The Department of Pulmonary Medicine at the Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh is unique in many ways. It was the only center in India for the postdoctoral course (DM) in Pulmonary and Critical Care Medicine for almost two decades (since its inception in 1989). This was one of the earliest full-fledged and independent departments of Pulmonary Medicine in India. Besides Respiratory Intensive Care Unit (RICU), it has got a well-equipped Pulmonary Function Testing (PFT) Laboratory, Bronchoscopy and Interventional Pulmonology Unit, Lung Cancer Clinic, Sleep Lab as well as a vast array of other facilities that are available for patient care and research. Every year, a number of research projects are undertaken, and PhD, DM and MD theses are guided by the faculty members. We continue to move forward with the Institute in the service of the country.
A brief history of this pioneer department…
The Chest Diseases Unit was first started in 1969 with the recruitment of one faculty member and one registrar within the department of the General Medicine. It was in 1978 that different divisions of the Department of General Medicine were established as independent departments. The Department of Chest Diseases at that time was a small unit with a functional Respiratory Laboratory and only one faculty member in position. Within a period of two years, we were able to introduce fiberoptic bronchoendoscopy. There were very few centers in the country at that time providing spirometry and bronchoendoscopy in routine clinical practice. We were also providing assisted ventilation and other respiratory therapeutic services in a limited fashion.
Soon the work-load and size of the department increased. From the very beginning, we had cherished the idea of building this department as a pioneer center of education and research in pulmonary sciences. The name “Chest diseases” did not commensurate with the medical terminology of all other departments. It was therefore rechristened as Pulmonary Medicine in 1989. Although there were several post-graduation programs in Tuberculosis/Chest diseases/ Respiratory/Thoracic Medicine etc. at various universities, where students were enrolled after MBBS, the post MD program (DM) was yet to evolve. We were able to introduce a two-year Postdoctoral (DM) Course in Pulmonary Medicine in 1989. It envisaged Pulmonary Medicine as a super-specialty of Medicine at par with sister specialties such as Cardiology, Gastroenterology, Neurology and others. Considering the specialized nature of diagnostic and therapeutic procedures required for management of respiratory diseases and an intimate relationship with other medical specialties, the Institute had implemented the wise decision, which has made a tremendous impact on pulmonary practice in this country.
Critical care has always been an integral part of respiratory services. This is largely attributed to two essential components of critical care which lie largely in the domain of pulmonologists i.e. oxygen and assisted ventilation. Taking the Western and US models, therefore, an additional year of training in critical care was added and the course was redesignated as DM (Pulmonary and Critical Care Medicine) in 1995. A separate 6 bed Unit was also added to provide respiratory critical care services especially for patients with medical disorders. The Respiratory Intensive Care Unit (RICU) continues to grow with time and was shifted to a new area having 8 beds with state-of-the-art facilities in 2008.
In the area of bronchoscopy and interventional pulmonology also, the department has pioneered the introduction of procedures like transbronchial needle aspiration (TBNA), endobronchial ultrasound (EBUS) guided TBNA, radial EBUS, medical thoracoscopy, and rigid bronchoscopy.
Being a member of Group B (all the medical specialties), the department contributes and participates in all training, teaching and service activities. Postgraduate students pursing MD (Medicine) rotate through the department for a period of 2-4 months during their 3-year course. The department also offers the MSc (Respiratory Therapy) course for technical and nursing staff who wish to advance their knowledge and experience after completing their respective basic graduate training.
Another pioneer activity undertaken by the department is related to continued medical education for the postgraduate students of different medical colleges and practicing physicians of this region. The Pulmonary Continuing Medical Education Program is in operation since 1985. We hold an Annual Update Session under the aegis of this program. Several books for pulmonologists have been also published. Several international symposia and workshops as well as national conferences/CMEs in the field of pulmonary medicine have been conducted in the past including Chest India 1998 (a major South Asian Conference in Respiratory Diseases with active participation and co-sponsorship of the American College of Chest Physicians, USA) and NAPCON 2007 (9th joint ICS-NCCP national conference on pulmonary diseases). We have also hosted and organized such educational initiatives for specific focus areas like Bronchoscopy (1989, BRONCOCON 2011) and Lung Cancer [in collaboration with the International Association of Study on Lung Cancer (1998) and American Society of Clinical Oncology (2014)]. A series of workshops for formulating national guidelines with sponsorship and participation of the Indian Chest Society and National College of Chest Physicians (NCCP, India) were organized for Community Acquired Pneumonia (2012), COPD (2013), Asthma (2014), and Spirometry (2016).