Pediatric Pulmonology — Specialty Profile

Exploratory, not prescriptive. This profile blends hard data (pay, match rates, burnout, demographics — each sourced and dated) with generalizations and synthesized online opinion about culture and "who fits." It's here to help you get curious and go find out for yourself — not to tell you who to become. Numbers marked ⟳ verify change every year; check the linked source before you quote one. Last reviewed: 2026-07-25.

Subspecialty fellowship of Pediatrics.

Also called: peds pulm, pediatric pulmonary medicine. Not a residency you enter from medical school: you finish a pediatrics residency first, then a 3-year fellowship. Organ system: the respiratory tract, meaning airways, lungs, and the physiology of breathing in a growing child.

The 30-second version

Pediatric pulmonology is the care of children's lungs and breathing, from the extremely common (asthma) to the lifelong and complex (cystic fibrosis, chronic lung disease of prematurity, kids who live on tracheostomies and home ventilators). It's an acute-and-chronic hybrid, but the center of gravity is longitudinal: you follow the same families for years, in clinic, becoming a fixture in their lives. Layered on top are inpatient consults on kids in respiratory failure and a modest procedural slice: flexible bronchoscopy, bronchoalveolar lavage, pulmonary function and sleep-study interpretation. Crucially for lifestyle, the call is real but classically taken from home, not as in-house overnights. And it's reached through one of the most accessible ladders in medicine: an accessible pediatrics residency, then a fellowship that leaves roughly a third to half its seats empty most years.

Quick dashboard (details and sources below)
Training after med school Peds residency (3) + Peds Pulmonology fellowship (3) = 6 yrs after med school
Total from college start ~14 years (4 undergrad + 4 med school + 3 residency + 3 fellowship)
Entry Two-step: match into pediatrics, then apply through the NRMP Pediatric Specialties Match during residency
Competitiveness (as a peds subspecialty) Low — one of the most accessible peds fellowships; consistently underfills (63.2% of positions filled, 2026) ⟳
Typical full-time pay $282,000 average total comp (Survey · Doximity 2025) ⟳
Pay range (structure) Doximity average $282,000; self-reports cluster ~$320k–$340k (small n); aggregators span ~$115k–$400k ⟳
Lifestyle Largely scheduled clinic + procedures; home call, little/no in-house overnight
Burnout No peds-pulm row on either survey. Both parents sit in the high band on Medscape 2024 against a 49% average (peds ~51%, adult pulm ~50%); this page reads general pediatrics, because the adult row carries ICU nights this field doesn't work ⟳
% women 69.1% of fellows in AY2024–25 (ACGME), against 74.8% of pediatrics residents ⟳
DO / IMG accessibility Open — 20% DO and 20% IMG of matched fellows (2026); IMG ran 37% in 2025 ⟳

What they actually do

Pediatric pulmonologists manage the child respiratory system across its full range. The bread-and-butter volume is asthma, the most common chronic disease of childhood, run largely as cognitive, outpatient, E/M-heavy clinic work. The signature longitudinal work is the cystic fibrosis (CF) center, a CF Foundation–accredited multidisciplinary clinic where you follow the same patients and families for years. On top of that sit technology-dependent kids (tracheostomies, home ventilators, and the graduates of the NICU with chronic lung disease of prematurity), inpatient consults on children in respiratory failure or CF exacerbation, and a real if modest procedural component.

The work is a genuine acute-and-chronic blend, but it is not OR-centric or ICU-centric. The identity of the field is chronic, clinic-based, physiology-driven care with procedures and inpatient stakes layered in.1 Much of the field is hospital-employed and academic, because CF, ventilator, and bronchoscopy/PFT/sleep infrastructure concentrate at children's hospitals and large centers.2

Representative procedures: flexible fiberoptic bronchoscopy · bronchoalveolar lavage (BAL) · airway/lung biopsies · pulmonary function testing (PFT) performance and interpretation · exercise and exhaled-nitric-oxide testing · polysomnography (sleep-study) interpretation · chronic ventilator and tracheostomy management.21 These add incremental technical/wRVU revenue but are far lower-volume and lower-margin than adult interventional pulmonary or critical-care procedures, which shapes the pay picture below.

A week in the life: anchored by scheduled outpatient clinic, asthma volume plus CF and technology-dependent-child follow-ups, with inpatient consults and elective/semi-elective procedures woven through. You carry a chronic panel you know deeply rather than a shift board of strangers. Night and weekend call exists, but classically it's home call. You get paged about a crashing CF patient or a ventilator question rather than living in the hospital overnight.1 Busy consult services or lung-transplant/ECMO programs at large centers are more demanding; the classic model is comparatively controllable.

