Figures
- Figure 1
Delphi rounds.
Tables
- Table 1
Certification status of respondents in the two Delphi rounds
Certification status Delphi 1 Delphi 2# Trainee 38 (10.1%) 17 (7.0%) Certified <5 years 71 (19.1%) 52 (21.3%) Certified >5 years 234 (63.1%) 155 (63.5%) Other (e.g. no certification, informal recognition) 28 (7.5%) 20 (8.2%) Total 371 244 #: Not all Delphi 2 respondents answered this question.
- Table 2
Paediatric respiratory medicine syllabus 2019
Module 1. Structure and function of the respiratory system (mandatory) 1 Anatomy and development
2 Applied respiratory physiology and pathophysiology (including common respiratory symptoms)
3 Immunology and defence mechanisms
4 Environmental determinants of childhood respiratory health and disease
Module 2. Evaluation of respiratory symptoms and signs (mandatory) Evaluation and management of: 1 Acute and chronic cough
2 Stridor, wheezing and other respiratory noises
3 Dyspnoea and breathlessness
4 Respiratory distress and respiratory insufficiency
5 Questionnaires in clinical assessment
Module 3. Pulmonary function and diagnostic testing (mandatory) Measurement, performance and interpretation of: 1 Volume–time and flow–volume curves
2 Static lung volumes
3 Respiratory mechanics
4 Reversibility testing
5 Bronchial provocation testing
6 Cardiopulmonary exercise testing
7 Blood gases and oximetry
8 Lung diffusion
9 Ventilation homogeneity
10 Respiratory muscle function
11 Equipment maintenance, hygiene and infection control during test procedures
12 Definitions of measured indices
13 Choice and appropriate use of reference values
14 Test variability and reproducibility
15 Quality control in paediatric lung function laboratories
16 Health and safety issues in relation to paediatric lung function testing
17 Lung function in non-cooperative children
Additional diagnostic tests Measurement, performance and interpretation of: 1 Exhaled nitric oxide measurements
2 Induced sputum testing
3 Assessing respiratory risk of air travel, altitude and diving
Module 4. Airway endoscopy (mandatory) 1 Organisation of an endoscopy suite including equipment maintenance and hygiene
2 Indications for, contraindications, performance and interpretation of flexible bronchoscopy and associated procedures
3 Sedation and anaesthesia for paediatric flexible bronchoscopy
4 Indications for and contraindications of interventional bronchoscopy techniques other than foreign body removal
5 Indications for and contraindications of rigid bronchoscopy
6 Evaluation and management of risks and complications of airway endoscopy
Module 5. Imaging (mandatory) 1 Indications for, interpretation and basic principles of conventional radiography, computed tomography, magnetic resonance imaging, ultrasonography and isotope imaging methods
2 Comparative radiation burden of the different procedures
3 Indications for interventional radiology
Module 6. Respiratory infections (mandatory) Epidemiology, diagnosis, management and complications of: 1 Acute upper respiratory tract infections
2 Acute lower respiratory tract infections
3 Pleural infections
4 Tuberculosis (TB) and non-TB mycobacterial diseases
5 Diagnosis and management of respiratory infections in high-risk situations
6 Diagnosis and management of protracted bacterial bronchitis and non-CF bronchiectasis
7 Lung involvement in the immunocompromised host
8 Microbiology and infectivity
9 Pharmacology of antimicrobial and antiviral drugs
10 Immunisations for respiratory pathogens
11 Accuracy and interpretation of microbiological tests
Module 7. Asthma and wheezing disorders (mandatory) 1 Different phenotypes and their different pathologies and long-term outcomes (including underlying pathophysiology and basic epidemiology)
2 Environmental factors relevant to asthma and other wheezing disorders
3 Difficulties in diagnosis and differential diagnosis
4 Management of asthma at different ages including age-related pharmacology, and pharmacological and non-pharmacological management
5 Management of difficult and severe asthma
Module 8. Allergic disorders (mandatory) Epidemiology, diagnosis and management of: 1 Anaphylaxis
