So you want to be an infectious disease doctor. You want to be on the cutting edge of medical
research and lead the nation during the next global pandemic. Let’s debunk the public
perception myths and give it to you straight. This is the reality of infectious disease.
Dr. Jubbal, MedSchoolInsiders.com. Welcome to our next installment in So You Want
to Be. In this series, we highlight a specific specialty within medicine, such as infectious
disease, and help you decide if it’s a good fit for you. You can find the other specialties on
our So You Want To Be playlist. If you want to vote in upcoming polls to decide what future
specialties we cover, make sure you’re subscribed. If you’d like to see what being an infectious
disease doctor looks like, check out my second channel, Kevin Jubbal, M.D.,
where we’ll be covering a day in the life of an ID doctor in the future.
Infectious disease is the specialty of medicine focused on the diagnosis and treatment of viral,
bacterial, fungal, and parasitic infections. Although all doctors have vast knowledge in
a variety of infectious diseases, ID doctors take it a step further.
They diagnose and treat the full spectrum of infectious diseases and consider details of
the patient’s history that other doctors might overlook. Does the patient have any
pets? Have they traveled outside of the country recently? Have they been in any hot tubs lately?
Infectious disease doctors consider even the most minute details to help determine the patient’s
diagnosis. They are true medical detectives and have earned a reputation in medicine for having
some of the most comprehensive chart reviews and histories you’ll ever see.
Infectious disease doctors treat a wide variety of conditions. On any given day, they may be
called to see patients for acute issues such as pneumonia, tuberculosis, and C. diff,
chronic issues such as HIV or Hepatitis C, or even to determine the cause of a fever or elevated
white blood cell count of unknown etiology. In addition, many of the rare and interesting cases
that you read about during medical school may end up on your patient list as an infectious disease
doctor. That being said, the bread and butter of an ID specialist can vary based on their
practice location and type of practice. This brings us to an important method of
differentiating their practice: academic vs community vs private practice.
In the academic setting, they’ll divide their time between clinical,
teaching, and research responsibilities. As a private practice or community-based ID
doctor, you will spend the majority of your time seeing patients. The most common conditions that
you will encounter include fever, leukocytosis, tuberculosis, HIV, and hepatitis C, among others.
In terms of compensation, infectious disease doctors working in academics tend
to make less than their community or private practice colleagues.
Another way to categorize infectious disease is clinical versus public health.
Given their expertise in epidemiology and the spread of infection, many ID doctors work either
part- or full-time in public health. Some do advocate work to combat the harmful effects
of antibiotic misuse. Some serve on hospital committees to help prevent infections in the
hospital including health-care-associated pneumonia and catheter-acquired urinary
tract infections. Some even end up working with the CDC to help prevent infection on
a national or global scale. Let’s clear up some of the
misconceptions about infectious disease. To start, many patients believe that every
infectious disease needs antibiotics. This is false. There are a variety of different pathogens
that cause infection including bacteria, viruses, fungi, and parasites. Antibiotics are only used to
treat bacterial infections and are not indicated for infections caused by other types of pathogens.
In addition, many patients believe that infections are only acute and that once they’re started on
medications they don’t need to follow up. This is false. There are many conditions that require
longer treatments such as tuberculosis and valley fever. Additionally, there are many
chronic infections such as HIV and hepatitis C that must be followed closely over the long term.
To become an infectious disease doctor, you must first complete
four years of medical school, followed by 3 years of internal medicine residency,
and 2 years of infectious disease fellowship. Three-year fellowships also exist which often
include an additional year of research. For those interested in going into pediatric
infectious disease, the pathway is slightly different. After medical school, you must
complete three years of pediatric residency followed by 3 years of pediatric ID fellowship.
In terms of competitiveness, internal medicine and pediatrics are among the bottom 10 least
competitive medical specialties. According to our analysis, internal medicine is the
9th least competitive specialty and pediatrics is the second least competitive specialty only
behind family medicine. But don’t let these rankings fool you. If your goal is to match
into a top-tier internal medicine or pediatrics residency, you will still need to do well on your
Step exams and obtain ample research experience. That being said, infectious disease is one of the
less competitive internal medicine fellowships. According to the 2019 Fellowship Competitiveness
Index by Tran et. al, infectious disease was the second least competitive IM
fellowship trailed only by nephrology. As for the type of medical student that
typically goes for infectious disease, they are usually curious, patient,
and detail-oriented. They tend to find pleasure in the cognitive aspects of medicine and enjoy
the opportunity to be a medical detective. After completing fellowship, there are a couple
of options for additional subspecialization. Transplant infectious disease is a 1-year
fellowship that provides additional training in the diagnosis, prevention,
and management of infectious diseases in solid organ and bone marrow transplant recipients.
