'The New England Pediatric Pulmonary Consortium (NEPPC; Participating institutions include: MassGeneral Hospital for Children, Boston Children's Hospital, UMass Memorial Medical Center, Tufts Medical Center, Boston Medical Center, Mass Eye and Ear Infirmary, Dartmouth Hitchcock) was founded in 1983. Physicians and trainees discuss and debate active cases involving pediatric patients with respiratory disease. The following dynamic case analysis based upon presentations at the NEPPC takes the reader through an iterative, experiential learning approach while promoting active learning. Challenge points allow for learner reflection and built in podcasts enable the reader to hear the consortium's deliberations.' This article is protected by copyright. All rights reserved.