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What is a Pulmonologist and Pulmonary Medicine?

Posted by Callie Torres
October 19, 2023

If you’re looking for details on Pulmonary Medicine and pulmonologists, then you’ve come to the right place. In this article, we will discuss what is a pulmonologist, what they do, their training and education, salary and more. Future medical students will also find useful information in this article and learn how to become a pulmonologist in our step-by-step guide.

Quick Navigation Links + FAQs

  1. What is a pulmonologist?
  2. What do pulmonologists do? 
  3. How to diagnose lung conditions?
  4. What to expect during a pulmonary examination?
  5. Pulmonologist education and training
  6. How much do pulmonologists make?
  7. What are common pulmonary conditions?
  8. Pulmonologist vs respiratory therapist - What is the difference?
  9. How do pulmonologists test your respiratory system?
  10. Getting started in medicine
  11. Video interview with alumni Elizabeth Nielsen, MD - Pulmonary and Critical Care Physician

What is a pulmonologist?

A pulmonologist is a MD or DO trained physician who specializes in treating diseases and disorders of the respiratory system including the oropharynx, larynx, and lungs. Pulmonologists attend medical school and complete residency and fellowship training in order to practice medicine. While they do not perform surgery, they often perform complex procedures such as laryngoscopies and bronchoscopies. They work in both a hospital and outpatient clinic setting. When treating patients they will perform physical exams, order and interpret laboratory tests and imaging procedures, prescribe medications and more. 

What does a pulmonologist do?

A pulmonologist is a doctor who diagnoses and treats diseases of the respiratory system, including the lungs, airways, and other breathing-related organs. As a doctor who specializes in both lung health and breathing problems, they identify and manage a variety of lung conditions, such as:

  • Allergies
  • Interstitial lung disease
  • Sarcoidosis
  • Cystic fibrosis
  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Pneumonia
  • Tuberculosis
  • Sleep apnea
  • Lung cancer

Pulmonologists also perform a variety of procedures, such as:

  • Lung biopsy
  • Sputum cultures
  • Bronchoscopy
  • Pulmonary function tests

The field of pulmonology is often combined with the field of critical care medicine, and many pulmonologists will train in both areas. This allows them to care for patients with severe respiratory issues and patients that are on ventilators. If necessary, pulmonologists will recommend patients to other medical professionals, such as surgeons or oncologists, to help treat pulmonary diseases.

How do pulmonologists diagnose lung conditions?

The are a wide variety of ways in which pulmonologists may diagnose different lung conditions including imaging, procedures, and laboratory tests. All of these can help to provide a picture of patient’s overall health, lungs’ functionality, and respiratory conditions. Some laboratory tests that pulmonologists may order and interpret include:

  • Blood gas analysis: This blood test evaluates blood oxygen, carbon dioxide, and blood pH levels; all are valuable indicators of lung function and health.
  • Complete blood count (CBC): A CBC determines whether anemia is present and looks at the health of red and white blood cells.
  • Comprehensive metabolic panel (CMP): The CMP assesses organ function by looking for chemical and electrolyte abnormalities.
  • Pleural fluid analysis: A pleural fluid analysis takes a sample of fluid present in the pleural layer, which lines the chest wall and lungs. Analyzing this fluid can help determine if the fluid build up is from an infection, malignancy, or other etiology.   

    

Pulmonologists may also perform certain procedures to help make diagnoses. Some examples include:

  • Lung function studies: This procedure measures the way in which lungs are functioning by looking at the amount of air that is breathed in and out.
  • Peak flow meter: Similar to a lung function study, this airflow-measuring tool measures exhalation.
  • Mediastinoscopy: In this procedure, a tube is introduced through a tiny incision in the chest to allow a doctor to view the area between your lungs, termed the mediastinum.
  • Bronchoscopy and Laryngoscopy: In both of these procedures, the pulmonologists will enter a small scope with a camera into the throat, larynx and bronchus to look for any abnormalities.
  • Lung biopsy: In this procedure, a pulmonologist will sample a small portion of the lung. This sample is then sent to a pathologist to render a diagnosis.

   
   
Lastly, for an accurate diagnosis of lung disease, advanced technology-based diagnostic imaging is frequently essential. Some imaging techniques that pulmonologists may utilize include:

  • Chest X-ray: One of the most basic imaging modalities that examines the lungs’ anatomy and the health of the thoracic cavity.
  • Computed tomography (CT) scan: This cross-sectional imaging method provides physicians with a more detailed picture than a standard X-ray.
  • Magnetic resonance imaging (MRI) scan: This scan uses radio frequencies and magnets to produce precise images of the lungs and chest cavity.
  • Positron emission tomography (PET) scan: A PET scan uses a unique tracer that labels highly proliferative cells offering an additional method to identify lung cancer.

 

pulmonologist-examination

What to expect when seeing a pulmonologist?

