Respiratory Medicine New Curriculum Clare Ramsey June 10, 2013

Current Respiratory Course Strengths ◦ Physiology curriculum ◦ Clinical Skills sessions ◦ Unknown patient tutorial series ◦ Reasonable balance between lectures and tutorials ◦ Instructional tests added this year

Weaknesses ◦ Need better integration of radiology, pathology and

clinical diseases ◦ Some particularly sections need revision and new

instructors ID

Respiratory Course Committee Course Leader Clare Ramsey Education Coordinator Julianna van de Beuken

Anatomy/Histology Sabine Hombach-Klonisch

Pathology Paul Wawryko

Physiology Zoheir Bshouty

Radiology Rene Kreml

Pediatrics Ruben Alvaro

Infectious Disease ? In discussion with Dr Zhanel

Sleep Medicine Stephen Corne

Surgery ?

Outline of Major Principals Integration of basic physiology with radiology,

pathology, anatomy and clinical presentations of respiratory diseases and sleep disorders

Important overlap with ENT and cardiology ◦ Need integration and collaboration between

courses

Integration of longitudinal themes

M1 Shared with CV and ENT ◦ 5 weeks long

Major focus ◦ Anatomy and histology ◦ Physiology ◦ Radiology ◦ ? Pathology ◦ ? Genetics vs. integration into specific disease topics

◦ ? Immunology

M1 Anatomic approach ◦ Upper respiratory tract Nose, pharynx, vocal cords Trachea

◦ Lower respiratory tract ◦ Lung parenchyma ◦ Pleura ◦ Chest wall and neuromuscular

MI Integrate anatomy, histology and radiology ◦ Normal cross sectional anatomy ◦ Normal radiology ◦ Incorporate bronchoscopic imaging as well

M1-Physiology Lung mechanics Gas exchange and transport ◦ Some overlap here with hematology

Exercise Pulmonary function testing ◦ Practical session ◦ Could be integrated in to clinical skills

Neonatology ◦ First breath physiology

? Immunologic mechanisms

M2 Combined with ENT 4 weeks long

Respiratory M2:Proposed Topics Introduction Obstructive lung diseases ◦ COPD, Asthma, Bronchiectasis

Restrictive lung disease ◦ Interstitial lung disease, chest wall disease,

neuromuscular disorders

Pulmonary vascular disease ◦ Pulmonary hypertension , PE

Respiratory M2:Proposed Topics Pediatrics ◦ CF, respiratory distress syndrome, TTN,

congenital diseases

Infectious diseases ◦ Upper and lower respiratory tract infections ◦ TB

Sleep ◦ Normal ◦ OSA, OHV, central sleep apnea, narcolepsy, RLS

Respiratory M2:Proposed Topics Pleural diseases Oncology ◦ Lung cancer ◦ Mesothelioma

Occupational lung disease

Respiratory M2:Proposed Topics Topics currently taught separately but should be

integrated as part of longitudinal themes or in each major disease category ◦ Ethics ◦ Role of surgery/interventional

M3- Consolidation More symptom/multiorgan disease based

problem solving approach ◦ Integration with other relevant systems ID CV ENT

◦ Integration with longitudinal themes

M3-consolidation Common symptoms to build case based

learning around ◦ Dyspnea ◦ Chronic cough ◦ Hemoptysis ◦ Chest pain ◦ Respiratory failure Hypoxemia Hypercapnia

Respiratory M3:Consolidation Integrate longitudinal themes ◦ Palliative care End stage lung disease care

◦ Indigenous Health TB cases Bronchiectasis

◦ Geriatrics COPD case Many comorbidities

Integration with other courses CVS ◦ Chest pain, dyspnea, pulmonary hypertension,

right heart failure

Hematology ◦ Oxygen transport, PE

ID ◦ URIs, pneumonia, TB

Reproduction ◦ Normal physiologic changes in pregnancy,

respiratory disease in pregnancy

Integration with other courses Oncology ◦ Lung cancers ◦ Pleural cancers

Specific topics Smoking cessation and burden