Microbiology as a Doctor

[sjlamb77]

So I'm enjoying microbiology way more than I thought I would. I really love studying about bacteria and viruses and immunology. Is there a way to still study this stuff as a doctor? I know there's a fellowship in allergy and immunology, but isn't this kind of a clinical area moreso? Is there a way to get into a virology niche without a PhD as a doctor? Perhaps even getting an MPH and trying to hit it from an epidemiology route? Thoughts or experience are appreciated!

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[Barcu]

Infectious Disease is a subspecialty of Internal Medicine.

 

[ArcGurren]

Infectious Disease is a subspecialty of Internal Medicine.

ID rarely requires actual clinical microbiology; sometimes basic science researchers will use it extensively but as a clinical ID physician most of your time is spent figuring out how to treat an infectious disease or diagnose it; you basically just take lots of history and try to figure out what antibiotics to give. You are never going to be doing gram stains or silver stains or cultures etc - anything of that sort because clinical microbiologists are the ones who actually do that.

It's a very cerebral subspecialty; from the monetary standpoint doesn't make very much more than general medicine, very light on procedures, and a lot of the private practice aspect involves running TB clinics or HIV clinics. It's a popular specialty for people who want to continue in academic medicine and research.

 

[D elegans]

It depends on what you mean by "study." If study means "learn about and treat," then Infectious Diseases (the IM subspecialty mentioned) is the way to go. If by learn you mean do lab work/basic science, you should do a PhD in microbiology.

You should shadow an ID physician and see if it's what you like.

Don't do allergy/immunology. It's mainly all outpatient allergy work, with very little of the interesting immunological disorders (other than allergies).

 

[ArcGurren]

Don't do allergy/immunology. It's mainly all outpatient allergy work, with very little of the interesting immunological disorders (other than allergies).

Depends, peds A/I has a lot of those crazy immunologic disorders (ATX, SCID, etc) especially if you go to a good peds program and work in a higher care hospital - but that's VERY niche

 

[siliso]

The MDs I have known who did micro research were pathologists.

 

[notbobtrustme]

I love microbiology (my PhD was going to be in microbiology before I quit). It's a shame that most microbiology for doctors is "how do I kill this bug without blowing my patient's kidneys"

 

[D elegans]

Depends, peds A/I has a lot of those crazy immunologic disorders (ATX, SCID, etc) especially if you go to a good peds program and work in a higher care hospital - but that's VERY niche

That would be awesome. I wasn't even thinking about peds. Very niche - I wonder how many positions there are for that kind of work.

 

[cliquesh]

So I'm enjoying microbiology way more than I thought I would. I really love studying about bacteria and viruses and immunology. Is there a way to still study this stuff as a doctor? I know there's a fellowship in allergy and immunology, but isn't this kind of a clinical area moreso? Is there a way to get into a virology niche without a PhD as a doctor? Perhaps even getting an MPH and trying to hit it from an epidemiology route? Thoughts or experience are appreciated!

Pathology followed by a microbiology fellowship.

 

[Barcu]

ID rarely requires actual clinical microbiology; sometimes basic science researchers will use it extensively but as a clinical ID physician most of your time is spent figuring out how to treat an infectious disease or diagnose it; you basically just take lots of history and try to figure out what antibiotics to give. You are never going to be doing gram stains or silver stains or cultures etc - anything of that sort because clinical microbiologists are the ones who actually do that.

It's a very cerebral subspecialty; from the monetary standpoint doesn't make very much more than general medicine, very light on procedures, and a lot of the private practice aspect involves running TB clinics or HIV clinics. It's a popular specialty for people who want to continue in academic medicine and research.

All true.

I was focusing mostly on the MPH/epidemiology part, which would make ID seem like a logical choice. Micro research would mean a different path.

 

[wholeheartedly]

Definitely also look into Path with the Micro fellowship as was mentioned. I know some people doing this and it might be a good fit.

 

[sjlamb77]

I think I would enjoy Path. I've heard it has a bleak future, but I'm not going to jump on the bandwagon of predicting the job market for 10 years from now. I'm going to shadow a pediatric infectious disease doc next week at the local teaching hospital, so I'm pumped to get to see the clinical side of that area.

