Infectious Diseases

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ID is a 2-3 year fellowship after IM. From what I've seen, it's a pretty reasonable mix of clinic and consult work. ID docs are often the last resort when trying to sort out a complicated and seemingly contradictory clinical dilemma in the realm of ID. What's neat is that they are fantastic internists first and build on that with a sophisticated and unique ability to apply specific knowledge treat infectious disease.

I think ID is one of those fields where you can make what you want of it, to some extent. It seems like a lot of the "clinic" stuff is the management of chronic ID like AIDS/HIV, with hospital consults for bread and butter stuff like cellulitis or endocarditis and zebras in the CNS or intraabd. stuff. Not a lot of late nights up -- mostly "here is the clinical issue, what would you suggest" but can be at the hospital late seeing consult. Clinic is much more follow-up stuff (other than HIV/AIDS) than following pt. longitudinally.

All in all, a well balanced field with a decent lifestyle.

Anyone else with some advice about a fellowship in infectious diseases? Is there not a direct residency in infectious diseases, without having to do internal medicine first?
How great is the demand-need for infectologists?

Originally posted by Peeshee
Anyone else with some advice about a fellowship in infectious diseases? Is there not a direct residency in infectious diseases, without having to do internal medicine first?
How great is the demand-need for infectologists?

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You must complete an internal medicine residency before doing a 2 yr fellowship infectious diseases. I don't think that infectious disease docs will ever get paid that much as the patients that really need them (HIV, IVDA) are usually uninsured, and ID docs don't have any procedures in their specialty (procedures always reimburse more). With regards to a shortage of ID docs, I think that's impossible to predict or even speculate on right now, there are way too many variables going on in ID. Besides the nature of infectious diseases (eg SARS, coming and going, new treatments for HIV), you don't know how many people are going to need ID docs in the future; and then there is always the issue of abx resistance. Some hospitals are starting to require that ID docs only write for really "strong" abx like Vancomycin to avoid building resistant organisms in their hospitals/communities, and with the number of abx resistant organisms showing up in hospitals steadily increasing, I suspect that more and more hospitals/communities will have to adopt this policy in order try to preserve what few abx we will have left to treat new organisms. This will also increase demand for ID docs. ID docs also have the same driving forces that a lot of docs have as well, with the increasing age of the population, that means more surgeries and more hospital times which inevitably means more infections. So, I'm no ID expert, but I don't think that any ID doc could give you a useful prediction of how in demand they will be in the future (10 years from now), it would be equivalent to a weatherman trying to predict the weather 10 years from now.

just stoking the fire of curiosity

mcandy said:

just stoking the fire of curiosity

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does any1 know of any instances where a resident in family medicine has been accepted to an ID fellowship? i am a fam resident interested in ID fellowships...any ideas what i should do?

Stinky T said:

http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

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I really dont understand why in that salary survery an IM makes the same amount of money than what an ID doc makes, considering that IDs is a subspeciallity and takes 2-3 years more.

Good Mountain said:

I really dont understand why in that salary survery an IM makes the same amount of money than what an ID doc makes, considering that IDs is a subspeciallity and takes 2-3 years more.

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I can comment more on WHAT ID docs actually do.

ID was one of the subspecialties I've rotated through which has the most diverse group of patients you see. You get consults from ALL OVER the place including internal medicine, general surgery, neurosurgery, obstetrics etc. etc. It's great 'cause a lot of the problems are very interesting with rare infections coming in to play (i.e. weird fungal or parasitic infections etc.)

The thing with ID is that it's not always glorious. A large part of the inpatient consult service is acting as a "family doctor" for surgical service patients who have fevers, and the residents don't feel like searching for the infection. Of course, this is highly offset with all the other cool stuff you see.

Someone asked if there is a direct entrance to ID without doing internal medicine first. This, I hope, NEVER happens (nor will it really). Infectious Disease has a very strong and extensive base in Internal Medicine, and all ID docs have to be good internists on top of being good "infectionists".

In Canada, it is one of the lowest paid subspecialists in Internal Medicine, but it is also one of the most interesting and diverse.

Does anyone know whether you can do ID and another field, say allergy medicine after ID? Would my chances improve in getting into another more competitive fellowship if I do ID first?

Don't know about the competitiveness part, but yes - allergy / immunology can follow ID (although rheum / A&I is more common and there are some dual fellowships). Clinical and Laboratory Immunology is another option after ID, according to the ACP website:

http://www.acponline.org/srf/subspecialty_brochure.htm#clinical

dante201 said:

Don't know about the competitiveness part, but yes - allergy / immunology can follow ID (although rheum / A&I is more common and there are some dual fellowships). Clinical and Laboratory Immunology is another option after ID, according to the ACP website:

http://www.acponline.org/srf/subspecialty_brochure.htm#clinical

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Thanks for the link