Respiratory Medicine

The Respiratory Medicine Programme is part of the HEKSS School of Medicine, established in April 2007, dedicated to providing the highest quality of training and clinical experience across a wide range of acute Trusts. We are here to provide you with the best possible opportunities, support and guidance as you progress through your professional career, and the information below has been designed to ensure you are fully informed about the options available to you within the HEKSS Respiratory Medicine training programme.

This is a truly exciting time to be enrolling into our training programme to become a Respiratory Physician with our 5 year Respiratory Medicine training programme, which 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.

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 to be a physician and to ensure that high quality training occurs in every Trust.

The Specialty Training Committee (STC), along with the HEKSS 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 very active trainee representatives in STC meetings ensuring everything we do is for the benefit of our trainees.

By electing to train within the Kent, Surrey and Sussex region you will be given the opportunity to acquire a vast range of specialty experience in a friendly and supportive environment. Training in the HEKSS region provides some of the best training centres in the country. 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; and St George’s Hospital.

At HEKSS our aim is to equip physicians with both technical skills and effective training in specific disease areas that are the principal remit of respiratory medicine. Amongst these is a wide spectrum of different respiratory conditions.

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 and Hospital acquired chest infections to Ventilated Associated Pneumonias and Empyema’s. They will also have 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 will 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 the conditions such as Pulmonary Embolism, Pulmonary Hypertension and Opportunist infections including Transplant and HIV related disorders.

At HEKSS 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 offer our 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.

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

Practical Procedures

Respiratory - practicalWe 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

Respiratory TrainingAt HEKSS we offer several different training courses at world-class centers 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

Where we provide Training

Our posts are organized at several different geographical locations across Kent, Surrey, East Sussex and West Sussex. Trainees will be given the opportunity to train across the hospitals which are clustered in four different groups (see map and key below).

Respiratory map

Respiratory KSS map key

Our trainees will also be given a fantastic opportunity to train at world renowned London teaching Hospitals as part of their 5 year rotation (Which will be negotiated on a yearly basis with London centres). These affiliated hospitals include: –

Resp London

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 HEKSS. 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.

T&H Orange

Research

Respiratory Medicine is a specialty that attracts a high level of opportunities for research; in fact at HEKSS, research during training is encouraged. We have opportunities in research in our region 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 discussing with both their educational supervisor and HEKSS training programme director, as applications are required at least 6 months ahead of time, in order to manage vacancies within the programme accordingly.  Trainees may take time out of programme for reasons other than research; further information can be found here.

Less-than-full-time training (LTFTT)

At HEKSS we understand the needs and necessities of every trainee’s life circumstances and therefore show support by providing the opportunity to work in respiratory medicine on a less-than-full-time basis (LTFT), if needed. 

Library Facilities

We provide excellent Library facilities at all hospitals throughout the rotations in HEKSS with numerous accessible electronic journals. The staff are well trained, friendly and approachable to facilitate with literature or journal search.

Testimonials of trainees

“It is a pleasure to be a HEKSS trainee as I am enjoying my work and there are ample opportunities for learning and training in the region. The learning opportunities range from Thoracic Ultrasound, Bronchoscopy skills, EBUS and Medical Thoracoscopy. There are number of Respiratory and GIM training days which are excellent learning opportunities, as well as covering the curriculum. The HEKSS team have been organising frequent courses on Thoracic USS, Bronchoscopy and EBUS. There has also been focus on teaching and leadership skills and HEKSS has arranged short courses for this. Finally it covers a large geographical area but the TPDs and the team are very friendly and cooperative in order to accommodate you, considering family and training needs.”

Ashfaq Hussain (ST6 Trainee)

Meet the Training Programme Director

Dr Syed Arshad Husain FRCP, FCCP, Consultant Respiratory Physician, Maidstone Hospital

Syed Husain

I am currently the Training Programme Director for Respiratory medicine at HEKSS.

I was trained in the Southwest region, getting my CCST in Respiratory Medicine in 2005, I then completed my OOPE at Royal Brompton Hospital London and I worked as an Interventional Bronchoscopy Fellow in Lille France before taking up a Respiratory Consultant post in Maidstone Hospital.

I also work as the Executive Board member of the European Association of Bronchology Interventional Pulmonology (EABIP). I am also a fellow member of the Royal College of Physicians, UK, and also a Fellow of the American College of Chest Physicians.

I have worked for the last three years for the British Thoracic Society (BTS) as a Consultant member for the Specialist Advisory Group (SAG) with interventions in the Chest. I am also currently involved in research being the Principle Investigator for LASER multi centred trial in UK on allergic asthma patients.

In Maidstone hospital I am the Trust Lead for Innovations and also established the EBUS services with ROSE. I have been organising regularly the highly educational and very popular International Interventional Bronchoscopy & Thoracoscopy courses since 2008. I am also the course director for Thoracic Ultrasound courses, safety Chest drain insertions and Endobronchial Ultrasound courses in UK. In addition, I have also been involved in teaching in training medical students. I also introduced Medical Thoracoscopy services in Teaching Hospitals in Karachi Pakistan including for a Charitable Hospital for the poor & underprivileged on a sabbatical in 2008-09.

My specialist interests are in the field of bronchial asthma, interventional Bronchoscopy, Thoracic Ultrasound and Lung cancer. Other activities include serving as a Patron for a local breath easy group. I enjoy cricket, swimming and squash as leisure activities.

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