Name: 想成為… 肺部專科醫師？【EP 53】 (So You Want to Be… PULMONOLOGIST [Ep. 53])
Uploaded: 2026-01-31T18:21:02.000Z
Duration: 11 min 20 s

So you want to be a pulmonologist, ridding the world of asthma one patient at a time?

所以你想成為一名肺科醫師，一次一位病患地為世界擺脫氣喘嗎？

Let's debunk the myths and misconceptions.

For this installment in so youo Want to Be, we're bringing our insider expert to you.

在「所以你想成為」系列的這一集，我們將請來我們的內部專家。

Pulmonologist Dr. Sahil Chopra will join me to give you a glimpse into the world of pulmonology.

肺科醫師 Sahil Chopra 醫師將與我一起，帶你一窺肺醫學的世界。

He's quadruple board certified in internal medicine, critical care, pulmonary medicine and sleep medicine.

他在內科、加護醫療、肺醫學和睡眠醫學都獲得四重認證。

Pulmonology is a specialty focused on the respiratory system and diseases of the airway, lungs and chest wall such as asthma, chronic obstructive pulmonary disease, interstitial lung disease, pneumonia and lung cancers.

肺醫學是一門專注於呼吸系統和呼吸道、肺部及胸壁疾病的專科，例如氣喘、慢性阻塞性肺病、間質性肺病、肺炎和肺癌。

Pulmonologists also manage patients who require mechanical ventilation and other forms of life support.

肺科醫師也會照護需要機械式通氣和其他維生系統的病患。

Pulmonary medicine can be categorized in at least three different ways by practice setting, practice type, and

肺醫學可以從執業場域、執業類型和

Pulmonologists can work in a variety of practice settings such as inpatient, outpatient and research.

肺科醫師可以在各種執業場域工作，像是住院、門診和研究。

With inpatient, pulmonologists focus on treating patients admitted to the hospital.

在住院方面，肺科醫師會專注於治療住院的病患。

Most pulmonologists are trained in critical care, so they round in the icu, managing critically ill patients suffering from severe respiratory failure, including acute lung injury, acute respiratory distress syndrome or ards, severe severe pneumonia, COPD exacerbations and those on mechanical ventilation.

大部分的肺科醫師都受過重症加護訓練，所以他們會在加護病房巡視，照護因嚴重呼吸衰竭而受苦的重症病患，包括急性肺損傷、急性呼吸窘迫症候群（ARDS）、嚴重肺炎、慢性阻塞性肺病惡化，以及使用機械式通氣的病患。

If on the general floor and not in the icu, they consult on patients admitted to the hospital who have developed respiratory complications such as asthma, pneumonia or copd.

如果是在一般病房而非加護病房，他們會會診住院期間出現呼吸道併發症的病患，像是氣喘、肺炎或慢性阻塞性肺病。

They could also be involved in pre and post lung transplant care.

他們也可能參與肺臟移植前後的照護。

For hospitals that offer these programs, Outpatient focuses on managing patients in an office or clinic setting for chronic diseases such as asthma, cf, copd, cystic fibrosis, bronchiectasis and interstitial lung diseases like pulmonary fibrosis and sarcoidosis.

對於有提供這些計畫的醫院來說，門診則著重於在診間或診所照護患有慢性疾病的病患，例如氣喘、囊性纖維化、慢性阻塞性肺病、支氣管擴張症，以及間質性肺病，像是肺纖維化和肉樣瘤病。

They evaluate patients with persistent respiratory symptoms, abnormal chest images such as masses or nodules, and

他們會評估有持續性呼吸道症狀、胸部影像異常（例如腫塊或結節），以及

Pulmonologists may also screen for and manage lung cancer, coordinating with oncologists and thoracic surgeons to take biopsies and develop treatment plans.

肺科醫師也可能進行肺癌篩檢和治療，並與腫瘤科醫師及胸腔外科醫師合作進行切片檢查和制定治療計畫。

Additionally, there are research and collaboration opportunities with startups, including companies that focus on health optimization, such as those that aim to improve breathing to enhance overall well being.

