Doctorate of Medicine in Pulmonary Medicine is a super – specialty Post Doctorate course in the field of medicine. Comprehensive pulmonary medicine program include specialized treatment of specific diseases such as asthma, chronic obstructive pulmonary diseases, sleep-disordered breathing, interstitial lung diseases, cystic fibrosis, occupational lung diseases, pulmonary rehabilitation, tuberculosis, lung cancers and dedicated smoking cessation program. The course aims to develop skilled candidates in pulmonary and neural related disorders. After this course he/ she would able to take up a career in clinical and or academic Pulmonary Medicine.
Lung disease is a major cause of morbidity and mortality all over the world. Tuberculosis, which primarily involves the lungs, is reported in 1.3 to 2.5 percent of general population, The recent threat of Acquired Immuno Deficiency Syndrome (AIDS) has further aggravated the tuberculosis problem, globally and is a major problem in our country. Besides tuberculosis, there is a heavy burden of non-tuberculous lung diseases and respiratory emergencies. Diseases such as bronchial asthma, chronic bronchitis, respiratory infections, lung cancer and others, account for about 70 percent for the lung diseases seen in any large hospital in India. Asthma alone may affect 5-7 percent of adults & about 10 percent of children. Occurrence of occupational and environmental hazards has also increased. The Bhopal gas tragedy is only one example of such disasters. Respiratory failure secondary to infections, road accidents and other trauma, poisoning and intoxication, medical disorders, and several other conditions, may account for a heavy mortality. Tobacco-smoking, a widely prevalent habit, is the major cause of many lung diseases in India, responsible for 7 to 13 million patients of chronic obstructive pulmonary disease (COPD) and 0.11 to 0.21 million COPD deaths.
Critical care medicine is managed by pulmonary physicians in majority of the international and many national institutes. has been included in pulmonary programmes in several developed countries. More and more ICUs are being established all over the country. There are several other specialities such as cardiology and cardiothoracic surgery, aviation and space medicine, sports medicine, environmental and industrial medicine, where a liaison with pulmonary physicians is essential. Thus there is a great need of comprehensive training of physicians in pulmonary medicine and critical care similar to the postdoctoral fellowship programmes of the developed countries. The existing training programmes (diploma and MD courses) are not fully capacitated to deal with the emerging changes in this field. In order to incorporate all new and emerging information and new technologies it is imperative to initiate postdoctoral programmes in Pulmonary Medicine urgently.
Goals
The essential goal of the Programme is to produce postdoctoral fellows who should:
- Recognise the importance of pulmonary and critical care in the context of the health needs of the community and the national priorities in the health sector.
- Practice pulmonary and critical care ethically and in accordance with the principles of primary health care.
- Demonstrate sufficient understanding of basic sciences in pulmonary and Critical Care Medicine appropriate to the level of postdoctoral training.
- Identify social, economical, environmental, biological and emotional determinants of health in a given case, and take them into account while planning therapeutic, rehabilitative, preventive and promotive measures/ strategies.
- Diagnose and manage pulmonary and critical care disease on the basis of clinical assessment, and appropriately selected and conducted investigations
- Plan and advice measures for the prevention and rehabilitation of patients suffering from respiratory diseases and disability
- Demonstrate empathy and humane approach towards patients and their families and exhibit interpersonal behavior in accordance with the societal norms and expectations.
- Play the assigned role in the implementation of National Tuberculosis and other health programmes effectively and responsibility.
- Organize and supervise the chosen/ assigned health care services demonstrating adequate managerial skills in the field situation.
- Develop skills as a self-directed learner, recognize continuing educational needs: select and use appropriate learning resources.
Objectives
At the end of the training, a postdoctoral fellow should be able to act as a consultant in pulmonary and critical care medicine.
He/She should e able to:
- Diagnose and manage independently Common medical and lung diseases. including Tuberculosis
- Pulmonary problems of specialized nature related to other medical and surgical disciplines, occupation, industry, environment, highaltitude, aviation, under-water conditions and drowning.
- Resuscitate the critically ill and provide respiratory support.
- Diagnose and manage independently medical emergencies specially those involving the respiratory system.
- Adopt preventive measures at individual and community level against the commonly prevalent preventable medical and lung diseases.
- Various beside procedures required in medical management of patients.
- Specialized procedures for diagnosis and management of lung diseases such as fiberoptic bronchoscopy, lung and pleural biopsies, thoracocentesis, thoracostomy and image guided interventions.
- Comprehensive lung function studies including spirometry, Co diffusion capacity
- Allergy and bronchoprovocation tests.
Each DM student is required to possess a comprehensive knowledge of the basic and clinical sciences related to pulmonary medicine and critical care, and clinical skills in diagnosing respiratory and other medical disorders. He/She should have personally performed a sufficient number of both invasive and noninvasive procedures for diagnosis and treatment (such as bronchoendoscopic examination and assisted ventilation): and manage acute respiratory emergencies. He /she should also possess sufficient knowledge and experience in research methodology and development.
