- What This Credential Actually Is
- The Eligibility Pathway, Step by Step
- The Announced New Training Model: What Needs Confirming
- Registration Mechanics and Fee Structure
- Exam Format and Scoring Rules
- What the 19-Domain Outline Means for Qualified Candidates
- Matching Your Preparation to the November 2026 Sitting
- After You Qualify: Continuing Certification and Careers
- Verification Checklist Before You Apply
- Frequently Asked Questions
- This credential is issued by the American Board of Pediatrics (ABP) and delivered through Prometric.
- Traditional eligibility combines a medical or osteopathic degree, general pediatrics certification, three-year subspecialty fellowship, and scholarly...
- The official regular fee is $2,992, including a $750 processing component.
- The November 1, 2026 content outline (19 domains) applies to the November 5, 2026 initial-certification exam.
What This Credential Actually Is
When people search for pediatric pulmonology requirements, they are usually asking one question: what must I complete, and in what order, before the American Board of Pediatrics will let me sit for the subspecialty examination? This article answers that question for one credential only: Certification in Pediatric Pulmonology, awarded by the American Board of Pediatrics. It is a subspecialty certificate built on top of general pediatrics certification, which means you cannot reach it directly from medical school or from a general residency alone.
If you want broader background on the field before you dig into prerequisites, our explainers on what Pediatric Pulmonology certification is and Pediatric Pulmonology training cover the ground that this article assumes you already understand.
The Eligibility Pathway, Step by Step
The traditional route to eligibility is sequential. Each step is a gate, and skipping or delaying one can push your first attempt back by a full examination cycle.
Step 1: Medical or Osteopathic Degree
Your foundation is an MD or DO degree. This is the entry requirement for everything that follows, including general pediatrics residency.
Step 2: General Pediatrics Certification
Because pediatric pulmonology is a subspecialty, the ABP expects you to hold general pediatrics certification. This is a distinct credential from the subspecialty exam, and its status should be current when you apply. Candidates who are still waiting on general pediatrics results, or whose certification has lapsed, should contact the ABP early to understand how that affects their application timeline.
Step 3: Three-Year Subspecialty Fellowship
The traditional pathway requires completion of a three-year fellowship in pediatric pulmonology. These programs are where you gain hands-on exposure to the clinical domains tested on the exam: asthma, cystic fibrosis, non-CF bronchiectasis, sleep-disordered breathing, interstitial lung disease, neonatal respiratory disorders, and respiratory failure, among others. They also build your skills in bronchoscopy, pulmonary function testing, and chronic ventilation management.
Step 4: Scholarly Requirements
The fellowship is not purely clinical. The ABP's subspecialty framework includes scholarly activity requirements, and the exam itself reflects this: Domain 19 is titled Core Knowledge in Scholarly Activities and Health Equity and carries an approximate 4% weight. Fellows should document their research, quality improvement, or other scholarly work carefully, because program directors must attest to completion.
Step 5: Licensure and Attestation
Current license and attestation details must be confirmed with the ABP. Do not assume the requirements are identical to those you met for general pediatrics certification. Verify what documentation is needed, who submits it, and by what deadline.
| Requirement | What It Means in Practice | Where to Confirm |
|---|---|---|
| MD or DO degree | Foundational medical credential | Your medical school and ABP records |
| General pediatrics certification | Prerequisite subspecialty gateway | ABP |
| Three-year fellowship | Traditional training pathway in pediatric pulmonology | Your program director and ABP |
| Scholarly requirements | Documented scholarly work during training | Program director attestation, ABP |
| License and attestation | Current details require ABP confirmation | ABP |
The Announced New Training Model: What Needs Confirming
The ABP has announced a new training model, and candidates currently in the pipeline sometimes ask whether it changes their eligibility. The honest answer is that its applicability to your specific situation requires direct confirmation from the ABP. Nothing in the verified information available for this article establishes exactly how the new model maps onto the traditional three-year route, which cohorts it covers, or when transitions take effect.
In the meantime, the safest planning assumption for most candidates is the traditional pathway described above, with the understanding that the ABP may refine it.
