Subspecialty Careers: Highlights about Careers in Internal Medicine: Pulmonary Disease
The Discipline
From the word pulmo, Latin for "lung."
Pulmonary medicine is the diagnosis and management of disorders of the lungs, upper airways, thoracic cavity, and chest wall. The pulmonary specialist has expertise in neoplastic, inflammatory, and infectious disorders of the lung parenchyma, pleura and airways; pulmonary vascular disease and its effect on the cardiovascular system; and detection and prevention of occupational and environmental causes of lung disease. Other specialized areas include respiratory failure and sleep-disordered breathing.
Procedures
Important procedural skills include arterial blood gas sampling and interpretation, flexible bronchoscopy and related bronchoscopic procedures, endotracheal intubation, spirometry and peak flow assessment, pulmonary artery catheterization and interpretation, thoracentesis, pleural biopsy, placement and management of chest tubes, ventilator management, progressive exercise testing, and complete pulmonary function testing.
Training
Pulmonary Disease fellowship training can be obtained either through a combined Pulmonary and Critical Care fellowship (the most common path) or through a Pulmonary fellowship alone. Combined programs require three years of accredited training beyond internal medicine residency. The three years must include a minimum of 18 months of clinical training (at least nine months of Pulmonary training and nine months of Critical Care training). Pulmonary Disease fellowship training without Critical Care requires two years of accredited training beyond internal medicine residency. Of the two years, a minimum of 12 months must include clinical training in the diagnosis and management of a broad spectrum of pulmonary diseases.
Certification
The American Board of Internal Medicine offers separate certificates in Pulmonary Disease and in Critical Care.
Training Positions
As of July 2007, there were 130 ACGME-accredited combined training programs with 1,237 active positions in Pulmonary Disease and Critical Care Medicine, and there were 25 ACGME-accredited training programs with 83 active positions in Pulmonary Disease alone. For combined training programs in Pulmonary Disease and Critical Care Medicine, 27% of the trainees were female, and 56% were US medical graduates. For training programs in Pulmonary Disease alone, 22% of the trainees were female, and 19% were US medical graduates.
Practice
Approximately 48% of the graduates of combined programs enter clinical practice in the United States, and 36% enter academic medicine.
Major Professional Societies
American College of Chest Physicians
3300 Dundee Road
Northbrook IL 60062-2348
(847) 498-1400
http://www.chestnet.org
American Thoracic Society
61 Broadway
New York, NY 10006-2755
(212) 315-8600
http://www.thoracic.org
Major Publications
American Journal of Respiratory and Critical Care Medicine
Chest: The Cardiopulmonary and Critical Care Journal
Match Day 2012: An Exciting Experience
Go behind the scenes at Match Day 2012 at The Perelman School of Medicine at the University of Pennsylvania and hear Dr. Katrina Armstrong, Chief of the Internal Medicine Division at Penn Medicine describe being part of the Match Day experience.
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