 

[Smokemont]

I think I would enjoy Path. I've heard it has a bleak future, but I'm not going to jump on the bandwagon of predicting the job market for 10 years from now. I'm going to shadow a pediatric infectious disease doc next week at the local teaching hospital, so I'm pumped to get to see the clinical side of that area.

Let us know how your shadowing experience goes as I am thinking about doing a peds ID elective in the future.

 

[sjlamb77]

Will do! If I can get my TB test in time, I'll be shadowing him a week from today.

 

[ArcGurren]

I think I would enjoy Path. I've heard it has a bleak future, but I'm not going to jump on the bandwagon of predicting the job market for 10 years from now. I'm going to shadow a pediatric infectious disease doc next week at the local teaching hospital, so I'm pumped to get to see the clinical side of that area.

Peds ID was kind of a dull specialty for me to experience, involved mostly just kids with HIV... which to be honest isn't all that different from adult HIV. Peds immuno was more interesting because of all the crazy immunodeficiencies that you get to see, though again like I said it was a niche field.

Path... I dunno. I know plenty of people who are applying for path and I don't think the job market is quite that bad. A lot of people are planning to sub-specialize in pathology as well, as it makes you more competitive.

 

[Frozen]

So I'm enjoying microbiology way more than I thought I would. I really love studying about bacteria and viruses and immunology. Is there a way to still study this stuff as a doctor? I know there's a fellowship in allergy and immunology, but isn't this kind of a clinical area moreso? Is there a way to get into a virology niche without a PhD as a doctor? Perhaps even getting an MPH and trying to hit it from an epidemiology route? Thoughts or experience are appreciated!

You can get there with either pathology or IM-ID or possibly other specialties. Contact specific programs for details.

If you're interested in dealing with the nasty viral pathogens, you'll probably want to go the CDC or Army route as they operate the only Level 4 labs in the country (that I know of anyway).

http://www.mayo.edu/msgme/residenci...robiology-md-or-post-phd-fellowship-minnesota

http://www.unmc.edu/pathology/clinical_microbiology_fellowship.htm

https://www.mc.vanderbilt.edu/root/vumc.php?site=vmcpathology&doc=29056

 

[sjlamb77]

Hey guys, just wanted to update on my shadowing today. I shadows a Peds ID doc for his afternoon rounds. We saw cases such as Kawasaki Disease, Hand Foot and Mouth disease, pus infection from strep in a young boy's throat, paronychia, and a bad staph infection in a hip bone. His role seemed pretty chill as a consultant to the other doctors. He's the head of the program there so he does a good bit of teaching alongside of taking care of his patients. I actually found the stuff pretty interesting since, as stated above, I find bacteria and viruses really interesting. It's a very small hospital, so I'm not sure if maybe at a bigger hospital ID docs would have more acute stuff, but this one pretty much teaches residents and manages the medication and diagnoses for any kind of infectious disease symptoms. I'll be going back for a few more Friday afternoon rounds, so let me know if there's anything yall want me to ask him!

 

[ArcGurren]

Hey guys, just wanted to update on my shadowing today. I shadows a Peds ID doc for his afternoon rounds. We saw cases such as Kawasaki Disease, Hand Foot and Mouth disease, pus infection from strep in a young boy's throat, paronychia, and a bad staph infection in a hip bone. His role seemed pretty chill as a consultant to the other doctors. He's the head of the program there so he does a good bit of teaching alongside of taking care of his patients. I actually found the stuff pretty interesting since, as stated above, I find bacteria and viruses really interesting. It's a very small hospital, so I'm not sure if maybe at a bigger hospital ID docs would have more acute stuff, but this one pretty much teaches residents and manages the medication and diagnoses for any kind of infectious disease symptoms. I'll be going back for a few more Friday afternoon rounds, so let me know if there's anything yall want me to ask him!

Wow I'm glad you actually took our advice lol. Kawasaki's is a pretty interesting entity though I'm not sure if I'd call it strictly "infectious" (I don't think they know exactly what causes it).