The training path & time to completion

This is a subspecialty with a two-step entry. You don't match into pediatric pulmonology from medical school. First you match into a categorical pediatrics residency; then, during residency, you apply through the NRMP Pediatric Specialties Match (the Specialties Matching Service) for a fellowship.3

Medical school (4 yrs) → Pediatrics residency (3 yrs) → Pediatric Pulmonology fellowship (3 yrs) → board-eligible with the ABP. That's 6 years after medical school to independent practice, and ~14 from the start of college.34

  • Fellowship: a 3-year ACGME-accredited program, entered after completing (or nearly completing) pediatrics residency.34
  • Board: the American Board of Pediatrics (ABP), subspecialty of Pediatric Pulmonology, with general pediatrics certification as a prerequisite. The subspecialty was first established in 1986.4
  • Program landscape: ACGME lists 58 accredited programs (AY2024–2025); 50 offered positions in the 2026 NRMP cycle (not every accredited program offers a slot every year).56
  • Total from the start of college: ~14 years (4 + 4 + 3 + 3).

How competitive is it?

Here the framing has to shift: the meaningful competitiveness question for a subspecialty isn't "can you match from med school". It's "how hard is the fellowship, given that you're already a pediatrician?" And on that measure, pediatric pulmonology is one of the most accessible subspecialty matches in all of medicine.

In the 2026 Appointment Year (Pediatric Specialties Match, conducted late 2025):5

  • 50 programs offered 87 positions and filled 55, a fill rate of 63.2%, leaving 24 programs short of a full class. ⟳
  • 59 applicants ranked the specialty, fewer applicants than positions (~0.68 applicants per position). ⟳
  • Of the 55 matched fellows: 33 U.S. MD (60.0%), 11 U.S. DO (20.0%), 3 U.S.-citizen IMG (5.5%), 8 non-U.S.-citizen IMG (14.5%), for a combined IMG share of 20.0%.5
  • The fill rate moves a long way year to year: 73.5% (2022), 67.4% (2023), 59.3% (2024), 48.4% (2025), 63.2% (2026). 2025 was the low of those five years. ⟳

The honest read: a fellowship that leaves a third of its seats empty, with more positions than applicants, is genuinely reachable, without an elite pedigree, a perfect record, or a pedigree-signaling arms race. That accessibility is the single most important, and most misread, fact about the field (see Culture and the FLI angle). It reflects the economics of pediatric subspecialization, long training for a modest pay premium over general pediatrics, far more than the quality or importance of the work.78 ⟳

Compensation — the robust version

A note on sources first, because the spread is wide and the why matters. Doximity's 2025 report publishes a pediatric pulmonology line directly, so the headline below is a named compensation survey rather than a derivation.9 Around it sit two weaker source types that disagree with each other by roughly $100k: physician self-report surveys (SalaryDr panel, n=10) and generic salary aggregators (Salary.com, ZipRecruiter, Marit Health) that scrape job postings and mixed data. Both are shown for range and spread context and labeled as such. MGMA publishes peds-pulm-specific percentiles, but only inside a paid report, so no percentile band is quoted below.2 ⟳

National number. $282,000 average annual compensation (Doximity 2025, reporting 2024 earnings from about 37,000 US physicians).9 ⟳ Adult pulmonology on the same table is $425,700, so the field's much-quoted 51% adult-versus-pediatric gap resolves against two published figures rather than an estimate.

  • SalaryDr (physician self-report, n≈10, July 2026): median $330,000 / average $332,000 total comp; base $273,000 (82% of total), 18% bonus/incentive. Small sample, and it runs well above the survey figure, so treat it as directional.2 ⟳
  • Physicians Side Gigs: ~$263,000, right at the pediatric-subspecialty midpoint (range ~$175k–$500k).10 ⟳
  • Aggregators (spread context): ZipRecruiter ~$341,187; Marit Health ~$271,000; Salary.com ~$242,671. Wide and methodology-driven.2 ⟳

The spread (structure). Physician self-report is tight but thin (SalaryDr: 25th–75th all clustered ~$320k–$340k, n≈10). Aggregators show the real dispersion: ZipRecruiter spans ~$115,000 (min) → $400,000 (90th pct), middle-50% roughly $300k–$400k; Salary.com runs lower and narrower ($201k–$287k, 10th–90th).2 ⟳

