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The provision of specialist paediatric thoracic medical services commenced in Victoria when in 1948 Dr. Howard Williams was appointed Director of Clinical Research at the Royal Children's Hospital. He had a specific interest in chest disorders and this was his major research interest during the next 25 years. He made an outstanding contribution to the understanding of asthma, bronchiectasis, tuberculosis and respiratory infections. A pulmonary function laboratory was established within the Clinical Research Unit in 1966. From this laboratory came much of the early work in the world on the measurement of pulmonary function in infants and children. Because of the research expertise Dr. Williams developed, he was increasingly sought as a consultant in respiratory disease. By the mid 1960's he had a very large clinical practice in respiratory disorders. At that time he was joined by Dr. Peter Phelan and both the research and service activities continued to grow. The service work was very clearly a development of their research activities. In 1953 Dr Williams encouraged Dr. (later Professor) Charlotte Anderson to establish a Cystic Fibrosis clinic within his unit. This was initially a research activity as Dr. Anderson had a very specific research interest in gastrointestinal disorders. However, again her expertise was rapidly recognised and increasing numbers of patients with cystic fibrosis were referred to her for ongoing care.
In 1973 Professor Donald Cheek was appointed as Director of the Royal Children's Hospital Research Foundation. He wished the Foundation to be primarily a research one and requested that units such as the Clinical Research Unit and the Gastroenterological Research Unit (which had formerly separated from the Clinical Research Unit in the early 1960's) should become hospital service departments. This seemed realistic at the time because of the increasing service demands that had resulted from their successful research activities.
The Department of Thoracic Medicine was formally established in 1974 with Dr Peter Phelan as its first Director. Medical, paramedical, scientific and support staff were transferred from the Clinical Research Unit. Dr Phelan continued as Director until 1984 when he was appointed to the Chair of Paediatrics at the University of Melbourne. At this time, Dr Tony Olinsky was appointed Director and held the post for 16 years. In 1998, the department was renamed the Department of Respiratory Medicine. In 2000, following Dr Olinsky's retirement, Professor Nicholas Freezer was appointed Director and retained the post for five years until appointed Chair of Paediatrics at Monash Medical Centre. In 2005, Professor Colin Robertson was appointed Director of Respiratory Medicine and in 2010 was appointed Chief of Medicine. In 2012, Associate Professor Sarath Ranganathan was appointed as Director of Respiratory Medicine.