APSR Short-Term Research/Training Scholarship

At the outset, I would like to thank the APSR for providing this excellent platform for its early career members to nurture their skills under experts in the field. I am honoured to have been given this scholarship to support my training. I thank Prof. V Nirmal Coumare, Host Supervisor and Director of Hospital and Outreach Services, Prof. Seetesh Ghose, Dean, Mahatma Gandhi Medical College, Sri Balaji Vidyapeeth (a deemed-to-be University), and Prof. Pajanivel R, Head, Department of Respiratory Medicine, for all their support and guidance.

China Medical University Hospital (CMUH) is a tertiary care hospital-cum-teaching institute that is at the forefront of many fields of medicine. The Division of Pulmonary and Critical Care Medicine, at CMUH, Taichung City, is an apex centre for Interventional Pulmonology (IP) in Taiwan. The team has been doing full-fledged IP procedures since 2008. The Department is a high-volume centre in IP. They have performed >11,000 bronchoscopies, >900 electrocautery and stents, >1,100 tracheostomies, and close to 200 pleuroscopies in their first ten years. The Department has two bronchoscopy suites – one is at the Critical Care Centre (CCC) and another one at the Li Fu building. While both the suites are equipped with video bronchoscopes and Radial EBUS, critical procedures are performed at the CCC suite.

Dr Chih-Yen Tu, Head of the Division of Pulmonary and Critical Care Medicine, and Head-Elect of APSR Bronchoscopy and Interventional Techniques Assembly, was my mentor. In my humble opinion, he is the best IP faculty in Taiwan and one of the best in the world. He has vast experience in the field and is a good teacher who always ensures that fundamentals are grasped correctly in any IP procedure. He gave me a fair amount of hands-on experience during the training period. Dr Tu encouraged my interest to write a case series and the manuscript on Bronchoscopic Lung Cryobiopsy in Pulmonary Alveolar Proteinosis is in progress. His Deputy, Dr Chia-Hung Chen, is an equally adept and down-to-earth faculty who taught me the procedures regularly.

Lecture classes were slated on all crucial topics in IP at regular intervals. The first set of lectures was on Thoracic Ultrasound by Dr Wu-Huei Hsu, Professor of Medicine & Vice Superintendent, of Critical Medical Center, CMUH. He is a renowned expert in Thoracic Ultrasound. Ms Chihmei Huang, a senior cytopathologist, who performs Rapid On-Site Examination (ROSE), taught the meticulous preparation of a slide and step-by-step reading of the same. Every Thursday, we had CMEs on current trends in IP, newer drugs/updates in oncology, antibiotics, aerosol therapy, etc. I had the opportunity to attend the Taiwan Society of Pulmonary and Critical Care Medicine's (TSPCCM) Annual Conference in December 2022 in the Southern city of Kaohsiung. We had an IP hands-on workshop, which was very useful. On my farewell day, I was honoured to have been given a chance to share the culture and lifestyle of my country with the Department faculty and staff.

I also had the opportunity to learn from Dr Hung-Jen Chen, an expert in Thoracic Ultrasound; Dr Biing-Ru Wu, an attending physician on Tuesday morning sessions, with whom I had the opportunity to assist in bedside tracheostomies and a few ICU scopies; Dr Wen-chien Cheng, Attending Physician on Monday; and Dr Wei-Chih Liao, in-charge of the Respiratory Care Center and Hyperbaric Oxygen Therapy Center. During ICU scopies at RICU and MICU, I had the chance to interact with Dr Shinn-Jye Liang, Director of MICU, Dr Wei-Cheng Chen, Chief Secretary & Ward Director of RICU, Dr Ding han Chen, Dr Chieh-Lung Chen, and other attending physicians.

Ms Ying Ying Tzeng, Ms Yahui Lin, Ms Shang Chun Tseng, and Ms Ru ling hung are the proficient IP staff of the Department. They were instrumental throughout my training period in imparting the nuances of preparing the suite for every procedure and assisting the procedures tacitly. And finally, the first batch of Fellows (Post-MD Internal Medicine trainees in Pulmonology) of the Department, Dr Yu-Chu Kuo, and Dr Hsu-Yuan Chen, without whom this training would not have been this memorable. During my free time, I had the chance to explore this beautiful country's culture and diversity. The Department and the public in general were very welcoming and considerate despite the cultural, racial, and linguistic differences between our nations.

I thank everyone again for supporting me to complete my training successfully.

As I return to my institute, I will try my best to develop an IP suite and apply the knowledge and skills for the needful population in my country.

Vimal Raj

(Click any photo to enlarge)

With the Faculty and other delegates in one of the IP CMEs

With the Faculty and Fellows during the National Conference at Kaohsiung

Department Procedure record