In order to prevent rejection of new organs, transplant patients are often given medications
to suppress the immune system which opens the door for opportunistic infections. Transplant
ID doctors are trained to meet the needs of this unique patient population and help ensure the best
possible outcomes for transplant patients. Orthopedic infectious disease is a 1-year
fellowship that provides additional training in the prevention, diagnosis, and treatment of all
types of musculoskeletal infections. Due to the aging patient population and an increasing number
of prosthetic joints being placed, orthopedic infections have become a growing issue within
medicine. Orthopedic ID doctors are given in depth exposure to infections of the MSK system including
osteomyelitis, septic arthritis, and prosthetic joint infections to help care for these patients.
There’s a lot to love about infectious disease. To start, if you love the patient care aspects of
being a physician, there are few specialties that allow you as much time with patients
as with infectious disease. Given the nature of the conditions you’ll be seeing, taking a
comprehensive history is crucial to getting the correct diagnosis. You’ll talk about where the
patient has been, what their profession is, any recent travel, and other information—all with the
purpose of identifying the correct pathogen. It is often incredibly satisfying to be able
to talk to a patient, comb through seemingly insignificant details,
find a diagnosis, get them on the correct treatment, and watch them get better.
Infectious disease is also a highly collaborative field. You will regularly interact with other
physicians and members of the healthcare team including pathologists, radiologists,
oncologists, rheumatologists, and surgeons, to help treat the patient’s infection and
get them the care that they need. Furthermore, infectious disease
is on the cutting edge of medicine. As we’ve seen with the COVID-19 pandemic,
pathogens are constantly changing and evolving. And when they do, infectious disease doctors are
often the ones leading the charge in researching and treating whatever new infections arise.
In terms of lifestyle, there are also few emergencies within the specialty.
Although you will have to be available for your patients around the clock if you work
in private practice or during your on-call hours in academic or community settings,
there are no emergencies within infectious disease that require you to wake up in the middle
of the night to go see a patient in the hospital. While infectious disease is an awesome specialty,
it’s not for everyone. To start, the training
is long. After college, it takes around 9 years to become an infectious disease
specialist which is longer than most specialties. Despite the long training process, it’s also at
the lower end of physician compensation. According to Medscape’s 2022 Physician
Compensation Report, the average infectious disease doctor earns approximately $260,000,
which puts them in the bottom 5 specialties in terms of compensation along with PM&R,
pediatrics, family medicine, and endocrinology. The rapidly evolving nature of infectious diseases
also means that you will need to keep up with the most current literature. There are always
new pathogens, new antibiotics, and new treatments coming out. This means that continuing education
through research papers and conferences is integral for infectious disease doctors.
Given the patient populations you work with as an infectious disease doctor, you are also
at higher risk than some other specialties for getting sick yourself. Some pathogens such as
those that cause COVID-19, tuberculosis, and meningitis are highly contagious. By virtue
of seeing and treating patients with these types of active infections, you are also at
a slightly higher risk of contracting them yourself. That being said, these risks can
largely be mitigated through proper precautions including appropriate PPE and hand washing.
Lastly, infectious disease can be heavily reliant on other fields of medicine. For instance,
if a patient has severe osteomyelitis of the foot and the extremity isn’t receiving blood flow,
it becomes a surgical problem. Although the patient has an infection and it is
the job of the ID doctor to help treat it, the patient ultimately needs surgical intervention.
How can you decide if infectious disease is right for you?
If you enjoy the cognitive aspects of medicine and want a specialty where you
can spend ample time with patients, infectious disease might be for you.
You should have a curious mind and find pleasure in sorting through the minute
details that most people overlook to uncover the patient’s diagnosis.
You should enjoy being on the cutting edge of medicine and be willing to put
in the time and effort to keep up with the latest medical literature.
And if you prioritize work-life balance, infectious disease won’t
make you choose between your family or work. Huge shout out to Dr. Kathleen Wairimu for
helping me with the creation of this video. Are you hoping to become an infectious disease
doctor? To get into medical school, match into internal medicine residency, and get into an
infectious disease fellowship, you’ll need to score well on your class tests and standardized
exams. As you look at resources and companies to work with, seek out those who are actual M.D.
physicians, not Ph.D. or other types of doctors that didn't go to medical school. Look for those
who have achieved stellar results themselves, a track record of success with positive ratings
from customers, and a systematic approach so you know you'll always receive high-quality service.
If you decide on Med School Insiders, we'd love to be a part of your journey to becoming a future
physician. Visit us at MedSchoolInsiders.com. Thank you all so much for watching! If you
enjoyed this video, check out our So You Want to Be an Internist video, or another specialty in
our So You Want to Be playlist. Much love and I’ll see you guys in that next one.