Dr Ahsan Akram, ST5
‘Definition’ of specialty

It's  a varied and challenging mix of problems ranging from acute medical emergencies through to palliative care.

Overview of training programme 

The respiratory medicine curriculum (2010) encompasses three years of respiratory training, with a total of five years when dual accrediting with General (Internal) Medicine (GIM). Most trainees dual accredit (with GIM) but opportunities still exist for accreditation with critical care. Within respiratory there are excellent opportunities to sub-specialise during training and areas range from cystic fibrosis, pleural disease, pulmonary infections, sleep medicine through to lung cancer, airways disease, pulmonary fibrosis and transplant medicine.

Exam requirements

Entry to respiratory medicine will require an MRCP (UK). During training you will be expected to pass the MRCP (UK) Respiratory Specialty Certificate Exam.

Other requirements

Trainees will have exposure to and be expected to become trained in the following areas:

  • Chest drain insertion
  • Pleural ultrasound training (2010 curriculum to level 1)
  • Bronchoscopy (diagnostic and interventional)
  • Endobronbchial ultrasound (EBUS) training
  • Medical thoracoscopy
  • Lung function testing
Opportunities for out of programme research

Respiratory medicine has always had close links with academia. Time out of programme for dedicated research (OOPR) training is generally encouraged and there is a breadth of opportunities ranging from basic science to epidemiological and clinical research. Most trainees who take time OOPR will register for a higher degree.

A day in the life of a Registrar

The work can be very variable. A typical day can include any combination of the following

  • Time on-call seeing respiratory referrals from acute receiving units, critical care and other wards. The patients referred are often very interesting and range from patients with chronic respiratory illness, to previously well and fit individuals.
  • Ward rounds for respiratory inpatients
  • Clinics including sub-specialty clinics (tuberculosis [TB]/fibrosis/sleep)
  • Attending X-ray meetings, oncology multi-disciplinary team (MDT) meetings
  • Procedures including bronchoscopy, EBUS and medical thoracoscopy
  • Chest drain insertion

The work is varied and the intensity remains variable. As up to 30% of hospital admissions to medical receiving units are for primary respiratory problems we are often kept busy during on-calls.

Pros and Cons of working in this specialty


  • A variety of cases seen ranging from acute medical emergencies, management of chronic illness and palliation for respiratory conditions
  • Close links with critical care, accident and emergency and acute receiving units
  • Practical procedures including interventional bronchoscopy, medical thoracoscopy and pleural ultrasound
  • Ability to develop sub-specialist interests
  • Working closely with various specialties (radiology, oncology, microbiology)


  • Sputum
How this specialty differs to others and why I chose it

The biggest appeal was the breadth and diversity of the specialty, the integration with research and the ability to perform practical procedures. Respiratory medicine will continue to evolve with new treatments and investigation methods make it an exciting specialty to be a part of.

Tips for success in applying for this specialty

Show you are keen. Become involved in activities within departments e.g. audit, attend some multi-disciplinary meetings (lung cancer, fibrosis etc.) and observe practical procedures such as bronchoscopy and medical thoracoscopy. Respiratory physicians are a friendly bunch and are always happy to help if someone shows an interest in their specialty.

For more information

Joint Royal Colleges of Physicians Training Board (JRCPTB) respiratory medicine

British Thoracic Society