Respirologist

What lung doctors make

There is no separate federal wage line for lung doctors, so the figures come from Physicians, All Other, a catch-all for specialties the survey does not name. In the 2025 federal wage survey that group's median is $265,930 a year, the bottom tenth earn $69,170 or less and the top tenth $452,360 or more. These figures describe the whole group, not this specialty alone, and they count only physicians paid a wage, so doctors who own their practice are largely missing.

Pay while you train

You are a paid hospital employee for 5 to 6 years: 3 years of internal medicine residency, then a 2 to 3 year fellowship. Each hospital sets its own scale. Interest on medical school loans keeps growing meanwhile. Nationally, the AAMC (Association of American Medical Colleges) survey of 345 teaching hospitals puts the average first-year stipend at $68,166 as of July 1, 2025, and about $81,807 in the fifth year. Read from the AAMC's data, downloaded in a browser with Claude in Chrome on 6 November 2026, because aamc.org refuses our checker.

Where pay is highest

Montana is next at $438,850 and Maine at $419,410. The lowest is the District of Columbia, at $77,430. State medians from the 2025 federal wage survey, for the whole mixed group of doctors.

What it costs to get there

Most graduates borrow, and the debt is large. File the FAFSA (Free Application for Federal Student Aid) every year. Residency at a nonprofit or government hospital counts toward Public Service Loan Forgiveness, and 5 to 6 years of training gets you about halfway to the ten required.

How the money actually arrives

• Hospital salary

  Most lung and critical care doctors are employed by a hospital or health system on a contract.

• Productivity bonuses

  Paid on the volume of patients seen and procedures done, on top of base salary.

• Intensive care shifts

  Covering the unit overnight and at weekends is often paid separately.

• Procedures

  Bronchoscopy and other airway procedures are billed separately from clinic visits.

• Rural signing bonuses

  Small hospitals that cannot recruit pay lump sums and loan repayment to fill the post.

The path to becoming a respirologist, step by step

One of the longest routes on this site. Thirteen years from high school, minimum.

1. 1

   High school

   Grades 11 and 12

   Top grades in biology, chemistry, physics and math. Medicine is a numbers game long before it is a caring one, and it starts with your college admission.

2. 2

   Bachelor's degree

   4 years

   Any major, as long as you finish the science prerequisites and keep a high GPA. Sit the MCAT (Medical College Admission Test).

3. 3

   Medical school

   4 years

   Two years of science, two of clinical rotations, ending in an MD (Doctor of Medicine) or a DO (Doctor of Osteopathic Medicine). Admission is brutal.

4. 4

   Internal medicine residency

   3 years

   Paid, supervised hospital training in adult medicine. You are matched to a program by a national algorithm, not by applying job by job.

5. 5

   Pulmonary and critical care fellowship

   2 to 3 years

   Lungs, ventilators and intensive care. Two years for pulmonary alone, three for the combined pulmonary and critical care training most people do.

High school courses that help you become a respirologist

• Biology and chemistry

  Every college prerequisite for medical school is built on these two.

• Physics

  Gas laws and pressure are the daily physics of the lung and the ventilator.

• Calculus and statistics

  Statistics is on the admission test and you read research for the rest of your life.

• English

  The admission test has a long critical reasoning section, and explaining bad news well is a skill.

Time and money, at a glance

Licensed by the state, certified by a board

Your license to practice comes from the medical board of each state you work in. The exam behind it is national: three steps of the United States Medical Licensing Examination, taken across medical school and the first year of residency. On top of that sits specialty certification from ABIM (the American Board of Internal Medicine), first in internal medicine and then in pulmonary disease and critical care medicine. Every residency and fellowship you train in has to be accredited by ACGME (the Accreditation Council for Graduate Medical Education), or the boards will not accept your training.

Where people study

• Medical schools across the country

  Each one sets its own admission requirements and publishes them.

• Public schools in your own state

  State medical schools reserve most seats for residents and charge them far less.

• Osteopathic medical schools

  A second route to the same license, with its own application service and growing quickly.

• Fellowship programs

  Pulmonary and critical care fellowships sit at large teaching hospitals, and you apply through a national match.

Subspecialties inside the specialty

• Critical care medicine

  Running the intensive care unit. Most lung doctors in the United States train in this alongside pulmonary.

• Sleep medicine

  One extra year. Sleep apnea and sleep labs, with clinic hours and no night calls.

• Interventional pulmonology

  Advanced airway procedures and lung biopsies. Technical and procedural.

• Lung transplant and cystic fibrosis

  Academic centers only, long relationships with young patients, and high stakes.

Nice-to-haves along the way

• Research during college and medical school

  Fellowship programs in this field care about it more than most.

• Work as an emergency medical technician or hospital aide

  Paid patient contact that admissions committees take seriously.

• Spanish or another second language

  You explain frightening things to families under pressure, often through an interpreter otherwise.

• Stamina

  Five to six years of residency and fellowship means years of nights, weekends and 24-hour calls.

A computer decides where you train

American doctors do not apply for residency jobs one at a time. You interview at many programs, rank them in order, the programs rank you, and the National Resident Matching Program runs an algorithm that pairs everyone at once. The result arrives on a single day in March and it is binding. The research behind that algorithm won the 2012 Nobel Prize in economics. Fellowships in pulmonary and critical care run their own match on the same principle.

What a respirologist does day to day

Two jobs in one. On clinic weeks you see 12 to 20 patients: asthma, COPD (chronic obstructive pulmonary disease), lung nodules, coughs that have lasted a year, people frightened by a shadow on a scan. On unit weeks you round through an intensive care unit at seven in the morning, deciding ventilator settings, sedation and whether a patient is well enough to breathe alone. Procedures fill the afternoons and family meetings fill the gaps, including the ones about stopping treatment.

The honest pros and cons of being a respirologist

Work life

Similar paths

• Internal Medicine DoctorThe adult body, all of it, and the complicated patients nobody else can sort out. Eleven years of training.
• CardiologistA heart doctor who diagnoses and treats heart disease, often without ever opening the chest.
• Allergist and ImmunologistThirteen years of training for one of the calmest schedules in medicine.

One in five applicants did not match

In the December 2025 match for fellowships starting in 2026, 1,112 doctors wanted a pulmonary and critical care place. There were 844 places, and 225 of those applicants matched to no fellowship at all.

Lung doctors often run the intensive care unit

Pulmonary and critical care are usually trained together here. In the December 2025 fellowship match, combined programs offered 844 places, against 21 for lung medicine alone. So the doctor who treats your asthma on Tuesday may run the ventilators on Thursday.

The wage survey counts a mixed group

Federal wage data has no line for lung doctors. They are counted in Physicians, All Other together with many other specialties, so the federal median of $265,930 a year describes that whole group rather than this job. Pay figures for the specialty on its own come from private surveys of doctors.