After talking to the IP fellow at my home program, understand that IP procedures do vary from program to program. Also, a lot of things that where considered "IP" are now considered general pulm. For example, EBUS/TBNA, navigational branch, thermoplasty where considered IP, but now if you go to certain fellowships, you should know how to do these by the time you graduate. I really consider "IP" anything to involves a rigid bronch (i.e. stents etc). Also, like previous posters have said, at the current state of IP, if you really want to do all the cool procedures you are likely going to be working academics. Private practice is NOT going to pay for all those cool toys with little reimbursement. Not to take away from your dreams, but I would consider a STRONG FELLOWSHIP that allows you to do cool procedures and then seeing if you still want it....