Bigger university hospitals in cities definitely have more acute cases, esp in places like the ICU.

 

[DrSnips]

Wow I'm glad you actually took our advice lol. Kawasaki's is a pretty interesting entity though I'm not sure if I'd call it strictly "infectious" (I don't think they know exactly what causes it).

Bigger university hospitals in cities definitely have more acute cases, esp in places like the ICU.

Kawasaki's may not be an infectious disease, but ID will get consults on virtually any condition that can cause fever. Since many autoimmune diseases can cause fever, the ID consultant should be prepared to encounter these fairly frequently.

 

[sjlamb77]

Yeah the Kawasaki was an interesting one. She had a fever and a crazy high heart rate, but she was on antibodies and getting a lot better.

What kind of acute stuff would an ID doc see? Would it be like a baby with a bad infection needing a quick diagnosis and antibiotics?

 

[ArcGurren]

Kawasaki's may not be an infectious disease, but ID will get consults on virtually any condition that can cause fever. Since many autoimmune diseases can cause fever, the ID consultant should be prepared to encounter these fairly frequently.

That's true; although I'd be very surprised if a pediatrician wasn't able to catch Kawasaki's since it's a purely clinical diagnosis. I remember having a patient with Kawasaki's (poor girl thankfully didn't have a coronary aneurysm though).

Yeah the Kawasaki was an interesting one. She had a fever and a crazy high heart rate, but she was on antibodies and getting a lot better.

What kind of acute stuff would an ID doc see? Would it be like a baby with a bad infection needing a quick diagnosis and antibiotics?

I can only speak about adult ID but when I say "acute" in ID terms that doesn't usually mean the same sort of acute you'd think of when a trauma rolls into the ER. It means that they need a firm diagnosis or change in medication regimen soon because the patient has such badly failing kidneys from the colistin being pumped into his veins that he might be on lifelong dialysis if it isn't stopped soon (this actually happened to one of my patients) or something of that nature. I remember our team admitted a case of pretty severe pneumococcal meningitis which wasn't responding to cef/vanco so we needed ID to check that out (and it worked thank god for the poor lady). Things like that.

 

[D elegans]

As an addendum to ArcGurren, if you broaden "acute" to mean "hospitalized and really sick," you'll deal with all sorts of stuff on adult ID - necrotizing fasciitis, meningitis, bacteremic sepsis, endocarditis, atypical pneumonia, acute viral hepatitis (although GI does that a lot), and of course, AIDS patients (very interesting stuff there); just to name a few.

 

[Smokemont]

Hey guys, just wanted to update on my shadowing today. I shadows a Peds ID doc for his afternoon rounds. We saw cases such as Kawasaki Disease, Hand Foot and Mouth disease, pus infection from strep in a young boy's throat, paronychia, and a bad staph infection in a hip bone. His role seemed pretty chill as a consultant to the other doctors. He's the head of the program there so he does a good bit of teaching alongside of taking care of his patients. I actually found the stuff pretty interesting since, as stated above, I find bacteria and viruses really interesting. It's a very small hospital, so I'm not sure if maybe at a bigger hospital ID docs would have more acute stuff, but this one pretty much teaches residents and manages the medication and diagnoses for any kind of infectious disease symptoms. I'll be going back for a few more Friday afternoon rounds, so let me know if there's anything yall want me to ask him!

Thanks for sharing and glad to hear you enjoyed your shadowing 👍

 

[sjlamb77]

I have a question about picking a residency. The residents in this hospital seem very friendly and relaxed. Is that a tradeoff for getting the best training? I know I've heard some people say things like you need to be working 80-100 hour weeks and seeing all kinds of different crazy stuff to get the most out of your residency. This is also a fairly small hospital, but I don't know if the peds residents stay in this hospital or if they rotate to the larger hospital that isn't specifically women's and children's. But say residency remains within a small hospital in a mid sized town, and seeing the residents being fairly relaxed (and the nurses too), can you get just as much training in this atmosphere as in a large hospital and a crazy hectic residency?

 

[Owlie]

Pathology would be good for you, then.

 

[dr08]

Thinking about taking microbiology soon at UNE...any recommendation anyone?