Defining a training framework for clinicians in respiratory critical care

As intensive care medicine (ICM) advances through technological developments, diagnostics and therapeutics, there are increasing demands on resources and healthcare budgets. For these reasons, there is a need to create adequate legal and administrative structures. There is also an increasing requirement for qualified specialised personnel and an internationally recognised high-standard training programme [1]. This is especially relevant considering the multidisciplinary nature of ICM. Bearing these developments in mind, a way to progress ICM would be to involve, among other specialties, more respiratory physicians, who can be significant care providers for critically ill respiratory patients [2]. Furthermore, respiratory intermediate care units providing non-invasive monitoring and non-invasive ventilation allow for a more efficient and cost-effective management of respiratory failure patients without decreasing the quality of care or adversely affecting outcome [3], [4]. Additionally, the development of weaning centres and long-term care facilities, including home ventilation, provide important economic advantages that decrease the burden on regular intensive care units (ICUs) by reducing admissions and facilitating discharge to step-down areas [1]. As a result, the respiratory physician with specialist critical care training can provide advantages to patients in these critical care settings [2]. Historically in Europe, respiratory physicians have not usually been in the forefront of assuming the care of the critically ill respiratory patient compared with other countries such as the USA [5]. However, growing interest in Europe in the role of the respiratory physician is manifested by joint consensus papers and employment of respiratory physicians in ICUs [6]. To facilitate this movement, the Respiratory Intensive Care Assembly of the European Respiratory Society (ERS) and the ERS Education Committee supported the creation of a Respiratory Critical Care HERMES (Harmonised Education in Respiratory Medicine for European Specialists) Task …