Respiratory Medicine

The Respiratory Medicine Programme is dedicated to providing the highest quality of training and clinical experience across a wide range of acute Trusts. The programme is led by Nik Patel, Head of School, and Training Programme Directors Deepak Jayaram and Katherine Hurt. To find out more about their roles visit the Meet the Team webpage.

Our programme provides trainees with the best possible opportunities, support and guidance as they progress through their professional careers. The information below has been designed to ensure trainees are fully informed about the options available within the HEE KSS Respiratory Medicine training programme. Our aim is to equip physicians with both technical skills and effective training in the specific disease areas that are the principal remit of respiratory medicine. Amongst these is a wide spectrum of different respiratory conditions.

This is a truly exciting time to be enrolling into our five-year training programme to become a Respiratory Physician. Our programme aims to provide you with comprehensive exposure to all aspects of Respiratory and General Internal Medicine, preparing you for Dual Accreditation in both respective specialties.

By electing to train within the KSS region you will be given the opportunity to acquire a vast range of specialty experience in a friendly and supportive environment. The HEE KSS region provides some of the best training centres in the country.

Some of these entail inherited lung disorders like Cystic Fibrosis and Congenital Pulmonary diseases. Trainees will experience managing patients with a range of different infections, including Community Acquired Pneumonias, hospital-acquired chest infections, Ventilated Associated Pneumonias and Empyema’s.

Trainees also get plenty of practice in looking after patients with Typical and Atypical Mycobacterium Infections, TB and other lung conditions such as Bronchiectasis and Sarcoidosis. In addition, trainees have adequate exposure to rarer inflammatory diseases like Eosinophilic Lung Disease, Vasculitis and more commonly diffuse Parenchymal (Interstitial) Lung disease and asbestos-related conditions .There will be a good amount of experience on conditions such as Pulmonary Embolism, Pulmonary Hypertension and Opportunist infections including Transplant and HIV related disorders.

At HEE KSS we have centres providing dedicated services to the following conditions.

  • TB services
  • Pleural services
  • Interstitial lung disease
  • COPD
  • Emphysema with Pulmonary rehabilitation services
  • Intensive care and High dependency care services
  • Allergic conditions and Bronchial Asthma
  • Sleep medicine and sleep related disorders
  • Bronchiectasis dedicated clinics

We also have a 60 day provision for trainees to go into intensive care units and high dependency care units, giving them the opportunity to gain experience in upper airway management and caring for acutely unwell patients.

With the experience gained at both District General Hospitals and teaching hospitals in HEE KSS Trusts, trainees can effectively acquire the skills and experiences needed to become excellent, well rounded and confident Respiratory physicians.

Where do trainees train?

Our posts are organized at several different geographical locations across Kent, Surrey, East Sussex, West Sussex and London. Trainees will be given the opportunity to train across the hospitals which are clustered in four different groups. The region offers rotations in general respiratory as well as head and neck oncology, advanced rhinology and advanced otology. 

To find out more about each training location, please visit the  Local Education Provider webpage.

Kent

Kent and Canterbury Hospital, Canterbury – East Kent Hospitals University Foundation Trust

William Harvey Hospital, Ashford – East Kent Hospitals University Foundation Trust

Queen Elizabeth and Queen Mother Hospital, Margate – East Kent Hospitals University Foundation Trust

Maidstone Hospital, Maidstone – Maidstone and Tunbridge Wells NHS Trust

Tunbridge Wells Hospital, Pembury – Maidstone and Tunbridge Wells NHS Trust

Medway Maritime Hospital, Medway – Medway NHS Foundation Trust

Darent Valley Hospital, Dartford – Dartford and Gravesham NHS Trust

Surrey

Ashford and St Peter’s Hospital, Chertsey – Ashford and St. Peter’s Hospitals NHS Foundation Trust

Frimley Park Hospital, Frimley – Frimley Health NHS Foundation Trust

Royal Surrey County Hospital, Guildford – Royal Surrey NHS Foundation Trust 

East Surrey Hospital, Redhill – Surrey and Sussex Healthcare NHS Trust

Sussex

Conquest Hospital, St. Leonards-on-Sea – East Sussex Healthcare NHS Foundation Trust

Eastbourne District General Hospital, Eastbourne – East Sussex Healthcare NHS Foundation Trust

Royal Sussex County Hospital, Brighton – Brighton and Sussex University Hospitals NHS Trust

Worthing Hospital, Worthing – Western Sussex Hospitals NHS Foundation Trust

St Richard’s Hospital, Chichester – Western Sussex Hospitals NHS Foundation Trust

Princess Royal Hospital, Haywards Heath – Brighton and Sussex University Hospitals NHS Trust

London Teaching Hospitals

Trainees will also be given access to placements at London teaching hospitals where they can further deepen their sub-specialty knowledge at world-renowned centres of expertise.

