Claymore

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Hello, I am an interested in learning a bit more about pulmonology. Specifically, what are the pros/cons. I am familiar with the educational route to become a pulmonologist and am more interested in what experiences you may have had or heard about in this field. I am concerned because it doesn't seem to be that popular, is this because of relatively long hours? How does it compare to other IM specialties? Thanks.
 

DR

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I think it isn't as popular for a couple of reasons. I don't know a ton about the field, but I recently spoke to a pulmonologist. They essentially are trained as intensivists. I believe this is because if you are specializing in pulmonary care, then you will be a ventilator expert, and these are the people in the intensive care unit. They usually work in intensive care units, and often in specialty hospitals dealing with people with very difficult, chronic illnesses with poor outcomes. Of course this is not always the case, but usually it is; if you need a pulmonologist, you usually have a serious chronic problem. As a result of their having to be intensivists, their hours can stink. However, if you decide to work for a hospital in a community, and work where there are other intensivists, and don't need to make tons of money, you can swing working less hours. I think that it takes a certain type who enjoys that type of specialty.
 

EidolonSix

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Pulmonology/ Critical Care ranks behind cardiology and GI in competitiveness. The profit potential is not nearly as high in Pulm(some sleep docs are doing pretty good though) and as DR stated, a good percentage of your patients will not be blessed with a cure. Then again accepting death and often clearing the way for a good death is a lot of what being a good doctor means sometimes. Another possible downside (or upside depending on perspective) is that....you will be triple boarded...which sounds cool until you think of having to take the IM board, the pulm board, and the critical care board every 8 years.....And...you will work...sick patients have high care demand and it just comes with the territory.....but certainly no more than one does in internship or during fellowship.

However, in a lot of ways it really has all the components that a jack-of-all trades type would want. Procedures along with some of the most challenging medical problems and diagnostic dilemmas. Also, practice can include work as a hospitalist, which in some centers w/ open ICUs, means you will have the added benefit of the critical care background. The other benefit of the training is....when things really go to pot, you are likely the one to get called...and to be the go-to-guy can be pretty cool. You do see both medical and surgical patients as well. Most of the pulm docs I know are fantastic and judicious internists w/ a surgical edge and nerve....the best of both worlds. The other good thing about the field is that there is still a lot of research potential, as the "specialty" of critical care is really rather young....everything from the immunopathology of critical illness to the social, economical and psychological impacts of ICU care are issues deserving attention.

Anyways, If you can't tell...I am applying for a pulmonary critical care next year.....
 
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