此外，還有與新創公司合作進行研究和協作的機會，包括專注於健康優化的公司，例如旨在改善呼吸以提升整體健康的這些公司。

Next, pulmonologists can work in community, academic or private practices.

接著，肺科醫師可以在社區、學術或私人診所執業。

In the community, pulmonologists with training in critical care medicine serve as intensivists, leading the care of critically ill patients.

在社區醫療方面，受過重症醫學訓練的肺科醫師擔任加護病房醫師，領導重症病患的照護。

They may also be called to consult on hospitalized patients with breathing concerns.

他們也可能被邀請會診住院期間有呼吸問題的病患。

Generally in academic settings, day to day work involves a combination of patient care, teaching and research, typically at a university hospital.

一般來說，在學術機構的日常工作包含病患照護、教學和研究，通常在大學附設醫院進行。

In private practice, pulmonologists focus primarily on clinical patient care outside of a university setting.

在私人診所執業的肺科醫師，主要專注於大學醫院以外的臨床病患照護。

Subspecialization also distinguishes a pulmonologist after completing general pulmonary training of two to three years, which is itself a fellowship that follows three years of internal medicine.

在完成兩到三年的一般肺醫學訓練後，肺科醫師還可以進一步專攻次專科，而這本身也是在三年內科訓練之後的進修。

There are several sub fellowships that a pulmonologist can pursue.

肺科醫師可以追求幾種次專科進修。

Each requires an additional year of training, with the exception of allergy and immunology, which is two to three years.

除了過敏與免疫學需要兩到三年外，其他各項都需要額外一年的訓練。

Interventional pulmonology focuses on performing procedures.

介入性肺醫學主要在於執行各種侵入性檢查。

These specialists perform complex, minimally invasive procedures such as stent placements and bronchoscopies, where they use a camera to go into the airways to take samples or biopsies.

這些次專科醫師會執行複雜的微創手術，像是氣管支架置放、支氣管鏡檢查，也就是利用攝影機進入呼吸道來採集檢體或進行切片。

They also collaborate with other specialists to develop treatment plans.

他們也會和其他專科醫師合作，共同制定治療計畫。

Sleep medicine is an outpatient focused specialty involving sleep testing and managing patients with sleep disorders.

睡眠醫學是一門以門診為主的次專科，包含睡眠檢測以及處理睡眠障礙的病患。

Sleep medicine is the subspecialty that I chose to pursue because of my exposure to a breathing condition during sleep called sleep apnea.

我選擇進修睡眠醫學這個次專科，是因為我曾接觸過一種叫做睡眠呼吸中止症的睡眠呼吸問題。

Now I run my own sleep clinic called Empower Sleep.

現在我經營自己的睡眠診所，叫做 Empower Sleep。

Contrary to the popular belief, sleep medicine is not about just a sleep study or sleep test.

跟一般人認為的不同，睡眠醫學不只是做睡眠檢查或睡眠檢測。

It's about understanding the process of human physiology during a state of sleep, understanding the intricate rhythms of different organ systems, and

它更是要了解人類在睡眠狀態下的生理過程，瞭解各個器官系統的複雜節律，以及

the profound impact that sleep has on our physical, emotional and cognitive health.

睡眠對我們身心和認知健康所帶來的深遠影響。

On a technical level, sleep medicine experts explore the nuances of various different sleep disorders from insomnia all the way to sleep apnea.

在技術層面上，睡眠醫學專家會深入探討各種不同的睡眠障礙，從失眠到睡眠呼吸中止症。

Pulmonologists can also specialize in treating sleep related breathing conditions.

肺科醫師也可以專攻治療與睡眠相關的呼吸問題。

Pulmonary hypertension is a highly specialized area that focuses on this specific and complex lung condition which is a disorder of the lung's blood vessels.