These include:

– Royal Brompton Hospital

– Royal London and London Chest Hospitals

– Royal Free Hospital

– St Thomas’ Hospital

– Kings College

– St George’s Hospital

Paediatric rotations in London

Currently there is no specific tertiary paediatric respiratory department in KSS, therefore trainees will need to do a 6 month rotation in London (depending on space) at either:

The Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust  

Great Ormond Street Hospital, Great Ormond Street Hospital for children NHS Trust.

Within this framework, we aim where possible for rotations to be family-friendly, and to minimise the need for travel or relocation during the programme. We therefore ordinarily attempt to rotate trainees through hospitals that are geographically close, i.e. within a regional cluster (Kent, Surrey, East Sussex and West Sussex). Typically, you can expect to spend the first 2 years (ST3, ST4) in geographically close District General Hospitals (DGHs) within your sub-rotation, before gaining tertiary centre experience at our teaching hospitals placements, (i.e. Royal Sussex County Hospital or London placement hospitals) in the following 2 years (ST5, ST6). These are allocated in accordance to your training needs and curriculum progress.

The final year (ST7) is an opportunity to consolidate your training with a view towards planning your post-CCT career, and is usually spent in a DGH placement within your sub-rotation. Please note, this is decided in accordance to the request made by the trainee and availability of the placement, which is decided by the training programme director in consultation with HEE KSS. Occasionally there may be the need to move trainees outside of their allocated cluster for a variety of reasons, e.g. a particular curriculum training requirement, trainee request, service provision within the region and others.

Teaching and learning

Our trainees have dedicated educational supervisors and locally organised teaching, led by the Royal College of Physicians (RCP) tutor in each Trust, who meets regularly with the Head of School, fellow tutors and trainee representatives to be updated on the latest developments in training and to ensure that high quality training occurs in every Trust.

Specialty Training Committee

The Specialty Training Committee (STC), along with the HEE KSS team, very actively supports our trainees and consultants in the use of novel teaching and assessment methods, including curriculum-mapped Regional Training Days. Furthermore, the School ensures that the trainee voice is at the heart of all its activities and plans, with active trainee representatives in STC meetings ensuring everything we do is for the benefit of our trainees.

Practical Procedures

We offer a range of fantastically unique training opportunities in practical procedures in the region. These include:

  • Thoracic Ultrasound training by accredited trainers
  • Endobronchial Ultrasound with Rapid Onset Slide Examination (EBUS training with ROSE)
  • Basic and Interventional Bronchoscopy
  • Medical Thoracoscopy
  • Cardiopulmonary Exercise Testing (CPEX)
  • Non-invasive Ventilation (NIV) -BIPAP,CPAP & Optiflow Oxygen delivery
  • Safe Chest Drain insertions
  • reporting and reviewing Lung Function Testing
  • in flight assessments of Oxygen Requirements
  • interpretation of CT scan and PET CT scans

Training courses

At HEE KSS we offer several different training courses at world-class centres to help trainees augment their knowledge and expertise in Respiratory Medicine. Examples of courses include:

  • Safety in chest drain insertion Course
  • Thoracic Ultrasound Course
  • Basic EBUS training Course
  • Bronchoscopy and Medical Thoracoscopy course
  • Interventional Bronchoscopy and Medical Thoracoscopy Course
  • Semi rigid Thoracoscopy course

Other opportunities

We also offer trainees excellent opportunities to participate in our enriching multi-disciplinary meetings (MDM) with support from Oncologists and Thoracic surgeons who travel from renowned centres around the country, along with Radiologists, Chest consultants and Palliative care teams. Here trainees can extensively learn about the care of patients with Lung Cancer, Mesothelioma and Mediastinal tumours. We also hold MDMs for patients with Chronic Obstructive Pulmonary Disease and Interstitial Lung Disease.

Throughout training we also provide excellent opportunities to trainees to develop leadership roles by attending many leadership training courses and training days.

Respiratory Medicine is a specialty that attracts a high level of opportunities for research; in fact at HEE KSS, research during training is encouraged. There are opportunities in research in subjects like Pulmonary Hypertension, Interstitial lung disease, COPD and Lung cancer. Trainees are encouraged to explore these local opportunities as well as opportunities outside our region by taking up Out Of Programme Research (OOPR). Trainees are advised to plan time out of programme early, and should discuss with both their educational supervisor and HEE KSS training programme director, as applications are required at least 6 months ahead of time in order to manage vacancies within the programme accordingly. 

The programme shares its regional training days with North Thames and South Thames deaneries, and mock viva days are shared with Wessex deanery.