- What the Credential Actually Is
- Who Certifies and How the Exam Is Delivered
- Who Can Sit for It
- The 19-Domain Blueprint
- Where the Weight Sits
- Scoring and Pass-Rate Context
- Fee Mechanics
- Where Certified Pediatric Pulmonologists Work
- A Domain-Driven Study Sequence
- Staying Certified After You Pass
- Frequently Asked Questions
- Certification in Pediatric Pulmonology is issued by the American Board of Pediatrics and delivered through Prometric.
- The exam has roughly 200 multiple-choice questions and a passing scaled score of 180 on a 1-300 scale.
- The outline effective November 1, 2026 has 19 domains; Asthma is the largest at 9%.
- Latest verified first-time national pass rate is 73% (2024), up from 68% in 2022.
What the Credential Actually Is
When someone asks "what is a Pediatric Pulmonology?", the precise answer is that it is a board certification: Certification in Pediatric Pulmonology, a subspecialty credential awarded to pediatricians who have completed fellowship training in the diagnosis and management of respiratory disease in infants, children, and adolescents. It is not a degree, a fellowship program, or a job title, though it is closely tied to all three. If you are looking for the broader field definition, see our overview What Is Pediatric Pulmonology?; this article focuses on the credential and the exam behind it.
The scope is wide. A certified pediatric pulmonologist is expected to manage everything from premature infants with chronic lung disease to adolescents with cystic fibrosis, children with technology-dependent breathing, sleep-disordered breathing, interstitial lung disease, and the ubiquitous problem of asthma. The exam reflects that breadth, which is why the blueprint spans 19 distinct domains rather than a handful of broad buckets.
Who Certifies and How the Exam Is Delivered
The certifying body is the American Board of Pediatrics (ABP). Exam delivery runs through Prometric testing centers. The initial-certification exam contains approximately 200 multiple-choice questions. Rules on open-book access, calculator availability, remote proctoring, and scheduled breaks for the initial exam should be confirmed directly with the ABP before you register, because those details are not something to assume from other board exams you have taken.
The upcoming initial-certification administration is scheduled for November 5, 2026, and the content outline effective November 1, 2026 applies to it. Note the distinction: the subboard approved the new outline in October 2025, but approval is not the same as the effective date. Candidates sometimes study from the wrong version because they see the approval date and assume it governs. For scheduling specifics, see Pediatric Pulmonology Exam Dates 2026, and always verify against the official ABP page at abp.org/exams/exam-dates-and-fees-subspecialties.
Who Can Sit for It
The traditional eligibility path has a clear sequence:
- A medical or osteopathic degree.
- Certification in general pediatrics.
- A three-year subspecialty fellowship in pediatric pulmonology.
- Completion of the scholarly requirements attached to that fellowship.
Two items need live confirmation with the ABP rather than a blog summary: current license and attestation details, and whether the announced new training model changes the pathway for your cohort. Training rules are one of the places where board policies evolve, so treat any secondhand summary, including this one, as a starting point. Our dedicated guide to Pediatric Pulmonology Requirements walks through the prerequisites in more detail, and the related piece on Pediatric Pulmonology Training covers the fellowship experience itself.
The 19-Domain Blueprint
The ABP publishes a content outline with approximate examination weights for each domain, totaling 100%. Published versions can vary slightly, so download the current one from the official outline link at abp.org/sites/public/files/pdf/content-outline-pulmonology.pdf. Here is the full breakdown:
| 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% |
For a domain-by-domain walkthrough, see Pediatric Pulmonology Exam Domains 2026: Complete Guide to All 19 Content Areas.
Where the Weight Sits
No single domain dominates. The largest, Asthma, carries 9%, and the next tier is Common Signs and Symptoms and Core Principles of Pulmonary Diagnosis and Monitoring Techniques at 8% each. That flat distribution is itself the strategic lesson: you cannot pass by mastering a few favorite topics. A candidate who is brilliant at cystic fibrosis but weak on lung development, sleep-disordered breathing, and scholarly activities will bleed points across a dozen small domains.
Asthma (9%)
The single largest domain, and one that tests both common and difficult presentations rather than only first-line management.
- Severity classification and control assessment across age groups
- Stepwise therapy decisions and when biologic therapy is considered
- Differentiating asthma from its mimics when response to treatment is poor
- Exacerbation management and the role of objective testing
Common Signs and Symptoms (8%)
This domain tests clinical reasoning from a complaint to a differential and a workup.
- Chronic cough, wheeze, stridor, and recurrent pneumonia in children
- Hemoptysis and chest pain evaluation in the pediatric setting
- Choosing the next test that best narrows the differential
Core Principles of Pulmonary Diagnosis and Monitoring Techniques (8%)
The technical domain. Expect interpretation questions, not just recall.