Seniority barely moves it. SalaryDr's ten-physician panel shows entry-level $320,000 → 6–10 yrs $332,000 → 10+ yrs ~$333,000, only a ~4% lift from entry to senior, the flat trajectory characteristic of salaried, hospital-employed pediatric subspecialists.2 Academic starting pay is compressed further: the pediatric-subspecialty literature documents assistant-professor specialists earning at or near general-pediatrics benchmarks. One cited comparison notes a computer-science new grad can start above a pediatric-infectious-disease assistant professor's base.28 ⟳

Academic vs. private. The field is overwhelmingly hospital-employed and academic. SalaryDr reports 100% of submissions in hospital-employed settings, and standalone private peds-pulm practice is rare because CF/vent/bronchoscopy/PFT/sleep infrastructure concentrates at academic centers.2 Academic pediatric pulmonology is paid at roughly 83% of the adult-pulmonology AAMC benchmark.11 Where community/large-multispecialty peds-pulm groups exist, higher clinical/procedural volume can pay somewhat above pure-academic, though the field lacks the high-margin procedures that let adult pulm/PCCM reach $450k+.2

Geography. Directional, with limited peds-pulm-specific tables. Marit Health lists New York State ~$306,000 vs. ~$271,000 national; ZipRecruiter cites a top-paying city (Berkeley, CA) at ~$425,731, with regional swings up to ~$100,000.2 The broader pediatric-subspecialty pattern: pay tends to run higher in the Midwest/South and lower-cost markets (where children's hospitals compete for scarce subspecialists) and lower, in real-dollar terms, in coastal high-supply/high-cost academic hubs.2 ⟳

The context that colors all of it: the pediatric pay problem. Pediatrics is a low-comp base to begin with (general pediatrician avg $265,230, Doximity 2025, up 2.2% nominally but down ~6.7% in real terms since 2017), and the pediatric-vs-adult subspecialty gap is stark: adults out-earn the pediatric version by +96% (oncology), +80% (GI), +67% (cardiology) … and +51% (pulmonology, $425,700 against $282,000).9 ⟳ The upshot is the "fellowship penalty": because many pediatric subspecialists earn only modestly above a general pediatrician, and over a career sometimes near one, despite three extra fellowship years, the financial ROI of subspecializing is weak. That, not lack of interest, is the recognized driver of the underfilling and workforce shortage.89 ⟳

Lifestyle & the home-call bargain

The lifestyle headline is call. Per the field's own descriptions, pediatric pulmonology clinical service does not typically require in-hospital overnight call, and night and weekend call is taken from home.1 You'll get paged about a crashing CF patient or a ventilator question, and large centers with busy consult services or transplant/ECMO programs are more demanding, but the classic model spares you the resident-style in-house overnight grind that defines the PICU or neonatology.

Because so much of the work is scheduled clinic plus elective/semi-elective procedures, days are more predictable, more weekday-centric, and more controllable than the "acute" pediatric subspecialties peds-pulm is often lumped near. It's not a pure "lifestyle" specialty, since inpatient consults, procedures, and home call inject unpredictability, but on the pediatric-subspecialty spectrum it sits toward the more controllable end, trading the top-tier pay of PICU/neonatology for a saner rhythm.1

The cost isn't in the hours so much as the load: chronic-disease clinics are cognitively and emotionally dense, and the administrative weight is real: prior authorizations for expensive inhaled/biologic/modulator therapies, CF-center multidisciplinary coordination, and, for the large academic share of the field, the grant treadmill.1

Lifestyle rating: 4/5. High schedule predictability and control for an acute-flavored field, with the honest caveat of home call and a heavy administrative/emotional load rather than a heavy hours load.

Wellbeing — the part to take seriously

Burnout has no clean subspecialty number, so triangulate honestly. Medscape does not publish a burnout figure for pediatric pulmonology specifically. The nearest anchors from the Medscape Physician Burnout & Depression Report 2024 are the two parent fields: pediatrics ~51% and adult pulmonary medicine ~50%, both in the high band and both measured against that survey's own 49% all-physician average.12 Peds-pulm likely lands in that neighborhood, with two offsetting forces: lighter in-house call cuts one major driver, while chronic-disease emotional load, grant pressure, and mid-tier pay push the other way. The honest read is "~50%, high but not the worst, mixed drivers," which is a triangulation rather than a measured statistic. ⟳

Of the two parents, this page reads general pediatrics. The reason is what sits inside the adult number: most adult pulmonologists practice combined pulmonary and critical care, so their row carries ICU nights and unit acuity that a pediatric pulmonologist does not work, since the PICU is a separate specialty with its own fellowship. The patients, the clinic schedule, the children's-hospital employer and the payer mix here are pediatric. These two rows happen to sit a point apart, so the choice moves the number very little, and it is stated anyway because on other pediatric subspecialties the same choice moves it a great deal. Both anchors are Medscape's because no one else publishes them: AMA's 2025 Organizational Biopsy prints about fifteen specialty rows and has neither pediatrics nor pulmonary medicine.12 ⟳