If you are seeing a pulmonologist for the first time, there are several essential steps that they will perform to adequately provide medical treatment. They will start by reviewing your symptoms and health history. This will entail inquiries concerning respiratory issues, such as chest pain, coughing, wheezing, and shortness of breath. Also discussed will be one’s past medical history, including any lung conditions and history of smoking. Next, the pulmonologist will perform a physical examination which includes examining breathing, heart rate, blood pressure, and oxygen levels. They will also use a stethoscope to listen to your lungs. They might recommend further tests in order to make a diagnosis or determine the severity of certain conditions. A chest X-ray, CT scan, pulmonary function test, or bronchoscopy are some examples. Lastly, the pulmonologist will go over the diagnosis and available therapies in order to treat or manage the condition.

What education and training do pulmonologists have?

The path to becoming a pulmonologist is very long and challenging. Following completion of high school, it takes at least 13 years to become a pulmonologist. Along the way, trainees will need to pass numerous standardized exams which include the MCAT, USMLE, and pulmonology board examinations. Starting after high school here are the steps required to become a pulmonologist:

  • College or University Undergraduate Program (4 years): The first step to become a pulmonologist is to complete four years of academic work in an undergraduate program. During this time students will take courses in Biology, Chemistry, Physics, English, Math and more.
  • Medical School (4 years): Following college, students will matriculate into medical school. During this time students will learn the basics of medicine including: Biochemistry, Physiology, Pathology, and Pharmacology. They will also spend two years in a hospital setting learning more hands on training and gaining practical medical experience.
  • Internal Medicine Residency (3 years): Prior to training in pulmonology, physicians must first complete an internal medicine residency. Residency programs in internal medicine last three years. During this time internal medicine residents gain knowledge about common medical illnesses and learn to collaborate with other medical specialists to deliver patient care all while honing the abilities needed to become capable and sympathetic doctors.
  • Pulmonary Fellowship (2 - 3 years). After completing internal medicine residency, physicians must complete a fellowship to become a pulmonologist. The majority of pulmonology fellowships (>150 programs in the US) are combined with critical care medicine and last three years. However, there are still some pulmonology only programs (~20 in the US) which take two years on average to complete. During this period, physicians learn the more advanced medical knowledge and techniques of pulmonology.
  • Licensing and Board Certification: Following Pulmonology fellowship, physicians are qualified to apply for a full medical license. Pulmonologists will also apply for and take board examinations in their field. While this is not technically required, the majority of Pulmonologists will complete this extra step to  demonstrate their dedication to offering top-notch medical care.

Pulmonologists salary - How much do pulmonary medicine specialists make?

Pulmonologists are well paid for their hard work and extensive education. According to AAMC Careers in Medicine, Pulmonary and Critical Care Physicians in clinical practice make and average of $418,000. Another source, Medscape, reports that the average Pulmonologist makes $353,000. It is important to note however, that salary ranges can vary significantly depending on various crucial aspects, including education, credentials, location of employment, number of patients under care, employment setting like clinic or private practice, supplementary talents, and the length of time individuals have worked in a given field. 

 

pulmonary-doctor

What are the most common pulmonary conditions?

Some of the most common lung conditions that a pulmonologist may treat include:

  • Pulmonary edema: abnormal fluid buildup in the lungs
  • Asthma
  • COPD: chronic obstructive pulmonary disease
  • Pneumothorax or Atelectasis: partial or complete lung collapse
  • Lung infection: such as pneumonia
  • Lung cancer
  • Bronchitis: an inflammatory condition that affects the primary airways (bronchial tubes), which deliver air to the lungs.

What is the difference between a pulmonologist and a respiratory therapist?

A Pulmonologist is a doctor who specializes in treating lung conditions. They have finished medical school, residency, and fellowship training in pulmonology, distinguishing them from respiratory therapists. On the other hand, a healthcare professional who has completed training in respiratory therapy training is known as a respiratory therapist. This career path commonly includes obtaining a Bachelor’s degree. Patients with breathing issues can receive treatment from respiratory therapists, but they may also need more specialized care from a pulmonologist.

 How do pulmonologists test your respiratory system?

One of the most common ways in which a Pulmonologist may test the function of the respiratory system is through a pulmonary function test (PFT). During this procedure, you will be given a sterile mouthpiece connected to a spirometer. You’ll cover the mouthpiece with your mouth forming a tight seal. You will then be instructed how to breathe in and out in a particular fashion. The movement of air will be measured by a machine. Throughout the course of the treatment, you will be constantly watched for any vertigo, breathing, or other respiratory system-related problems. Utilizing this testing will provide an overall view into the health of the respiratory system and serve as a baseline for further medical testing.

lung-evaluation

Getting started in Medicine

Now that you know some information about Pulmonologists and Pulmonary medicine, readers may be anxious to get started in medicine. It all begins with getting your MD degree at a medical school like the University of Medicine and Health Sciences (UMHS). You can apply to UMHS by clicking this link: Apply  To find out more information about our offshore medical school please check out this page: Top Caribbean Medical University overview. For questions, please contact a member of our admissions team: Contact admissions

 

Interview with Alumni Elizabeth Nielsen, MD, Pulmonary and Critical Care Physician

 

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Posted by Callie Torres

Callie Torres is a Captain in the United States Air Force and a chief resident at Wash U/Barnes Jewish Hospital in St Louis. She is a freelance writer with many published medical articles as well as multiple peer-reviewed medical publications

Topics: Feature Medical Practice

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