肺動脈高壓是一個高度專精的領域，專注於這種特定且複雜的肺部疾病，這是肺部血管的失調。

These specialists perform numerous procedures related to the lung's blood vessels or pulmonary vasculature and care for critically ill patients.

這些專科醫師會執行許多與肺部血管或肺血管系統相關的手術，並照護重症病患。

Lung transplant involves caring for lung transplant patients and is a busy and demanding specialty.

肺臟移植包含照護肺臟移植的病患，是一個繁忙且要求嚴苛的次專科。

Patients are typically very ill, have a limited life expectancy, and

病患通常病情嚴重，預期壽命有限，並且

are frequently in and out of the hospital and icu.

Cystic fibrosis focuses on caring for patients with this congenital condition.

囊性纖維化專注於照護患有這種先天性疾病的病患。

It often involves pediatric pulmonologists who manage children until they transition to adult care, a transition that is becoming more common as new medications extend patients lifespans.

這通常會涉及小兒肺科醫師，他們會管理兒童直到他們轉移到成人照護，隨著新藥延長病患壽命，這種轉移變得越來越普遍。

Occupational and environmental lung disease is characterized as a research centric field.

職業性和環境性肺病被歸類為以研究為中心的領域。

Specialists often collaborate with large government organizations such as the CDC or nih.

專科醫師經常與大型政府組織合作，例如疾病管制中心或國家衛生研究院。

Allergy and immunology means the pulmonologist is specialized in both pulmonary medicine and allergy immunology, allowing them to diagnose and treat a unique set of complex conditions where the respiratory system and the immune system significantly overlap.

過敏與免疫學的意思是，肺科醫師同時專精於肺醫學和過敏免疫學，這讓他們能夠診斷和治療呼吸系統與免疫系統有顯著重疊的一系列獨特複雜病症。

Pulmonology isn't the only path to allergy immunology.

肺醫學並非通往過敏免疫學的唯一途徑。

We took a deep dive into this career path in a previous video.

我們在之前的影片中有深入探討過這個職涯路徑。

Check it out to determine whether becoming an allergist immunologist is a good fit for you on our so youo Want to Be playlist that now covers over 50 medical career paths.

快去看看，在我們涵蓋超過 50 種醫學職涯路徑的「你想成為什麼」播放清單裡，找出成為過敏免疫專科醫師是否適合你。

Let's clear up some common misconceptions about pulmonology.

讓我們來釐清一些關於肺醫學的常見迷思。

First off, there's a misconception that pulmonologists don't do procedures.

首先，有個迷思認為肺科醫師不做侵入性檢查。

In fact, we perform several different outpatient elective and inpatient emergent procedures such as bronchoscopy.

事實上，我們執行好幾種不同的門診選擇性檢查和住院緊急檢查，像是支氣管鏡檢查。

In this procedure, using a thin tube with a camera that's inserted through the mouth through the nose, we can examine the airways and even obtain biopsies.

在這個檢查中，我們會用一根帶有攝影機的細管，從嘴巴或鼻子伸入，來檢查呼吸道，甚至取得切片。

There's also endobronchial ultrasound or ebus, where an ultrasound is used to perform a needle aspiration of a lymph node or lung tissue.

還有支氣管內超音波（EBUS），利用超音波對淋巴結或肺部組織進行細針抽吸。

Additionally, there is a thoracentesis, a medical procedure in which fluid is removed from a thin space between the chest wall and the lungs known as a pleural space using a needle.

此外，還有胸腔穿刺術，這是一種醫療程序，使用針頭從胸壁與肺部之間稱為肋膜腔的狹小空間中移除液體。

Another misconception is that they only treat breathing disorders like asthma and copd.

另外一個迷思是，他們只治療像氣喘和慢性阻塞性肺病這類的呼吸道疾病。

In fact, they also treat conditions like bronchiectasis, cystic fibrosis, pulmonary embolism, sleep apnea and different forms of lung cancer.