Satisfaction and would-choose-again run positive. Self-reported SalaryDr data (small n) puts the field at a 4.0/5 career-satisfaction rating with ~70% saying they'd choose it again. Respondents name the variety of cases and deep patient/family relationships as the rewards, and on-call demands, administrative burden, and work-life balance as the top frustrations.2 ⟳

The emotional arc of chronic disease, and how it changed. The heart of the field is long-term relationships: you follow CF kids, NICU chronic-lung-disease graduates, and technology-dependent children for years. Historically this carried a heavy grief load. CF was a disease of watching young patients decline, with life expectancy in the mid-30s to early-40s as recently as the 2010s. The CFTR-modulator era transformed that arc. For the ~90% of CF patients with eligible mutations, drugs like elexacaftor-tezacaftor-ivacaftor (Trikafta) and newer agents have turned a fatal childhood disease into, for many, a manageable chronic condition with projected life expectancy approaching ~65. A CF clinic in 2026 is a dramatically more hopeful place than a decade ago, though the ~10% of patients with nonsense/rare mutations still can't benefit, and technology-dependent and non-CF chronic-lung populations remain heavy.13

Career longevity. Controllable call, intellectual variety, strong satisfaction, the transformed CF outlook, and near-guaranteed demand all support long careers. The main longevity threats are chronic-disease emotional weariness, academic grant stress, and the persistent sense of being under-compensated relative to the length of training.1

Who's in the field (demographics)

  • Women: 69.1% of pediatric pulmonology fellows in academic year 2024–25, 134 of 194, against 74.8% of pediatrics residents on the same ACGME table, so the subspecialty tracks its parent field closely.6 ⟳ The AAP workforce study documents the rise over the past decade.14
  • IMG: 20.0% of matched fellows in 2026 (11 of 55: 5.5% U.S.-citizen IMG plus 14.5% non-U.S.-citizen IMG), down from 37.0% in 2025 (17 of 46). On cohorts of that size the share swings hard between cycles, and the entry point is substantial in both years.5 ⟳
  • DO: 20.0% of matched fellows in 2026 (11 of 55), up from 13.0% in 2025 (6 of 46).5 ⟳
  • URiM: the AAP workforce study states plainly that the proportion of pediatric pulmonologists from underrepresented-in-medicine backgrounds still lags behind the general population. The Black and Hispanic/Latino percentages live in the ABP's own dashboards, published year by year rather than as a single headline figure.715 ⟳
  • Workforce size (context): small. ABP had certified 1,301 diplomates cumulatively through 2017; the AAP 2024 study projects the subspecialist-to-child ratio rising a further 20–40% over 2020–2040, though absolute numbers remain small.47 ⟳

Culture, personality & the online stereotypes

Who gravitates here: the archetype is a physiology lover who wants longitudinal relationships plus a little procedure. Respiratory mechanics and PFTs genuinely reward people who like understanding how a system works. Add a temperament that wants to know families over years (chronic disease), tolerance for complex, technology-dependent, medically fragile kids, comfort with a modest procedural skill set (bronchoscopy) without needing the OR as an identity, and very often a mission-driven streak, especially toward CF care and the sickest, most complex chronic children. It draws people who found the PICU/neonatology's acuity and hours too punishing but still want inpatient stakes and procedures, not a pure clinic career. As always, plenty of people in the field do not fit any single mold.116

The stereotypes. community caricatures, not facts. Each with an unfair edge, and a counterpoint:

  • "It's just asthma clinic and CF clinic." Reframes the field as two diagnoses on loop. Reality: the actual scope spans bronchoscopy, chronic ventilator/trach management, sleep medicine, BPD/chronic lung disease of prematurity, rare interstitial and congenital lung disease, and, after the modulators, CF care that is now fast-moving and genuinely exciting.
  • "Cerebral and chronic: all thinking, little doing." Flatters the intellect but ignores real procedures (bronchoscopy, BAL), acute consults on children in respiratory failure, and life-or-death management of vent-dependent kids. "Cerebral" and "hands-on with high stakes" aren't mutually exclusive here.
  • "Underfilled, so it must be a weak backup." The one to handle most carefully. The fellowship genuinely underfills, which some read as "the specialty nobody wants." Reality: underfilling reflects the economics of pediatric subspecialization (long training, modest pay premium over general peds), not the quality or importance of the work. The people who choose it are typically mission-driven and self-selected rather than consolation-prize applicants, and demand for them is intense.

