Postgraduate School of Respiratory Medicine

Integrated (i.e., core) training objectives
The trainee must have acquired satisfactory theoretical knowledge and professional competence in the clinical and instrumental diagnosis and treatment, including emergency and urgent conditions, of the most common internal medicine diseases. The trainee must acquire fundamental knowledge of the pathophysiology of various organs and systems, the theoretical and practical knowledge necessary to recognize diseases affecting the various body systems, the theoretical and practical knowledge of the main areas of instrumental and laboratory diagnostics related to the aforementioned diseases, and the ability to evaluate the connections and influences of internal medicine and specialists. Therefore, the trainee must be able to recognize the clinical and functional symptoms and signs of diseases affecting various organs and systems, having acquired the fundamental diagnostic, therapeutic, psychological, and ethical knowledge necessary for a comprehensive patient perspective. To this end, the trainee must develop the ability to clinically assess the patient based on the medical history and physical examination; develop critical and analytical diagnostic skills; Become familiar with the main diagnostic procedures and laboratory and instrumental investigations; recognize and be able to address major medical emergencies; become familiar with therapeutic resources to plan their optimal use and recognize their indications and contraindications, as well as the effects of interactions and potential iatrogenic effects; acquire fundamental knowledge of clinical research methodologies and pharmacological trials; and understand the fundamental issues related to prevention, public health, and social medicine. The trainee must have acquired satisfactory theoretical knowledge and professional competence in the recognition and treatment, in emergency situations, of the most common pathologies. Finally, the trainee must also have clinical and therapeutic knowledge of the most common pathologies covered by the other categories of the class.

Basic Educational Objectives
The trainee specialist must perfect their fundamental knowledge of biology, biochemistry, physics, morphology, physiology, general pathology, genetics, and microbiology in order to acquire further knowledge of the biological and functional bases of respiratory diseases.

General Educational Objectives
The trainee specialist must learn the fundamentals of biology, etiopathogenesis, pathophysiology, and pathology, develop an understanding of the phenomenological coexistence of various disease processes, and acquire knowledge of epidemiology, methodology, and physical, laboratory, and instrumental semiotics, as well as diagnostic imaging, including ultrasound and nuclear medicine techniques.

Educational objectives specific to the School
The trainee specialist must acquire:
- advanced knowledge of the etiopathogenetic mechanisms that determine the development of respiratory diseases and knowledge of respiratory pathophysiology;
- technical and theoretical knowledge in all laboratory areas applied to respiratory diseases, with particular emphasis on cytohistopathology, immunoallergological techniques, techniques for assessing the function of the various tracts of the respiratory system, and pulmonary cardiohemodynamics;
- practical methodological knowledge in functional respiratory diagnostics, with particular emphasis on the assessment of thoracopulmonary mechanics, intrapulmonary gas exchange, ventilation regulation mechanisms, pulmonary hemodynamics, sleep-disordered breathing, critically ill patient monitoring techniques, and methods for assessing respiratory disability;
- knowledge and interpretative skills in diagnostic imaging and various diagnostic techniques relevant to respiratory diseases;
- Adequate skills in Interventional Pulmonology to independently manage endoscopic diagnosis and treatment of the airways, pleural space, and respiratory systems accessible with video-endoscopic techniques, including performing biopsies at various sites, sampling bronchoalveolar lavage fluid, and using complementary and innovative techniques for the diagnosis and treatment of respiratory diseases;
- Theoretical knowledge and clinical practice required to treat the main conditions that constitute respiratory emergencies, with particular expertise in the intensive and subintensive care treatment of patients with critical respiratory failure; adequate skills to promote all actions aimed at early recognition and management of patients with acute and chronic respiratory failure, the most common emergencies in internal medicine and critical illnesses, the application of mechanical ventilation, and the formulation and administration of special diets via enteral and parenteral routes;
- Theoretical and practical knowledge of the pathophysiology of breathing during sleep and the influence of sleep on various respiratory diseases; Acquisition of clinical experience in the recognition, diagnosis, and treatment of sleep-related breathing disorders;
- Theoretical and practical knowledge required for the epidemiological assessment, prevention, clinical and instrumental diagnosis, and treatment (in its various forms) of lung cancer; must know and be able to apply the relevant standards of good clinical practice.
- Knowledge of rehabilitation techniques and disability assessment methods, particularly regarding respiratory diseases, with acquisition of clinical experience required for the management of critically ill patients, especially regarding nutrition, physiotherapy, and weaning from mechanical ventilation.
- Knowledge required for the epidemiological assessment, prevention, microbiological, immunological, and clinical and instrumental diagnosis, treatment, and rehabilitation of tuberculosis and infectious diseases of the respiratory system. Must know and be able to apply the relevant standards of good clinical practice and prophylaxis.
- knowledge required for the epidemiological assessment, instrumental clinical diagnosis, and treatment of cystic fibrosis and its various clinical problems, and must be familiar with the relevant standards of good clinical practice and be able to apply them in controlled clinical trials;
- knowledge required for the standards of good clinical practice and be able to apply them in clinical trials;
- ability to analyze one's own motivations, with full awareness of one's moral presuppositions, and to relate them to the ethical and deontological standards required for human care;
- fundamental knowledge of the legal and healthcare organizational aspects of the profession, with adequate understanding of the ethical implications of medical developments