事實上，他們也治療支氣管擴張、囊性纖維化、肺栓塞、睡眠呼吸中止症，以及各種肺癌。

That being said, the COVID pandemic increased public awareness of pulmonologists and pulmonary conditions so that there are fewer misconceptions than there were before 2020.

話雖如此，COVID 疫情讓大家對肺科醫師和肺部疾病的認識提高，所以現在的誤解比 2020 年前少了很多。

There are a few different ways to become a pulmonologist.

要成為一名肺科醫師，有幾種不同的途徑。

The most common is completing a three year internal medicine residency followed by a three year combined pulmonology and critical care fellowship which provides additional intensive care unit tr.

最常見的是完成三年的內科住院醫師訓練，接著是為期三年的肺醫學和加護病房聯合進修，這提供了額外的加護病房訓練。

The less common path is three years of internal medicine followed by a two year general pulmonology fellowship.

比較少見的途徑是三年的內科訓練，接著是為期兩年的綜合肺醫學進修。

However, after fellowship, physicians are not required to practice both pulmonology and critical care.

不過，進修結束後，醫師不一定需要同時執業肺醫學和加護病房。

If you're interested in the pediatric route, you would complete a three year pediatric residency followed by a three year pediatric pulmonology fellowship.

如果你對兒科路線有興趣，你會完成三年的兒科住院醫師訓練，接著是為期三年的兒科肺醫學進修。

And as far as compensation goes, pulmonology is at the higher end of the mid pack at $411,000 a year.

至於薪資方面，肺醫學的年薪約為 411,000 美元，屬於中等偏高的水準。

However, this will vary depending on the specific career path you take.

不過，這會因為你選擇的具體職涯路徑而有所不同。

Before we dig into what's to love and not love about pulmonology, if you have a request for our next so youo Want to Be topic, leave a comment.

在我們深入探討肺醫學的優缺點之前，如果你對我們下一個「你想成為什麼樣的人」主題有任何建議，請留言告訴我們。

We collect every request and take it into consideration when choosing our topics.

我們會收集每一個建議，並在選擇主題時納入考量。

There's a lot to love about Pulmonology first off, pulmonology offers a blend of inpatient and outpatient medicine, allowing doctors to care for patients across a wide spectrum of illness severity ranging from stable outpatients to critically ill patients in the icu.

肺醫學有很多值得喜愛的地方，首先，肺醫學結合了住院和門診醫療，讓醫師能夠照護從病情穩定的門診病患到加護病房的重症病患等，各種不同嚴重程度的病患。

Working with inpatients means longer hours, whereas outpatient work typically follows an 85 schedule with minimal call.

住院病患的工作時間較長，而門診工作通常是朝九晚五，值班機會很少。

Many pulmonologists combine both, however, it is generally a busy specialty, not a lifestyle field like dermatology.

許多肺科醫師會結合兩者，不過，這通常是個忙碌的次專科，不像皮膚科那樣是個生活方式取向的領域。

Most pulmonologists are also trained in critical care and often split their time between the ICU and general pulmonology duties.

大多數肺科醫師也受過加護病房訓練，並且經常在加護病房和一般肺醫學業務之間分配時間。

This work is also quite fulfilling and gratifying.

這份工作也相當令人滿足和欣慰。

Relieving a debilitating symptom like shortness of breath brings a great deal of gratitude from patients.

緩解像呼吸急促這樣令人衰弱的症狀，能為病患帶來極大的感激。

Pulmonologists also have the opportunity to use advanced cutting edge technology to perform complex and precise procedures.

肺科醫師也有機會運用先進的尖端科技，執行複雜精確的手術。

For example, CT guided navigational bronchoscopy utilizes a patient's CT scan to create a GPS like system that guides a camera to a specific tiny lobe of the lung for biopsy.

舉例來說，電腦斷層導航支氣管鏡檢查會利用病患的電腦斷層掃描，建立一個類似 GPS 的系統，引導攝影機到肺部一個微小的特定葉狀區域進行切片。

I love pulmonary medicine because it allows me to practice both inpatient and and outpatient medicine.

