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.
What is Infectious Disease?
Infectious disease is the specialty of medicine focused on the diagnosis and treatment of viral, bacterial, fungal, and parasitic infections. Although all doctors have a vast knowledge of 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.
Academic vs Community vs Private Practice
In the academic setting, infectious disease doctors will 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.
Clinical vs Public Health
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 (HCAP) and catheter-acquired urinary tract infections (CAUTIs). Some even end up working with the CDC to help prevent infection on a national or global scale.
Misconceptions About Infectious Disease
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. There are many conditions that require longer treatments such as tuberculosis and valley fever. There are also many chronic infections such as HIV and hepatitis C that must be followed closely over the long term.
How to Become an Infectious Disease Doctor
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.
Subspecialties within Infectious Disease
After completing fellowship, there are a couple of options for additional subspecialization.
Transplant Infectious Disease
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
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.
What You’ll Love About Infectious Disease
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.
What You Won’t Love About Infectious Disease
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.
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.
Should You Become an Infectious Disease Doctor?
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.
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.
If you enjoyed this article, be sure to check out So You Want to Be an Internal Medicine Doctor or another specialty in our So You Want to Be series.