Rileva lingua

Italiano

Inglese

Francese

Inglese

Italiano

Spagnolo
Sono attività professionalizzanti obbligatorie per il raggiungimento delle finalità didattiche della tipologia:
a) avere seguito almeno 150 casi di patologia respiratoria in reparti di degenza o in DH, avendo redatto personalmente e controfirmato sia la cartella clinica (anamnesi, esame obiettivo, programmazione degli interventi diagnostici e terapeutici) che la relazione di dimissione (epicrisi), con presentazione di almeno 10 casi negli incontri formali della scuola;
b) avere seguito almeno 100 casi di patologia respiratoria in ambulatorio con esecuzione, quando indicati, dei più co-muni esami funzionali ed immuno-allergologici;
c) avere partecipato attivamente ad almeno 100 visite di consulenza specialistica;
d) avere partecipato ad almeno 70 turni di guardia/sottoguardia, assumendo la responsabilità in prima persona nei turni degli ultimi 2 anni ( consultazione tutor);
e) avere seguito in videoendoscopia almeno 80 sedute di Pneumologia interventistica e ne ha eseguite personalmente almeno 30;
f) avere eseguito e correttamente interpretato almeno 200 esami funzionali completi della respirazione;
g) avere partecipato attivamente alla gestione di almeno 50 casi di insufficienza respiratoria cronica grave nelle sue varie fasi clinico-evolutive con acquisizione delle relative pratiche terapeutiche, comprese quelle della terapia intensiva, e semi-intensiva.
h) avere partecipato alle esecuzione di almeno 3 trial clinici randomizzati;
i) avere partecipato attivamente alla gestione di almeno 30 casi di pneumo-oncologia incluse le fasi della chemioterapia, radio-terapia, terapie biologiche;
l) 70 Imaging Toracico (RX, TC, RMN, PET): Interpretazione e discussione con il Tutor di casi paradigmatici.
m) 50 Test di reversibilità e di broncostimolazione da eseguire in autonomia.
n) 200 emogasanalisi arteriosa.
o) 150 monitoraggi incruenti della saturimetria
p) 40 6-min walking test da eseguire in autonomia (esecuzione e refertazione)
q) 30 polisonnografie in autonomia ( esecuzione, estrapolazione tracciati, interpretazione e refertazione)
r) 30 intradermoreazioni alla Mantoux o test biologici indicatori di infezione tbc (da eseguire e valutare in autonomia).
s) 15 punture pleuriche esplorative/toracentesi anche in eco guida/toracoscopie mediche, 30 ecografie toraciche, 10 po-sizionamenti di drenaggi pleurici in assistenza.
t) 5 test da sforzo cardiopolmonare.

Lo specializzando potrà concorrere al diploma dopo aver completato le attività professionalizzanti.

Lo specializzando, nell'ambito del percorso formativo, dovrà apprendere le basi scientifiche della tipologia della Scuola al fine di raggiungere una piena maturità e competenza professionale che ricomprenda una adeguata capacità di inter-pretazione delle innovazioni scientifiche ed un sapere critico che gli consenta di gestire in modo consapevole sia l?assistenza che il proprio aggiornamento; in questo ambito potranno essere previste partecipazione a meeting, a congressi e alla produzione di pubblicazioni scientifiche e periodi di frequenza in qualificate istituzioni italiane ed estere utili alla sua formazione
3.111 / 5.000
Mandatory professional development activities to achieve the educational objectives of this type of training include:
a) having followed at least 150 respiratory disease cases in inpatient or outpatient departments, having personally compiled and countersigned both the medical record (anamnesis, physical examination, planning of diagnostic and therapeutic interventions) and the discharge report (epicrisis), with presentation of at least 10 cases in formal school meetings;
b) having followed at least 100 respiratory disease cases in the outpatient clinic, performing, when indicated, the most common functional and immuno-allergy tests;
c) having actively participated in at least 100 specialist consultation visits;
d) having participated in at least 70 on-call/under-call shifts, assuming direct responsibility for the shifts in the last 2 years (tutor consultation);
e) having followed at least 80 interventional pulmonology sessions using videoendoscopy and having personally performed at least 30 of them;
f) Have performed and correctly interpreted at least 200 complete respiratory functional tests;
g) Have actively participated in the management of at least 50 cases of severe chronic respiratory failure in its various clinical and developmental stages, with knowledge of related therapeutic practices, including those of intensive and semi-intensive care.
h) Have participated in at least 3 randomized clinical trials;
i) Have actively participated in the management of at least 30 pulmonary oncology cases, including chemotherapy, radiotherapy, and biological therapies;
l) 70 Thoracic Imaging (X-ray, CT, MRI, PET): Interpretation and discussion of paradigmatic cases with the Tutor.
m) 50 Reversibility and bronchostimulation tests to be performed independently.
n) 200 arterial blood gas analyses.
o) 150 bloodless pulse oximetry monitoring sessions
p) 40 6-minute walking tests to be performed independently (execution and reporting)
q) 30 polysomnograms (execution, tracing extrapolation, interpretation, and reporting)
r) 30 Mantoux intradermal tests or biological tests indicating TB infection (to be performed and evaluated independently).
s) 15 exploratory pleural punctures/thoracentesis, including ultrasound-guided thoracoscopies, 30 chest ultrasounds, 10 assisted pleural drain placements.
t) 5 cardiopulmonary exercise tests.

The resident may apply for the diploma after completing the professional development activities.

As part of their training, the trainee will be expected to learn the scientific foundations of the School's curriculum in order to achieve full maturity and professional competence, including an adequate ability to interpret scientific innovations and a critical understanding that allows them to consciously manage both their healthcare and their own development. This training may include participation in meetings, conferences, the production of scientific publications, and periods of attendance at qualified Italian and foreign institutions useful for their training.