RESPIRATORY TRAINING IN MALTA ERS Annual Congress 2011

RESPIRATORY TRAINING IN MALTA ERS Annual Congress 2011, Amsterdam Dr Christopher Zammit Mater Dei Hospital, Malta

Medical School Training for M. D. 5 years of Medical School, Mater Dei Hospital, Malta • 2 pre-clinical years �Anatomy and Physiology • 3 clinical years at Mater Dei hospital Structured training with experienced clinicians / academics

Recently constructed Single General State Hospital in Malta Recognized teaching centre Full range of laboratory / imaging centre Adequate library IT facilities Numerous sub-specialities centred in the same location Good exposure to numerous medical / surgical cases

Foundation Years First 2 years as Foundation years • 6 months of general medicine • 6 months of general surgery �Choice of medical / surgical specialities depending on preference, as well as on academic placement • UK-based foundation program with structured training �Introduced recently �On-line portfolio and regular appraisals, DOPs, Mini-CEX • Acquisition of warrant and licence to practise • Name placed in the EU list of the Medical Council of Malta

Basic Specialist Trainee (BST) 2 years full-time Medical BST: • Following the Foundation years • General professional basic training • Prior to period of higher specialist trainee (HST) • Application by interview basis / CV presentation

Basic Specialist Trainee (BST) 4 -month rotations in medical specialities �Ward rounds and medical out-patients �Diverse bed-side procedures as recommended by UEMS European union of medical specialists �On-call duties outside normal working hours �Unselected acute medical admissions �Emergency ward cover

Basic Specialist Trainee (BST) 4 -hours per week protected time �Weekly teaching “Grand Rounds” �Weekly teaching academic lectures �E-learning management system with online lectures �Speciality journal clubs �Radiology multi-disciplinary team meetings (MDTs) • Local and foreign conferences /courses • Involved in audits, studies, publications and local protocol guidelines

Basic Specialist Trainee (BST) • Completion of MRCP post-graduate examination as evidence of completion of training. Weekly tutorials “Mock examination” • BLS / ALS certification • Clinical and academic log-book • Satisfactory consultant appraisals

Respiratory Higher Specialist Trainee (HST) 4 years as Respiratory HST �Application by interview basis / CV presentation �Not an automatic progression �Competitive �Requires certificate of completion BST (CCBST) �Full registration with the EU medical council of Malta

Respiratory Higher Specialist Trainee (HST) 4 years as Respiratory HST Dual Certification: Certification Respiratory and General Medicine �General and respiratory ward rounds / out-patients � 1 year rotations between respiratory consultants �Yearly appraisals by consultant / clinical supervisor �Introduction of a separate mentor, changed every 2 years �Minimum requirement of on-call duties performed

Respiratory Higher Specialist Trainee (HST) Sub-speciality clinics • Asthma clinic • Sleep clinic • Rapid-access lung cancer clinic • TB clinic Opportunities for inter-speciality consultations �Cardiothoracic surgery, oncology / radiotherapy

Respiratory Higher Specialist Trainee (HST) �Weekly Flexible Bronchoscopy sessions �Thoracocentesis / Intercostal chest drain insertion �Introducing Thoracic ultrasound �Spirometry �Ventilatory support / NIV � 4 month ICU rotations Exposure to critical care respiratory medicine

Respiratory Higher Specialist Trainee (HST) Minimum of 4 hours per week protected time �Twice monthly respiratory journal clubs �Weekly Medical Grand Rounds �Monthly tutorials by respiratory consultants �Monthly respiratory meetings �Monthly radiology MDT meetings Encouraged to teach Medical students, Foundation year, BST doctors

Respiratory Higher Specialist Trainee (HST) • Expected to publish and present • Minimum of 2 audits and 1 publication per trainee • Encouraged to attend local / international educational courses / conferences • Opportunities to travel abroad for research / work experience • Prospects for M Phil, Ph D, MSc

Respiratory Higher Specialist Trainee (HST) Funding / Financial Aid • • • Study leave CME funding Post-graduate funding • • support for educational courses presentation of posters abroad

Respiratory Higher Specialist Trainee (HST) Certificate of completion Specialist Trainee (CCST) �Satisfactory yearly appraisals �Full academic / clinical log-book �Theoretical / Exit examination (MRCP college exam / HERMES) at the end of the specialization Thank You Specialist Accreditation Committee (SAC) Regulatory board for specialist training program