What people say online (synthesized and paraphrased, not quotes): Across trainee and physician forums the picture is fairly consistent. People broadly agree it's one of the more lifestyle-friendly pediatric subspecialties, with better call and controllability than PICU/neonatology and procedures and inpatient stakes still in the mix. Its accessibility comes up constantly, discussed both as a genuine advantage (you can get in without an elite pedigree) and as fuel for the "backup" stereotype. The single most common "think hard before you do it" theme is the pediatric-subspecialty economics problem: three extra fellowship years for pay only modestly above general pediatrics. And there's real, repeated enthusiasm about the CF modulator revolution having made the field more hopeful and scientifically alive. The through-line: people who love the physiology, the long family relationships, and the manageable lifestyle, weighed honestly against the pay-vs-training math and the emotional weight of chronic and technology-dependent kids.

Voices from the field. Paraphrased from public writing, with links to the originals:

  • The Council of Pediatric Subspecialties (COPS) description frames the draw as the mix of acute and chronic disease and the ability to form lasting relationships with patients and families, notes the procedural toolkit, and states plainly that clinical service does not typically require in-hospital overnight call, with more positions than available specialists.1
  • The American Thoracic Society's "Fellowship Training in Pediatric Pulmonology" frames the appeal as improving outcomes in high-impact conditions like asthma and cystic fibrosis, the inpatient/outpatient/procedure blend, and strong job prospects.16
  • Dr. McCoy, in Pediatrics Nationwide (Nationwide Children's, 2026), describes the modulator era as nothing short of dramatic for a large share of CF patients, with children who once struggled to gain weight beginning to thrive and families revising their life expectations, while emphasizing the ~10% still left behind and the gene-editing/gene-therapy work aimed at them.13

Why people choose it / why people leave

Why choose it: a controllable-for-an-acute-field lifestyle (home call, little/no in-house overnight, largely scheduled clinic + procedures) · a best-of-both clinical mix of longitudinal chronic relationships plus inpatient stakes plus a real procedure, without needing the OR · the physiology payoff for people who like understanding systems · a field being transformed by the CF modulator revolution · accessible to match and in durable demand, with more jobs than specialists · a strong mission pull toward CF and complex chronic kids.

Why leave or avoid it: the pay-vs-training math (three extra fellowship years for a modest premium over general peds) · the emotional load of chronic and technology-dependent disease even in the modulator era (the ~10% CF gap, BPD, fragile trach/vent kids) · the administrative grind (prior auths, CF-center coordination, grant pressure) · it's not procedure-defined enough for someone who wants the OR or cath lab as their identity · six years post-MD before an attending paycheck.

Best fit if: you love pulmonary/respiratory physiology and want to think mechanistically · you want to know families over years and can carry chronic-disease emotional weight · you want inpatient stakes and some procedures but not PICU/neonatology hours · you're mission-driven and value lifestyle and job security over maximizing pay.

Not for you if: you're optimizing lifetime earnings, because the fellowship ROI over general peds is poor · you want a procedure-defined, OR-centric identity · you can't tolerate longitudinal chronic-disease grief or medically fragile, technology-dependent patients · you need front-line acute/critical-care adrenaline as your core work.

The FLI angle — Pediatric Pulmonology for first-gen, low-income & immigrant students

Pediatric pulmonology is a notably FLI-accessible subspecialty, with a specific and honest catch, and both halves deserve equal airtime.

Where it fits FLI realities well:

  • The fellowship underfills, consistently. In the 2026 match it offered 87 positions and filled 55 (63.2%), against 59 applicants, with 24 programs left short; the year before it filled 46 of 95, under half.5 A fellowship that leaves a third of its seats empty is, by definition, reachable without an elite pedigree, a perfect record, or the pedigree-signaling arms race of competitive fields. For a first-gen/low-income applicant, that open door is enormous.
  • Reached through an accessible parent residency. General pediatrics is itself one of the more accessible residencies, so the whole ladder, accessible residency into accessible fellowship, is friendlier to applicants from state schools, DO programs, or without connections than the surgical-subspecialty pipeline.
  • Real DO/IMG entry. 20% DO and 20% IMG of matched fellows in 2026, against 13% DO and 37% IMG the year before, is a genuine, documented pathway, not a token one — though the swing between those two cycles is a reminder that a single year is thin evidence at n=55.5
  • Strong, durable demand and geographic choice. The field describes more positions than specialists; every children's hospital needs pulmonologists (asthma is ubiquitous; every CF and vent program needs them). Job security and location flexibility matter when you're supporting family and can't gamble on a thin market.116
  • A controllable lifestyle protects the life you're working for. Home call and largely scheduled days make it easier to be present for family than the acute pediatric subspecialties.