2 Allergic rhinitis
3 Bronchopulmonary aspergillosis
4 In vivo and in vitro testing for allergic disorders
5 Prevention measures
6 Diagnosis and basic management of associated allergic conditions
Module 9. Cystic fibrosis (CF) (mandatory) 1 Epidemiology, genetics, pathophysiology and prognosis
2 Screening and diagnosis
Epidemiology, diagnosis, management and complications of: 3 CF lung disease
4 Extrapulmonary manifestations of CF including nutrition
5 Microbiology relevant to CF, including cross-infection
Module 10. Congenital malformations (mandatory) 1 Epidemiology, diagnosis and management of congenital malformations affecting the respiratory system
2 Antenatal diagnosis and management
3 Follow-up and long-term outcomes
Module 11. Bronchopulmonary dysplasia/chronic neonatal lung disease (mandatory) 1 Epidemiology, aetiology, prevention, diagnosis, management and complications
2 Follow-up and long-term outcomes
Module 12. ENT (ear, nose and throat) and aerodigestive-related respiratory problems (mandatory) 1 Aspiration due to disorders of feeding and swallowing
2 Gastro-oesophageal reflux
3 Laryngeal and tracheal disorders
4 Foreign body inhalation
Module 13. Respiratory presentation or complications of systemic/extrapulmonary conditions (mandatory) 1 Primary immunodeficiency syndromes
2 Secondary immunodeficiency syndromes/immunosuppression
3 Cardiac disease
4 Gastrointestinal, liver and kidney disease
5 Haematological disease
6 Obesity
7 Connective tissue diseases
8 Musculo-skeletal and neuromuscular diseases
Module 14. Rare diseases (mandatory) Pathophysiology, genetics, aetiology, diagnosis and management of: 1 Primary ciliary dyskinesia
2 Bronchiolitis obliterans
3 Interstitial lung diseases
4 Pulmonary vascular disorders including pulmonary arterial hypertension
5 Pulmonary haemorrhage
6 Pleural diseases including spontaneous pneumothorax
7 Drug- and radiation-induced lung diseases
8 Other rare lung diseases
Module 15. Respiratory sleep medicine and breathing control disorders (mandatory) 1 Physiology and pathophysiology of sleep relevant for paediatric respiratory medicine
2 Indications and interpretation of the results of polysomnography
Epidemiology, aetiology, diagnosis of, screening for, and complications of: 3 Obstructive sleep apnoea syndromes
4 Central sleep apnoea/hypoventilation
5 Dysfunctional breathing/hyperventilation syndromes
Module 16. Long-term management of chronic respiratory disorders (mandatory) 1 The multidisciplinary team
2 Health education (preventive medicine)
3 Patient education and self-management
4 Nutritional management
5 Psychological support for children and families
6 Principles of physiotherapy techniques, indications and limitations
7 Sport and exercise therapy
8 Management of end-stage lung disease including palliative care
9 Indications for lung transplantation and non-surgical care of the lung transplant patient
10 Assessment of quality of life
Module 17. Inhalation therapy (mandatory) 1 Basic science of aerosol production and delivery
2 Indications for inhalation therapy
3 Available techniques and their advantages and limitations
4 Delivery of drugs in children with artificial airways
Module 18. Technology-dependent children (mandatory) Management, monitoring and weaning of: 1 Home oxygen therapy
2 Invasive and noninvasive home ventilatory support
3 Tracheostomy
4 Basic technical understanding of equipment
5 Airway clearance techniques
6 Recognition of associated problems (including neurodevelopmental assessment)
Module 19. Epidemiology and environmental health (mandatory) 1 Basic understanding of epidemiological principles
2 Impact of indoor and outdoor air pollution on respiratory health
3 Smoking impact, prevention and cessation
4 The burden of paediatric respiratory diseases on healthcare resources
Module 20. Evidence-based medicine (mandatory) 1 Scientific literature appraisal
2 Understanding and application of the ethical principles of paediatric research
Module 21. Research (optional) 1 Basic understanding and application of the principles of planning, designing, conducting, analysing and publishing research projects
