The speciality of internal medicine that studies and manages disorders and diseases of the respiratory system, other related systems.
The speciality of internal medicine that studies and manages disorders and diseases of the respiratory system, other related systems, its critical care and sleep medicine are called pulmonary medicine or pulmonology. Diseases that affect the mouth and nose, sinuses, larynx, pharynx, trachea, bronchial tubes, lungs and diaphragm, all come under pulmonology. These diseases include asthma, tuberculosis, cystic fibrosis, COPD, emphysema, obstructive sleep apnea, lung cancer, pulmonary hypertension, pneumonia, bronchitis, covid-19 pneumonia, and so on. Pulmonologists use diagnostic tools and procedures such as physical examinations, medical and genetic history, blood tests, pulmonary function tests, x-rays, chest fluoroscopy, bronchoscopy, biopsies, and sleep study. They perform special procedures such as airway ablation, pulmonary hygiene, etc to manage such conditions. In the earlier days, pulmonary medicine was solely focused on studying tuberculosis. However, the speciality has undergone radical transformation and development through research over the years. The recent promising developments in the field include guided needle aspiration, virtual bronchoscopy, biopsy with semi-rigid pleuroscopy, electromagnetic navigation bronchoscopy, surgical reduction of lung volume, leukotriene blocking agents in asthma treatment, lung transplantation from non-beating heart donors, use of positron emission tomography in diagnosing lung cancer, the ineffectiveness of corticosteroids in acute COPD, and so on. Sleep medicine and critical pulmonary care are also witnessing growth.
Doctor of medicine in pulmonary medicine is a course designed to produce competent specialists adept at handling all cases of the respiratory and associated systems. As more people succumb to chronic pulmonary diseases due to climate change and rising air pollution, specialists of the science are the need of the hour. The course is rigorous and requires a multidisciplinary approach; cardiology, paediatrics, infectious diseases, internal medicine, emergency medicine, are some of the other areas included. The syllabus includes topics such as general medicine, development of the respiratory tract, transport of blood gases diffusion, diffusion capacity, diagnostic procedures, assessment of lung function, interstitial lung disease including drug-induced/ radiation-induced lung disease, environmental lung disease including indoor/outdoor air pollution, high attitude/ diving injuries, pulmonary vascular disorders including pulmonary emboli, vasculitis syndromes, pulmonary hypertension, COR pulmonale, surgical aspects of pulmonary medicine including lung transplantation, immunology as applied to the lung, cardiology, radiodiagnosis, anesthesiology, pediatrics, social & preventive medicine, radiotherapy, and other clinical, and practical areas. Students on course completion are expected to possess the knowledge and skills to assess, manage and care for all types of respiratory and associated system disorders and diseases, carry out and assist in common and advanced procedures(both invasive and non-invasive) such as fiberoptic bronchoscopy, lung and pleural biopsies, thoracocentesis, thoracostomy and image-guided interventions and so on. Tests and studies such as lung function study, spirometry, allergy tests, etc should not be beyond their comprehension. They will be taught to interpret special investigative tests and procedures such as radiography, x-rays, endoscopies and so on. The course seeks to empower them to initiate, pursue and be part of research undertakings, and to teach and train paramedics and other medical students in all situations. They are expected to utilize their knowledge and skills with compassion and within the ambits of professional and legal ethics.
Students who have completed MD in internal medicine, chest medicine or paediatric medicine are eligible to apply for this three-year-long course. The course shall include clinical and ICU training and requires the candidates to keep a logbook and publish a research paper during the time period. As pulmonary medicine is critical in today’s changing world, successful students shall have no dearth of opportunities. They can be part of the government initiative to eradicate tuberculosis or practice as private consultants. They can also work as emergency health care experts, lecturers or as researchers who push the boundary of knowledge and medicine.