Registration Mechanics and Fee Structure
Registration runs through the ABP, while the exam itself is delivered at Prometric testing centers. The official indexed regular fee is $2,992, which includes a $750 processing component. That number is the anchor for budgeting, but candidates should check the official fee page for any late-registration differences or adjustments.
For a full breakdown of what you will spend across prep materials, travel, and the exam itself, see our guide to Pediatric Pulmonology certification cost. For deadlines and scheduling windows, our exam dates guide is the companion resource, and the authoritative source is the ABP page listing subspecialty exam dates and fees: abp.org exam dates and fees for subspecialties.
Key Takeaway
Budget for the $2,992 regular fee first, then add materials and logistics. Treat the ABP fee page as the final word, since published amounts can change between application cycles.
Exam Format and Scoring Rules
Knowing the format helps you judge when you are truly ready to apply, so it belongs in any requirements discussion.
- Length: approximately 200 multiple-choice questions.
- Scoring: a scaled score on a 1-300 scale, with a passing score of 180. This is not a raw percentage. A scaled score accounts for form-to-form difficulty differences, so you cannot translate it into a fixed number of questions answered correctly.
- Delivery: Prometric testing center.
- Rules not yet verified: initial-certification policies on open-book access, calculators, remote delivery, and scheduled breaks should be confirmed with the ABP and are not asserted here.
For a deeper look at what that cut score means, read our passing score guide. For performance context, the latest verified first-time national pass rate is 73% in 2024, up from 68% in 2022, as reported in a 2026 primary paper citing the ABP. Our pass rate analysis discusses how to interpret those figures, and the difficulty guide addresses what they imply for your preparation.
What the 19-Domain Outline Means for Qualified Candidates
Meeting the eligibility requirements gets you into the room. The content outline determines what you are tested on once you are there. The current ABP Pediatric Pulmonology initial-certification content outline is effective November 1, 2026, and it applies to the November 5, 2026 initial-certification examination. The outline has 19 domains with approximate published weights totaling 100%. Note that the October 2025 subboard approval date is not the effective date; do not confuse the two when planning.
Versions of the outline may vary slightly, so always download the current document from the official source: official ABP pulmonology content outline (PDF). A directory of all subspecialty versions is available at abp.org subspecialty content outlines.
| Domain | Approx. Weight |
|---|---|
| 1. Lung Development and Physiology | 6% |
| 2. Common Signs and Symptoms | 8% |
| 3. Respiratory Disorders of the Neonate and Infant | 5% |
| 4. Congenital and Acquired Malformations of the Airways and Lungs | 5% |
| 5. Respiratory Infections | 6% |
| 6. Cystic Fibrosis (CF) | 6% |
| 7. Non-CF Bronchiectasis | 4% |
| 8. Asthma | 9% |
| 9. Sleep-Disordered Breathing and Control of Breathing Disorders | 4% |
| 10. Restrictive Disease | 5% |
| 11. Respiratory Failure | 5% |
| 12. Interstitial Lung Disease | 5% |
| 13. Pulmonary Vascular and Lymphatic Diseases | 4% |
| 14. Lung Disease Associated with Systemic Disorders | 4% |
| 15. Environmental Injuries and Exposures (Acute and Chronic) | 4% |
| 16. Respiratory System Under Stress | 3% |
| 17. Other Disorders of the Respiratory System | 5% |
| 18. Core Principles of Pulmonary Diagnosis and Monitoring Techniques | 8% |
| 19. Core Knowledge in Scholarly Activities and Health Equity | 4% |
How Fellowship Training Maps to the Heavy Hitters
Asthma (9%): The Largest Published Domain
Asthma carries the single highest weight, so fellowship experience in severe and difficult-to-control disease directly supports your exam readiness.
- Phenotyping and step-up or step-down management logic
- Biologic therapy selection for severe pediatric asthma
- Differentiating asthma from mimics such as vocal cord dysfunction and airway malacia
Common Signs and Symptoms (8%)
Chronic cough, wheeze, stridor, recurrent pneumonia, and exercise intolerance are the presenting complaints you triage daily. Expect questions that ask for the next best diagnostic step rather than a recitation of facts.
