Pulmonology is the medical specialty devoted to respiratory diseases and therefore lung infections. More precisely, it may concern:

• lungs ;
• bronchi ;
• the pleura (which constitutes the “envelope” of the lungs and comprises 2 layers, the visceral pleura and the parietal pleura).

Pulmonology is interested in tumor pathologies (c) and non-tumor. Pediatric pulmonology is sometimes considered a specialty in its own right.

As a reminder, the lungs are the central organ of the respiratory system. They constitute a sort of “bag”, located on either side of the heart. They are divided into several lobes (two lobes on the left, three on the right), and are both enveloped by the pleura.

It is in the lungs that gas exchange takes place:

• the blood takes on oxygen;
• it discharges carbon dioxide, the “waste” produced by respiration.

The trachea carries air to the lungs, dividing into two main bronchi (left and right). Like a ramifying tree, each of these bronchi gradually ramifies, up to the terminal bronchioles.

The bronchioles end in the alveolar sacs, which are highly vascularized and strictly speaking constitute the zone of exchange with the blood.

Many pathologies (3) can be treated in pulmonology. These include:

• cancers of the lungs, bronchi or pleura;
• asthma ;
• respiratory allergies;
• respiratory failure ;
• chronic obstructive pulmonary disease (COPD);
• pulmonary arterial hypertension;
• pulmonary embolism ;
• pleurisy;
• respiratory disorders linked to systemic diseases (vasculitis, connectivitis, sarcoidosis, etc.);
• infectious diseases, such as TB, pneumonia or lung abscess;
• genetic diseases such as cystic fibrosis (cystic fibrosis);
• sleep disturbances (apnea, snoring);
• occupational respiratory diseases, due to exposure to certain substances (asbestos, chemicals, dust, etc.);
• diseases linked to smoking (emphysema, chronic bronchitis, etc.);
• neuromuscular diseases with respiratory symptoms;
• resuscitation, intensive care;
• lung transplantation.

Although lung conditions can affect anyone, there are certain recognized risk factors, in particular:

• smoking;
• certain professional environments (exposure to certain substances).

To arrive at a diagnosis and identify the origin of the disorders, the pulmonologist:

• questions his patient to find out the nature of the disorders, their date of onset and their triggering mode (exertion, cold, etc.), the degree of discomfort felt;
• inquire about the patient’s history, his risk factors (smoking, occupational exposure, etc.), family history;
• questions the environment and lifestyle (place of life, pets, recent trips, etc.);
• performs a first auscultation, using a stethoscope;
• may have recourse to additional examinations (radiography, for example).

Depending on the problem and the treatment to be provided, the pulmonologist may have recourse, among others:

• a bronchial endoscopy, which allows you to explore the bronchi with a camera
• respiratory function tests (FRT), to measure the intensity of the breath and the breathing capacity
• a chest x-ray
• interventional endoscopy (to perform a biopsy or other)
• ventilation devices

In cancer, thoracic surgery, chemotherapy and radiotherapy are generally recommended.

The consultation with a pulmonologist does not involve any particular risks for the patient.

Training as a pulmonologist in France

To become a pulmonologist, the student must obtain a diploma of specialized studies (DES) in pulmonology:

• he must first follow, after his baccalaureate, a common first year in health studies. Note that an average of less than 20% of students manages to cross this milestone.
• at the end of the 6th year, students take the national classifying tests to enter the boarding school. Depending on their classification, they will be able to choose their specialty and their place of practice. The pneumology internship lasts 4 years.

Finally, to be able to practice as a pediatrician and hold the title of doctor, the student must also defend a research thesis.

The pulmonologist training hasu Quebec

After college studies, the student must:

• follow a doctorate in medicine, lasting 1 or 4 years (with or without a preparatory year for medicine for students admitted with a college or university training deemed insufficient in basic biological sciences);
• then specialize by following a residency in pulmonology for 5 years (including 3 years in internal medicine).

Before going to the appointment with a pulmonologist, it is important to take any imaging or biology exams already carried out.. It is important to note the characteristics of the pain (duration, onset, frequency, etc.), to inquire about your family history and to bring the various prescriptions.

To find a pulmonologist:

• in Quebec, you can consult the website of the Federation of medical specialists or the Lung Association (4), which offers a directory of specialists;
• in France, via the website of the Ordre des médecinsâ ?? µ or the Fédération française de pneumologie6, which offers a directory.

The consultation with the pulmonologist is covered by the Health Insurance (France) or the Régie de l’assurance maladie du Québec.