- Pulmonary function testing patterns and what they imply
- Imaging selection and bronchoscopy indications
- Monitoring approaches including oximetry and capnography
Scoring and Pass-Rate Context
The passing standard is a scaled score of 180 on a 1-300 scale. It is not a raw percentage, so you cannot translate it into "I need to get X% of questions right." Scaling accounts for differences in difficulty across exam forms. Our explainer on the Pediatric Pulmonology Passing Score covers what that means in practice.
The latest verified first-time national pass rate is 73% in 2024, compared with 68% in 2022, as reported in a 2026 primary paper citing ABP data. Those are the figures to rely on; avoid any source quoting pass rates without a citation. Roughly one in four first-time takers did not pass in 2024, so the exam is passable but not a formality. For deeper analysis, see Pediatric Pulmonology Pass Rate 2026: What the Data Shows and How Hard Is the Pediatric Pulmonology Exam?
Fee Mechanics
The official indexed regular fee is $2,992, which includes a $750 processing component. That is the headline number for the initial exam, and it does not include your study materials, travel to a Prometric center, or time away from clinical work. Treat the fee as one line in a larger budget. A complete breakdown is in Pediatric Pulmonology Certification Cost 2026, and the return-on-investment question is covered in Is the Pediatric Pulmonology Certification Worth It?
Where Certified Pediatric Pulmonologists Work
Certification matters most where employers need to credential subspecialists. Typical settings include:
- Children's hospitals and academic medical centers: inpatient consult services, outpatient clinics, bronchoscopy suites, and research programs.
- Cystic fibrosis care centers: multidisciplinary programs where pulmonologists lead the care team.
- Sleep and ventilator programs: clinics managing sleep-disordered breathing and children dependent on home respiratory technology.
- Neonatal follow-up and chronic lung disease clinics: managing graduates of the NICU with bronchopulmonary dysplasia.
- Large pediatric multispecialty groups and some community hospitals: particularly where a regional referral base exists.
Many of these roles list board certification or board eligibility as a hiring or privileging condition. See Pediatric Pulmonology Jobs for the employment landscape and the Pediatric Pulmonology Salary Guide for earnings context.
A Domain-Driven Study Sequence
Because the blueprint is flat, sequence your preparation by dependency: physiology first, then diagnosis tools, then disease domains that build on both. Here is one way to map a twelve-week plan onto the actual domains.
Foundations
- Lung Development and Physiology (6%)
- Core Principles of Pulmonary Diagnosis and Monitoring Techniques (8%): PFT interpretation first, since it underpins every later domain
Airway and Infant Disease
- Asthma (9%)
- Common Signs and Symptoms (8%)
- Respiratory Disorders of the Neonate and Infant (5%)
- Congenital and Acquired Malformations of the Airways and Lungs (5%)
Chronic and Infectious Disease
- Cystic Fibrosis (6%) and Non-CF Bronchiectasis (4%), studied together to sharpen contrasts
- Respiratory Infections (6%)
- Interstitial Lung Disease (5%) and Restrictive Disease (5%)
Systemic, Critical, and Sleep
- Respiratory Failure (5%) and Respiratory System Under Stress (3%)
- Sleep-Disordered Breathing and Control of Breathing Disorders (4%)
- Pulmonary Vascular and Lymphatic Diseases (4%), Lung Disease Associated with Systemic Disorders (4%)
- Environmental Injuries and Exposures (4%), Other Disorders (5%)
Scholarship and Integration
- Scholarly Activities and Health Equity (4%)
- Timed mixed-domain question blocks in the 200-question format
For a fuller plan, see the Pediatric Pulmonology Study Guide 2026, and use the Pediatric Pulmonology Cheat Sheet for last-week review. When you are ready to test yourself against exam-style items, try the practice tests.
Staying Certified After You Pass
Passing the initial exam starts a continuing certification cycle. The ABP uses a five-year cycle in which diplomates choose between MOCA-Peds and an examination pathway. This means the credential is a long-term commitment rather than a one-time event, and the choice of pathway is worth thinking about early in your career. Further background on the credential as a whole is available in Pediatric Pulmonology Certification and What Is Pediatric Pulmonology Certification?. Practice questions at the main practice site remain useful for refreshing knowledge across the cycle.
Frequently Asked Questions
The American Board of Pediatrics issues it, with the examination delivered at Prometric testing centers. Candidates generally must already hold general pediatrics certification and have completed subspecialty fellowship training.
The exam has approximately 200 multiple-choice questions. The passing standard is a scaled score of 180 on a 1-300 scale, which is not a raw percentage of questions answered correctly.
Asthma, at approximately 9% of the exam under the outline effective November 1, 2026. Common Signs and Symptoms and Core Principles of Pulmonary Diagnosis and Monitoring Techniques follow at 8% each.
The official indexed regular fee is $2,992, which includes a $750 processing component. Confirm current fees on the ABP exam dates and fees page before registering, since schedules and fees can change.
The latest verified first-time national pass rate is 73% for 2024, up from 68% in 2022, according to a 2026 primary paper citing ABP data. Always check for newer published figures.