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What is a Pulmonologist?
A Pulmonologist is a physician who possesses specialized knowledge
and skill in the diagnosis and treatment of pulmonary (lung) conditions
and diseases. Pulmonology is classified as an internal medicine
subspecialty. Because of the variety of clinical problems encountered,
knowledge of internal medicine and other specialties is required
in order to obtain certification.
Education in Internal Medicine
- Graduation from an approved medical school
- Completion of an ACGME (American Council for Graduate Medical
Education) accredited internal medicine residency program, which
takes a minimum of 3 years
- A minimum of 2 years of meaningful patient contact and
responsibility (Of the 2 years, 20 months must be spent in in-patient
services, ambulatory settings, and in the services of dermatology
or neurology)
- The level of responsibility for patients must increase
with each year of training
- After satisfactory completion of graduate education, the
physician is allowed to take the Internal Medicine board certification
examination. After passing the exam, the physician receives board
certification in internal medicine. This is a prerequisite to becoming
certified in pulmonology. Once board certified in internal medicine,
the physician must be trained in the subspecialty of pulmonary medicine
in order to receive certification in pulmonology.
Education in Pulmonary Medicine
- A minimum of 2 years of full-time graduate training in
pulmonary disease, including instruction in the basic sciences with
emphasis on molecular biology, pulmonary physiology, and pulmonary
immunology
- 12 months of the 2 years must be spent in clinical training
in diagnosis and management
The physician seeking certification in pulmonary medicine is expected
to become knowledgeable about and acquire clinical experience with
pulmonary diseases and disorders. Knowledge and competence in performing
and interpreting tests and procedures must be acquired. Expertise
must be developed in monitoring and supervising special services
and facilities — such as critical care or respiratory care
units, pulmonary function laboratories, respiratory care techniques
and services, and respiratory physical therapy and pulmonary rehabilitation
facilities.
Examination & Certification
After training has been satisfactorily completed, the candidate
is allowed to take the board certification examination in pulmonary
medicine. After passing the exam, the physician receives board certification
in pulmonary medicine.
Education in Pulmonary and Critical Care Medicine
- All educational experience and program content required
for training in both areas must be included in an accredited program
- A minimum of 3 years training
- A minimum of 18 months of the 3 years is spent in clinical
training
- At least 12 months of clinical training must provide training
in critical care units
- At least 6 months of training in critical care units must
be devoted to the care of critically ill medical patients
- At least half a day, each week, for 30 months in pulmonary
care training in an ambulatory care setting
In addition to gaining expertise as a pulmonary disease specialist,
these physicians are expected to gain broad experience and competence
in the treatment and management of critically ill adult patients,
which includes tests, procedures, services, and treatments in other
areas of medicine, such as cardiology, endocrinology, infectious
diseases, and so on. The resident will monitor critical care patients
during their hospital stay and after they've left the hospital.
They are required to learn how to organize and manage a critical
care unit, and how to work as a member of a multidisciplinary team.
They also must acquire knowledge about medications used in critical
care. Equally important, an understanding of the ethical, economic,
legal, psychosocial, and emotional aspects of critical illness and
critical care must be obtained.
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What is a Nurse Practitioner?
Nurse Practitioners provide primary health care services to individuals, families, groups of clients,
and communities. In general, NP care is characterized by an emphasis on health promotion and disease prevention and,
in addition, involves the diagnosis and management of common acute illnesses/injuries and stable chronic diseases.
In the provision of these services, NPs may order, conduct, and interpret appropriate diagnostic and laboratory tests and prescribe pharmacologic agents,
treatments, and nonpharmacologic therapies. Educating and counseling individuals and their families regarding healthy lifestyle behaviors are key components of NP care.
Data in the following table lists services which may be performed by any NP, regardless of specialty. The general scope of services provided by NPs has three main categories:
assessment of health status, diagnosis, and case management. Specific services are listed for each category. Some NPs choose to seek additional training and experience to be
able to perform additional advanced clinical procedures to further expand the scope of practice. These procedures which can becompleted by NPs with additional training
depending upon prior experience and practice restrictions of individual state Nurse Practice Acts.
- Doppler exam of carotid and peripheral arteries
- Simple biopsy
- Lumbar puncture
- Suturing
- Insertion of invasive intravenous and arterial lines
- Intubation
- Bedside urodynamics
While the role of NP was first envisioned for practice based in the rural under-served community, NPs have worked in a wide variety of settings. Traditionally,
most NPs practiced in either community- or hospital-based ambulatory care. Today, new roles are expanding opportunities for NPs to practice in such acute settings
as hospital inpatient specialty units and emergency departments.
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