Welcome to respiratory medicine, undoubtedly the best specialty! Here is some advice from previous trainees to make your the transition into ST4 a little easier.
Understand the requirements of training thoroughly! Reading the Respiratory Medicine and GIM ARCP decision aids is a great start and gives you an idea of what you need to achieve to get through the ARCP each year.
Start a logbook. Keep track of all procedures (e.g. bronchoscopy, EBUS, pleural aspirations, chest drains etc) from the start. You can download a clinical logbook template below, or use your own, just make sure it stays up to date.
Get ultrasound trained as soon as possible. Do a course to teach you the basics (e.g. online BTS course, FAMUS course) and find supervisors for scans early. Keep a log of all your scans and get signed off (e.g. with DOPS) when you have the numbers and confidence. Be aware that even after sign-off there may still be lots of scans you want a second opinion for – that is totally normal! For more info about ultrasound training requirements see here.
Make crib sheets/prepare for your clinics in advance. This gives you an opportunity to have a read of some key guidelines in advance and ask any questions of the consultant before seeing the patient. It can also be helpful to keep a handy record of key management of common conditions for reference e.g. in a notebook or online app – helpful for the SCE and general patient management.
Get assessments done early. ARCP comes around surprisingly quickly and it can take some time for people to fill out tickets. It’s helpful to get some early DOPS for pleural aspirations, chest drains and bronchoscopy in order to show development in your skills over the course of the year. If you talk through clinic patients with supervisors – make the most of the opportunity to get an ACAT or OPCAT.
Don’t feel pressured into doing things just because everyone else is. If you have no interest in a career in academic medicine then you don’t need a PhD. Your energy may be better spent contributing to an ongoing project, joining a BTS committee or doing a really high quality QIP project. Speak to other trainees about what they are up to. Training days are a great opportunity to network, find out what other people are up to and what the rotations are really like.
Think about OOPs early (i.e. ST4 if possible). They take a lot of planning due to workforce management and you usually need to provide at least 6 months’ notice.
Plan early to take time out to do extra learning e.g. in smoking cessation clinic, lung function lab or with the respiratory physios. You can use SDT time, admin time or study leave to support this where necessary and don’t forget to document your experience through reflections.
Sign up to contents alert emails for the major respiratory journals to help keep up to date.
Don’t be afraid to ask questions of consultants, registrars and the wider MDT – you can’t be expected to suddenly become a respiratory specialist overnight!
HESW Respiratory 