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nurses, community respiratory teams, respiratory physiotherapists and specialist respiratory technicians as well as other medical staff. There are also close links between the specialty and both radiology and thoracic surgery. In addition to clinical and research skills, specialists have considerable technical abilities. Common procedures include bronchoscopy (both diagnostic and, increasingly, interventional); pleural procedures including pleural biopsy and chest drain insertion; medical thoracoscopy for the more invasive investigation of pleural effusion; and non-invasive ventilation. They are also responsible for providing the non-invasive ventilation services as well as the sleep services in most hospitals. Respiratory specialists have


considerable expertise in cardiopulmonary physiology and 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 (TB) in most


Q&A


Dr Elin Roddy, consultant respiratory physician at


Royal Shrewsbury Hospital


What first attracted you to respiratory medicine? I did respiratory medicine as my very first job after qualifying, and then again as an SHO. The respiratory physicians I met during my early training were hugely inspiring – supportive, compassionate and knowledgeable. It wasn’t until I went to Australia, though, and learnt to bronchoscope that I truly knew that my future lay in respiratory medicine.


What do you enjoy most about the job? I really enjoy the huge variety that I experience from day to day, and the sense of team working. I have also been able to do a lot of my training flexibly, and now work part-time which is important for me as it means I can balance family life with a rewarding career.


What do you find most challenging? The burden of the general medical take can sometimes make focusing on specialty issues a challenge.


Has anything surprised you about the specialty? I’m surprised that I haven’t yet found a respiratory physician I don’t like!


What do you consider the most important attributes of a good respiratory specialist? The ability to work well in a team and see others’ points of view is crucial. Good


trusts.


There are great opportunities to subspecialise or remain general. While there are no formally recognised sub specialties, there are a number of important “special interest” areas: adult cystic fibrosis, pulmonary hypertension, lung transplantation, domiciliary non-invasive ventilation, lung cancer, sleep breathing disorders and TB. The specialty has a strong future. It is


increasingly recognised that respiratory physicians are best placed to manage asthma, while the number of adult cystic fibrosis and COPD patients requiring specialist care continues to rise. Technical skills are also increasing, with expansions in interventional bronchoscopy and more widespread use of medical thoracoscopy. With such a diverse range of pathways to


follow, respiratory medicine promises a challenging and ever-changing career for doctors.


Sources: • The British Thoracic Society – A career in respiratory medicine – tinyurl.com/ hqfdvt2


• Specialty training curriculum for respiratory medicine – tinyurl.com/hgz9ycs


• For doctors by doctors: http://www. fordoctorsbydoctors.co.uk/home/ career-development


communication skills are vital for all doctors, but particularly in respiratory medicine where many of our patients have chronic disease and an uncertain prognosis. An interest in respiratory physiology and how it translates into pathology is vital, and the ability to think calmly and critically is crucial.


Is there any advice you could give to a final year or FY trainee considering respiratory medicine? It is very useful to spend some time with a respiratory consultant. Make sure that you go to some specialist clinics – lung cancer or cystic fibrosis, for example – and have seen a bronchoscopy being performed. It is good if one of your audits or QI projects has been based in respiratory, too – the British Thoracic Society do a number of annual audits for which willing data collectors are always required. Try to find a mentor within the specialty who can encourage and support you.


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