The honest catch, to go in with eyes open:

  • The pay is mid-to-lower for the training cost. Doximity puts the field at $282,000, about $17,000 above general pediatrics ($265,230), and self-reports run higher.92 It sits above peds endocrinology and heme/onc, below neonatology and pediatric cardiology, and only modestly above the generalist base. ⟳ You'd spend three additional post-residency years earning a fellow's stipend for a career that may out-earn general peds only modestly. For a debt-heavy FLI graduate, that opportunity cost is real.
  • Six years post-MD to attending pay. Three years of residency plus three of fellowship delays your first real paycheck, a genuine cost when family is counting on you now. If fast, strong income is the priority, general pediatrics (or a higher-paying subspecialty) may serve FLI goals better.

Bottom line: pediatric pulmonology is one of the more reachable subspecialties in medicine, offering security, meaning, a livable schedule, and a genuinely hopeful clinical frontier. It is a strong fit for a mission-driven FLI candidate who values those over maximum earnings. The earnings math, mid-lower pay plus three years of delayed income for a modest premium over general peds, is the tradeoff to weigh honestly rather than gloss over.

Sub-subspecialties & areas of focus

None is required, and practitioners often concentrate further within the field:113

  • Cystic Fibrosis (CF). The flagship focus; multidisciplinary, longitudinal CF-center care, transformed by CFTR modulators. Many pulmonologists build their careers around an accredited CF center.
  • Pediatric Sleep Medicine. Sleep-disordered breathing, obstructive sleep apnea, and sleep-study interpretation; a common formal add-on fellowship (sleep-medicine boards) and a lifestyle-friendly, revenue-adding line.
  • Technology-Dependent / Chronic Home Ventilator care. Children with tracheostomies and long-term ventilators, many NICU graduates with BPD/chronic lung disease of prematurity; intensive, longitudinal, among the most complex and rewarding niches.
  • Lung Transplant. A small, highly specialized niche at select centers; higher acuity, higher call, and more emotionally intense than the field's norm.

Fun facts

  • The CF modulator revolution is the field's defining recent story: CFTR modulators (Trikafta; now next-gen agents) took projected CF life expectancy from the mid-30s/40s toward ~65 years, converting a fatal childhood disease into a manageable chronic one for ~90% of patients, one of the most dramatic single-therapy transformations in modern pediatrics.13
  • ~10% of CF patients still can't benefit. Those with nonsense/premature-stop mutations have no protein for a modulator to act on, which is why gene-editing and gene-therapy research is now a hot frontier of the specialty.13
  • One of the most underfilled pediatric fellowships: the 2026 match filled 55 of 87 positions (63.2%), and the year before just 46 of 95.5
  • Home call, not in-house call. Unlike most acute-flavored pediatric fields, overnight coverage is classically taken from home.1
  • Trikafta was extended to children as young as 2, pushing modulator therapy earlier and earlier, potentially heading off lung damage before it starts.17
  • Sleep is part of the lungs' job description: many pediatric pulmonologists also read sleep studies and manage sleep-disordered breathing, and sleep medicine is a common add-on.1

Sources

Online sentiment synthesized and paraphrased (never quoted) from public discussion in trainee and physician forums. Figures marked ⟳ verify are volatile, so re-pull from the primary source before quoting.

Footnotes

  1. Clinical mix, procedures, home-call model, controllability, and workforce demand ("more positions than available specialists"). Council of Pediatric Subspecialties (COPS), "Pulmonary Medicine" subspecialty description: https://www.pedsubs.org/about-cops/subspecialty-descriptions/pulmonary-medicine/ ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10 ↩11 ↩12 ↩13

  2. Compensation — national figures, percentile spread, starting-vs-experienced, geography, academic-vs-private, and 100%-hospital-employed setting. SalaryDr — Pediatric pulmonology (median $330k, base $273k, flat trajectory, satisfaction), July 2026: https://www.salarydr.com/specialty/pediatrics/pulmonology ; ZipRecruiter (avg ~$341k; spread; top city Berkeley), July 2026: https://www.ziprecruiter.com/Salaries/Pediatric-Pulmonologist-Salary ; Salary.com (avg $243k; 10th–90th), July 2026: https://www.salary.com/research/salary/hiring/pediatric-pulmonologist-salary ; Marit Health ($271k national, ~$306k NY), 2026: https://www.marithealth.com/o/-/pediatric-pulmonologist/salary ; MGMA (percentiles paywalled, not retrieved): https://www.mgma.com/pediatriciansalary SalaryDr panel size: n=10. A self-selected physician panel; the n is disclosed here because it is what the figure rests on. On Marit Health: it publishes a panel of self-reported physician salaries, and displays MGMA and AMGA benchmarks beside them that are masked unless you create an account. The figure quoted here comes from the self-reported panel, not from either benchmark. Read it as crowd data: unweighted, of unstated sample size, and directional. On Salary.com: its CompAnalyst benchmark is HR-reported employer survey data blended with job-posting data, not a physician panel. It is base-weighted and so runs low against total-compensation surveys, and it is used here for percentile structure rather than for levels. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10 ↩11 ↩12 ↩13 ↩14

