Pediatric Pulmonology Career and Training
About Pulmonology and pediatric approaches
Pulmonary diseases include all conditions of respiratory ailments in the lungs, the chest and the bronchial tubesthis is particularly problematic for the young, as it is possible that major bodily and mental development may be impaired (not to mention the emotional stress inflicted on young patients) with the presence of any disease that affects a child's 'airways. Asthma and chest infections (particularly bacteriological ones, far more frequent in the young) and tubercular infections are common, and emphysema, cystic fibrosis and pneumonia may occur in children who have a genetic predisposition to it, or who live with second hand smoke.
Add to these the terror of a child's loss of breath, and the experience of restrictive lung diseases is bound to be more traumatic and difficult to overcome than a similar condition in an adult. This is why the specialist in this area needs special sensitivity, as well as extraordinary diagnostic and treatment expertise.
Pediatric Pulmonologists training
A pulmonologist s education, beginning with training in science and mathematics as early as high school, should be intensive and rigorous; it should continue in the medical science advanced courses, medical ethics trainings and internships far beyond medical school, and most pulmonologists are required to have professional certification (including a MD or DO) contingent upon their continuing professional development.
Internship is a must; the adult pulmonologist logs in at least 4000 hours in preliminary training as a medical specialist for adults before he begins to approach the pediatric field. In general, it is recommended that the pediatric specialist achieve at least 2000 to 3000 hours of adult work in the pulmonology unit before he attempts the same diagnostic work with children.
Pediatric Pulmonologists Work
Only the most experienced pediatric pulmonology specialist should approach a surgical technique in the cardiothoracic arena; small children, obviously, need operative surgeons who take infinite care and painstaking detail in their work. However, some pediatric specialists may do minor respiratory surgeries, particularly if there is scarring present due to chest infections, which are far more excoriating for children than for adults. Most if not all pediatric surgery will be done by a thoracic expert.
The pediatric specialist will be called upon to diagnose the child's exposure to toxicity (asbestos, cigarette smoke, exhaust fumes and even, in some rural communities, chest infections from coal mine residue). Children are especially prone to colds and influenza (especially the more severe avian and swine influenzas of recent memory) and will need special diagnosis and treatment in fighting these conditions (and the specialist must be able to tell the difference between a viral and bacteriological infection, as there are entirely different regimens to treat both). Hereditary diseases such as cystic fibrosis are also common in children.
The pediatric specialist must be comfortable with the pharmacopeia available to children, and have a current knowledge of treatments and drug interactions, since children react in a far more pronounced manner to medications.
A final note about the profession: the specialist, with so many demands on him in internship and finances, has numerous opportunities to work in pediatric pulmonology fellowship trainings. A pediatric pulmonology fellowship experience is designed to make a pediatric pulmonologist into a leading authority in the specialty, one who can head up a specialist team at a children's hospital or pediatric facility. Its an educational hand up in one of the most challenging medical professions in existence.
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