我熱愛肺醫學，因為它讓我能夠同時從事住院和門診業務。

There is a mix of both elective and emergent procedures.

這裡有選擇性的以及緊急的檢查。

When a pulmonologist works in the icu, it allows him to take care of critically ill patients who have very complex physiology.

當肺科醫師在加護病房工作時，他就能照顧到生理狀況非常複雜的重症病患。

If you're interested in Learning more from Dr. Chopra, he's helping me improve my sleep.

如果你對想從 Chopra 醫師那裡學到更多，他正在幫助我改善我的睡眠。

Over on The Kevin Jubbal, MD channel, we're comparing the data from the most popular sleep trackers like Aura and Ultra Human against my oneiro results a clinical grade PSG sleep monitor.

在 The Kevin Jubbal, MD 頻道上，我們將把最受歡迎的睡眠追蹤器，像是 Aura 和 Ultra Human 的數據，與我的 oneiro 臨床級 PSG 睡眠監測器結果進行比較。

Of course, pulmonology is not for everyone and does come with its downside.

當然，肺醫學並不是適合所有人，它也有其缺點。

First, your patients will often frustrate you as you'll be treating patients with chronic pulmonary conditions like COPD or emphysema, conditions that are caused or worsened by ongoing behaviors such as smoking.

首先，你的病患常會讓你感到挫折，因為你會治療患有慢性肺部疾病的病患，像是慢性阻塞性肺病或肺氣腫，這些疾病是由持續性的行為，例如抽菸所引起或加劇。

The challenge of helping your patients change these addictive self destructive behaviors cannot be overstated.

幫助病患改變這些成癮性的自我毀滅行為的挑戰，怎麼強調都不為過。

You'll also be dealing with many incurable chronic diseases.

你也會處理許多無法治癒的慢性疾病。

COPD and interstitial lung disease cause permanent scarring and damage to the lungs that cannot be reversed.

慢性阻塞性肺病和間質性肺病會造成肺部永久的疤痕和損傷，是無法逆轉的。

As a result, the focus of treatment is often on managing the disease and its symptoms rather than curing it.

是以，治療的重點常在於疾病及其症狀的管理，而不是治癒。

That said, on the positive side, managing a patient's chronic decline allows you to build a strong long term relationship with them which can be quite rewarding depending on your interest in patient interaction.

儘管如此，從好的方面來看，管理病患長期的病情惡化，能讓你和他們建立長久穩固的關係，這在病患互動方面，若你感興趣，會是相當有成就感的。

Another downside is the length of training with residency plus fellowship lasting five to six years.

另一個缺點是訓練時間長，住院醫師加上進修醫師需要五到六年。

While there are many other specialties with this length of training, pulmonologists make anywhere from 100 to $300,000 less than specialties with compar training lengths such as vascular surgery at 550k or plastic surgery at 620k.

雖然許多其他次專科的訓練時間也這麼長，但肺科醫師的收入會比訓練時間相近的次專科，例如血管外科的 55 萬或整形外科的 62 萬，少 10 萬到 30 萬美元。

那麼，你應該成為肺科醫師嗎？

I like to think of it as pulmonary and critical care.

我喜歡將其視為肺部與重症照護。

If you're someone who loves working with your brain, enjoys doing procedures with your hands and is fascinated by the specialty of internal medicine then you should consider becoming a pulmonologist.

如果你喜歡動腦、享受動手操作，並且對內科次專科感到著迷，那麼你應該考慮成為肺科醫師。

But if you hate being the detective internist and don't like doing procedures with your hands or you don't want to be in a high acuity workplace setting, then pulmonology is likely not a good fit for you.

但如果你討厭當偵探般的內科醫師，不喜歡動手操作，或者不想在高強度的執業場域工作，那麼肺醫學可能就不適合你。