  3. Training path and two-step entry via the NRMP Pediatric Specialties Match (3-yr peds residency → 3-yr ACGME peds pulmonology fellowship). NRMP, 2025 Medicine and Pediatric Specialties Match Results (2025): https://www.nrmp.org/match-data/2025/12/2025-medicine-and-pediatric-specialties-match-results/ ↩ ↩2 ↩3

  4. Board certification and subspecialty history — American Board of Pediatrics (ABP), subspecialty of Pediatric Pulmonology (established 1986; general peds certification prerequisite); cumulative diplomate count. ABP Pediatric Physicians Workforce Data Book 2017–2018, Table 1.1: https://www.abp.org/sites/abp/files/pdf/pediatricphysiciansworkforcedatabook2017-2018.pdf ↩ ↩2 ↩3 ↩4

  5. 2026 match figures, applicant-type breakdown and five-year fill series (50 programs, 87 positions, 55 filled / 63.2%, 59 applicants ranked; 33 US-MD, 11 DO, 3 US-IMG, 8 non-US-IMG). NRMP, Results and Data — Specialties Matching Service, 2026 Appointment Year (Feb 2026), Tables 1A and 2 and the five-year trend tables: https://www.nrmp.org/wp-content/uploads/2026/02/SMS_Results_and_Data_Report2026.pdf. The 2025 figures quoted beside them (53 programs, 95 positions, 46 filled / 48.4%, 51 applicants; 23 US-MD, 6 DO, 5 US-IMG, 12 non-US-IMG) come from the 2025 Appointment Year edition: https://www.nrmp.org/wp-content/uploads/2025/02/SMS_Results_and_Data_2025.pdf. Corrected 2026-08-17: the competitiveness section reported the 2025 cycle in the present tense while the dashboard, the FLI section and a fun fact used 2026, so the page carried two fill rates fifteen points apart for one question, and it built "roughly half of all positions went unfilled" on 48.4%, which the five-year series shows was the low of those years. The applicant-type mix was stale in the same way and sat one row across in the same table: DO moved 13.0% to 20.0% and IMG 37.0% to 20.0% in a single cycle, and ~37% IMG had been stated three times as a documented door. Both halves now come from the 2026 report with the prior year beside them. The two editions order their applicant-type columns differently — 2025 runs MD, DO, Canadian, US IMG, non-US IMG and 2026 runs MD, DO, US IMG, non-US IMG, Canadian — so the rows cannot be read positionally against each other. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8

  6. Program count — 58 ACGME-accredited pediatric pulmonology programs (AY2024–2025). ACGME Data Resource Book AY2024–2025: https://www.acgme.org/globalassets/pfassets/publicationsbooks/2024-2025_acgme_databook_document.pdf ↩ ↩2

  7. Workforce trends, URiM lag, and projected subspecialist-to-child ratio. AAP, "Child Health Needs and the Pediatric Pulmonology Workforce: 2020–2040," Pediatrics 2024;153(Suppl 2):e2023063678Q: https://publications.aap.org/pediatrics/article/153/Supplement%202/e2023063678Q/196580 ↩ ↩2 ↩3

  8. The pediatric-subspecialty "fellowship penalty" and compressed academic starting pay. Doximity Op-Med, "The Salary Problem in Pediatric Subspecialties" (2024): https://opmed.doximity.com/articles/the-salary-problem-in-pediatric-subspecialties ; AAP Pediatrics Open Science, assistant-professor pediatric pay gap (2024): https://publications.aap.org/pediatricsopenscience/article/1/3/1/203533 ↩ ↩2 ↩3

