an in-house training programme covering the local arrangements for the management of acute respiratory conditions including asthma, COPD, pneumonia and pulmonary embolism. Every hospital admitting an unselected medical take should have 24/7 provision for the emergency insertion of chest drains under ultrasound control and the safe and effective delivery of non-invasive ventilation by suitably qualified and trained staff. Robust mechanisms need to be in place to ensure middle-grade doctors are trained in these techniques and/or that the service is provided 24/7 by other suitably trained healthcare professionals (eg physiotherapists delivering non-invasive ventilation).
The British Thoracic Society (BTS) works closely with the Specialist Advisory Committee (SAC) of the Joint Royal Colleges of Physicians Training Board (JRCPTB) to develop and set out the training curriculum for respiratory trainees. All trainees undertake both respiratory and general medical training. Regional and national training programme directors ensure consistency of content, and out-of-programme experience is encouraged. The specialty has developed the curriculum to include training in the provision of integrated care. Respiratory medicine is usually a highly subscribed specialty and had a fill rate of 96% in 2017. The majority of respiratory consultants (86%) and specialty trainees (88%) work full time; however, there are well-established models of working less than full time (LTFT) both as a trainee and as a consultant physician.
The Academy of Medical Royal Colleges (AoMRC) has produced a cost of training document setting out the mandatory costs of training involved in college enrolment fees, examination costs and GMC fees. Published in October 2017, it has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway.
BTS has developed a series of national short courses that provide access nationally to learning about topics that are not easily available regionally – for example, lung transplantation and cystic fibrosis. BTS e-learning modules are also available, all of which are mapped to specific areas of the curriculum. Module topics are added in consultation with the SAC.