Core Principles of Pulmonary Diagnosis and Monitoring Techniques (8%)
This domain rewards procedural and interpretive fluency. Candidates should be comfortable with the strengths and limits of the tools they use in clinic and the procedure suite.
- Pulmonary function interpretation across age groups
- Imaging selection and bronchoscopy indications
- Overnight monitoring and sleep study interpretation
Because domains such as Cystic Fibrosis, Respiratory Infections, and Lung Development and Physiology each sit at 6%, your fellowship's case mix matters. If your program had limited exposure to a given area, flag it early and fill the gap before applying. Our complete guide to all 19 content areas goes domain by domain.
Matching Your Preparation to the November 2026 Sitting
Qualifying on paper and being exam-ready are two different milestones. One practical way to bridge them is to schedule study blocks around domain weight and clinical exposure rather than treating every topic equally. The sequence below is one example for a candidate targeting the November 5, 2026 exam.
Weakest-Exposure Domains First
- Start with domains your fellowship covered least, such as Pulmonary Vascular and Lymphatic Diseases or Environmental Injuries and Exposures
- Download the official outline and mark each domain green, yellow, or red
High-Weight Anchors
- Asthma (9%) and Common Signs and Symptoms (8%) for broad, high-yield coverage
- Core Principles of Pulmonary Diagnosis and Monitoring Techniques (8%) with an emphasis on test interpretation
Disease-Specific Clusters
- Cystic Fibrosis, Non-CF Bronchiectasis, and Interstitial Lung Disease together, to sharpen differentiation
- Neonatal and infant disorders alongside Lung Development and Physiology
Integration and Practice
- Timed blocks of multiple-choice questions across all 19 domains
- Review the scholarly and health equity domain, which is easy to underestimate
For a fuller plan, see our study guide, and when you want to test yourself under realistic conditions, our practice test platform offers question practice built around the published outline.
After You Qualify: Continuing Certification and Careers
Initial certification is the start of an ongoing relationship with the ABP. Continuing certification follows a five-year cycle, and diplomates can maintain certification through MOCA-Peds or through an examination pathway. Understanding this early helps you plan your professional development, since the longitudinal assessment model rewards steady engagement rather than a single high-stakes push.
Certified pediatric pulmonologists typically work in children's hospitals, academic medical centers, multidisciplinary cystic fibrosis and sleep programs, and specialty clinics. Our jobs overview describes the employer landscape, and for compensation context see the salary guide. If you are weighing whether the effort is justified, our ROI analysis lays out the trade-offs.
Verification Checklist Before You Apply
Several details in this article are deliberately flagged as requiring ABP confirmation. Before you submit an application, work through this list:
- Confirm your general pediatrics certification status is current.
- Obtain written confirmation from your program director that fellowship and scholarly requirements are complete.
- Ask the ABP how the announced new training model applies to your training timeline.
- Verify current license and attestation requirements.
- Check the official fee page and deadlines for the November 5, 2026 sitting.
- Download the current content outline and confirm its effective date.
- Ask about initial-certification rules on open-book access, calculators, remote delivery, and breaks, since these are unverified here.
The central overview at our Pediatric Pulmonology certification hub collects related resources in one place.
Frequently Asked Questions
The American Board of Pediatrics (ABP) issues the certification, and the examination is delivered through Prometric testing centers.
Yes. The traditional pathway requires a medical or osteopathic degree and general pediatrics certification, followed by a three-year subspecialty fellowship and scholarly requirements. Confirm your specific status with the ABP.
The ABP has announced a new training model, but how it applies to individual candidates must be confirmed directly with the ABP. Until you have written confirmation, plan around the traditional three-year fellowship pathway.
The official indexed regular fee is $2,992, which includes a $750 processing component. Verify the current amount and any deadline-related differences on the ABP fee page before registering.
The outline effective November 1, 2026, with 19 domains, applies to the November 5, 2026 initial-certification examination. Asthma is the largest domain at 9%. The October 2025 subboard approval date is not the effective date.