  9. Doximity, 2025 Physician Compensation Report (published 2025; reports 2024 earnings from ~37,000 US physicians) — pediatric pulmonology $282,000; adult pulmonology $425,700 (the +51% gap); general pediatrics $265,230 (+2.2% nominal, −6.7% real since 2017); neonatology/perinatology $354,841; pediatric cardiology $352,197; pediatric heme/onc $255,733; pediatric endocrinology $230,426. https://www.doximity.com/reports/physician-compensation-report/2025 ; companion piece "Despite a Small Bump in Pay, Pediatric Care Continues to Feel the Strain": https://opmed.doximity.com/articles/despite-a-small-bump-in-pay-pediatric-care-continues-to-feel-the-strain . Correction, 2026-08-13: this page previously carried no direct figure for pediatric pulmonology. It derived one, applying Doximity's stated 51% adult-versus-pediatric gap to an adult-pulmonology median of ~$460k to reach ~$305,000, and labeled that a two-source derivation. Doximity publishes the pediatric line itself at $282,000, and the adult line at $425,700, so the derivation is removed and both published figures are used. The derived estimate was high by roughly $23,000 because the adult anchor it borrowed was not Doximity's. ↩ ↩2 ↩3 ↩4 ↩5

  10. Pediatric-subspecialty midpoint ~$263,000 (range ~$175k–$500k). Physicians Side Gigs, "What Is the Average Salary for Physicians in Pediatric Specialties?": https://www.physiciansidegigs.com/average-salary-for-pediatric-specialties ↩

  11. Academic pediatric pulmonology paid at ~83% of the adult-pulmonology AAMC benchmark. J Pediatr / AMSPDC 2023: https://media.amspdc.org/wp-content/uploads/2023/09/12085008/peds-salaries-Jpeds-2023.pdf ↩

  12. Parent-field burnout anchors (pediatrics ~51%, adult pulmonary ~50%; no peds-pulm-specific figure published). Medscape Physician Burnout & Depression Report 2024, via Healthgrades: https://resources.healthgrades.com/pro/the-most-and-least-burned-out-physicians-by-specialty ; Medscape landing: https://www.medscape.com/sites/public/lifestyle/2024 ↩ ↩2

  13. CF modulator transformation (life expectancy toward ~65; ~90% eligible; ~10% left behind; Dr. McCoy). Pediatrics Nationwide (Nationwide Children's), "Beyond Modulators…" (2026): https://pediatricsnationwide.org/2026/04/13/beyond-modulators-ensuring-all-patients-with-cystic-fibrosis-bene%EF%AC%81t-from-the-next-wave-of-therapy/ ; supporting: "Cystic Fibrosis Year in Review 2024," Pediatric Pulmonology (2025): https://onlinelibrary.wiley.com/doi/10.1002/ppul.71222 ; "Impact of CFTR Modulators on Longitudinal CF Survival," PMC (2025): https://pmc.ncbi.nlm.nih.gov/articles/PMC12373600/ ↩ ↩2 ↩3 ↩4 ↩5

  14. Rising share of women over the past decade. AAP, "Child Health Needs and the Pediatric Pulmonology Workforce 2020–2040," Pediatrics 2024 (as above); ABP subspecialty fellow demographics dashboard (year by year, presented as an interactive dashboard rather than a table): https://www.abp.org/research/yearly-growth-pediatric-fellows ↩

  15. URiM race/ethnicity data (percentages not extractable; held in ABP dashboards). ABP race/ethnicity dashboard: https://www.abp.org/research/race-and-ethnicity-data ↩

  16. Field appeal, clinical blend, and job outlook. American Thoracic Society, "Fellowship Training in Pediatric Pulmonology," last reviewed February 2015: it lists asthma, bronchopulmonary dysplasia and cystic fibrosis among the required fellowship experiences, describes a practice spanning intensive care, chronic outpatient follow-up, bronchoscopy and the pulmonary function laboratory, and reports "fewer than 1,000 board certified Pediatric Pulmonologists in the United States" with employment opportunities that "abound." https://web.archive.org/web/20250914174314/https://www.thoracic.org/professionals/career-development/residents-medical-students/choosing-pediatric-pulmonology.php Corrected 2026-08-18: ATS retired this page in a site rebuild and its old address now lands on a professional-development index, so the citation points at the Internet Archive capture of 2025-09-14. The page titles itself "Fellowship Training in Pediatric Pulmonology"; this profile had called it "Choosing Pediatric Pulmonology," which is only its web address. Its February 2015 review date is the vintage behind the workforce claim. ↩ ↩2 ↩3

  17. Trikafta extended to children as young as 2. Pediatrics Nationwide, "Expanding Use of Trikafta for Cystic Fibrosis to Patients as Young as 2 Years Old" (2023): https://pediatricsnationwide.org/2023/08/02/expanding-use-of-trikafta-for-cystic-fibrosis-to-patients-as-young-as-2-years-old/ ↩

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