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194 A proud graduate of The University of the West Indies Professor Seemungal obtained his Bachelor of Medicine and Bachelor of Surgery training in Trinidad and continued his professional training in the United Kingdom. He then returned to Trinidad in 2003 as a Senior Lecturer in Medicine at the St. Augustine Campus of The University of the West Indies and Honorary Consultant Physician at the Port of Spain General Hospital. He was subsequently elevated to the rank of Professor of Medicine in 2011 where he continues his research into chronic obstructive pulmonary disease COPD and other chronic lung diseases. Professor Seemungal is currently Head of Department and President of the Thoracic Society of Trinidad and Tobago. COPD Not a breath of fresh air COPD is a progressive disease that makes breathing difficult and has major impacts on a variety of health outcomes includ- ing quality of life hospital admission and death. COPD is expected to be the third leading cause of death and the sixth leading cause of morbidity by 2020. Local research conducted by Professor Seemungal showed that COPD was present in about 20 of admissions to the General Hospital in Port of Spain with a similar prevalence in the chronic disease patients attending the local health centres. These findings have resulted in a greater emphasis on research into lung function and management of airways diseases in Trinidad. Internationally Professor Seemungal transformed the approach to managing COPD when he showed in 1998 that the frequency of chest infections exacerbation frequency in this disease is related to poor quality of life scores. This was the first such publication in this field and subsequently led to the inclusion of exacerbation frequency in international guidelines for assessment of COPD in individual patients. His work on chest infections in COPD patients led to his discovery in 2008 that a well-known easily available drug erythromycin could decrease the risk of chest infections. This discovery has revolutionized the treatment of COPD and has led to increased research into its use in the related diseases of bronchiectasis and asthma. His work on COPD is well-respected he is a speaker of international renown and well-referenced by his peers. Over the 10 year period from 1999 to 2009 Professor Seemungals work has been cited by Thompson Reuters Science Watch as the 18th most cited in the field of Chronic Obstructive Pulmonary Disease COPD worldwide and also as having the second highest citation rate per paper in the same field. Doctorate in Internal Medicine Emphasis on Research and Critical Thinking From 2007 onwards Prof Seemungal has focused on postgradu- ate training in medicine. I think that it is important to develop postgraduate-based medical research in Trinidad and Tobago in internal medicine and to focus on the training of really good internists.This has been done and so farI am happy with the quality of the graduates from the programme. In 2007 the Department of Clinical Medical Sciences started postgraduate training in Internal Medicine and has so far produced eight graduates. This programme is structured around active learning rather than lectures and emphasises principles of research critical thinking and communication skills. This focus on critical thinking and research-based philosophies recognises that medicine is evolving and that the next generation of doctors will need in-depth knowledge of science and research in addition to even better communication skills and empathy. The goal is to encourage and foster critical thinking skills we want to produce doctors who can think outside the box and base their treatment not on what an advocate for a particular product tells thembut on their own evaluation on what is best for the patient. Research in general internal medicine occurs during the third year of the programme with an emphasis on local and regional studies. The first study published out of this programme was a study of the newly created kidney transplant programme. The study found that the one-year and five-year patient survival rates are 91 and 86 respectivelystatistics which are in keeping with international standards. Other studies include the application of an internal scoring system to predict in-hospital mortality from heart attacks in Trinidad and Tobago as well as the efficacy of a simple blood test to detect rare but extremely disabling diseases of the nervous system referred to as inflammatory demyelinating diseases. BOLDly going where no man has gone before locally and regionally Respiratory disease results in a huge cost to society both in terms of disability and premature mortality as well as in direct primary and hospital healthcare. There are also indirect costs related to lost productivity. According to WHO estimates more than three million people died of COPD in 2012 worldwide. Most of the MEDICAL SCIENCES Professor of Medicine Adult Medicine Unit Department of Clinical Medical Sciences Tel 868 868 645 2640 ext. 2926 E-mail PROF. TERENCE SEEMUNGAL