What's the difference between medical microbiology and infectious disease the medical specialty?

[theepodiatrist]

Doesn't it amount to the same thing?? Doesn't an infectious disease MD know everything a medical microbiologist (PhD or something) know??

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[SunBakedTrash]

Medical microbiology is a subspecialty of pathology. You can specialize in it from IM but it entails overseeing a component of the core lab including supervising techs, maintaining and bringing on new tests/assays, and maintaining accreditation. The IM field of ID is seeing patients and treating disease. MM is most commonly done by PhDs who usually are more qualified and interested than pathologists who mostly do slide work. It’s a great choice if you want a more administrative role, but you take a pay cut.

 

[theepodiatrist]

Medical microbiology is a subspecialty of pathology. You can specialize in it from IM but it entails overseeing a component of the core lab including supervising techs, maintaining and bringing on new tests/assays, and maintaining accreditation. The IM field of ID is seeing patients and treating disease. MM is most commonly done by PhDs who usually are more qualified and interested than pathologists who mostly do slide work. It’s a great choice if you want a more administrative role, but you take a pay cut.

Two quick questions:

1. Wouldn't and ID MD know how to conduct and interpret all those lab tests that medical microbiologists run?

2. How does a phd medical microbiologist 's knowledge of the field compare to that of a pathologist's?

3. So medical microbiology is to pathology what business administration or management are to the field of business then?

 

[SunBakedTrash]

Two quick questions:

1. Wouldn't and ID MD know how to conduct and interpret all those lab tests that medical microbiologists run?

2. How does a phd medical microbiologist 's knowledge of the field compare to that of a pathologist's?

3. So medical microbiology is to pathology what business administration or management are to the field of business then?

1. No, not really. Medical microbiology is very technical. It is focused on things like the sensitivity/ specificity and analytical characteristics of PCR, next gen sequencing, maldi-tof etc. This is much more specialized testing than a clinician is familiar with. An ID MD has functional knowledge of these tests, but their expertise is more related to what tests are needed to diagnose a disease and the protocol to treat the patient. It’s much more clinically oriented than lab work.
2. A pathologist is a medical doctor. Their expertise is the same as any other doctor at baseline. The residency training largely focuses on the microscopic diagnosis of cancer. This differs from a PhD microbiologist who usually has significant background knowledge regarding the various areas of microbiology as well as basic science research exposure.
3. Uh not sure what that relates. It’s a fellowship, which you can do after your residency. So basically it’s an opportunity to further sub specialize in an area of interest.

 

[theepodiatrist]

1. No, not really. Medical microbiology is very technical. It is focused on things like the sensitivity/ specificity and analytical characteristics of PCR, next gen sequencing, maldi-tof etc. This is much more specialized testing than a clinician is familiar with. An ID MD has functional knowledge of these tests, but their expertise is more related to what tests are needed to diagnose a disease and the protocol to treat the patient. It’s much more clinically oriented than lab work.
2. A pathologist is a medical doctor. Their expertise is the same as any other doctor at baseline. The residency training largely focuses on the microscopic diagnosis of cancer. This differs from a PhD microbiologist who usually has significant background knowledge regarding the various areas of microbiology as well as basic science research exposure.
3. Uh not sure what that relates. It’s a fellowship, which you can do after your residency. So basically it’s an opportunity to further sub specialize in an area of interest.

Question 3 was an analogy. To make another one: would a phd medical microbiologist be to an ID MD what a technologist (not to be confused with technician) be to an engineer or architect?

 

[SunBakedTrash]

Question 3 was an analogy. To make another one: would a phd medical microbiologist be to an ID MD what a technologist (not to be confused with technician) be to an engineer or architect?

I have no idea. It’s apples and oranges man. They are not really comparable like that. Both deal with micro, but you have to decide if you want to see patients or if you want to manage a lab. You probably should go rotate in both areas during medical school.

 

[Startingover123]

Question 3 was an analogy. To make another one: would a phd medical microbiologist be to an ID MD what a technologist (not to be confused with technician) be to an engineer or architect?

Why do you keep making these pointless threads?

 

[cj_cregg]

Bottom line: Microbiologists work in a lab. They are basic scientists. ID docs work at the bedside. They are clinicians.

There may be significant overlap in knowledge - but PhD microbiologists know more about the technical aspects of testing for these pathogens or microbiology that is not necessarily related to human medicine, ID docs know more about actually taking care of patients. The microbiologist may know more about how to culture and identify a particular bug, both probably know about which antibiotic works on it and why, and the ID doc knows more about actually treating the bug - why is it cellulitis vs. erysipelas, what dose and duration of antibiotics is appropriate, etc. They're looking at opposite ends of a topic and using that information very differently.

 

[theepodiatrist]

Why do you keep making these pointless threads?

Why don't you keep your rude opinions to yourself??

 

[theepodiatrist]

I've heard it said that phd medical microbiologists are more likely to end up working in CDC and military laboratories than ID MDs and even pathologists. Do you guys think this is true?

 

[cj_cregg]

I've heard it said that phd medical microbiologists are more likely to end up working in CDC and military laboratories than ID MDs and even pathologists. Do you guys think this is true?

Yes, because neither of those types of labs are usually directly involved in patient care. Pathologists and ID docs are physicians whose job it is to provide patient care. ID docs almost never work in labs, that's not their area of expertise.

 

[Jillofalltrades]

The ID MD is the patient-facing clinician. I think of them as the people taking the detailed patient history, doing the physical exams, having the expertise to form the differential diagnosis and order the tests to help them figure things out, and manages the treatment plan for the patient.

There are certainly PhD microbiologists, and there are pathologist MDs (often MD/PhDs) that sub-specialize in microbiology. Both paths of training will prepare the individual to manage/oversee the lab as someone mentioned above (personnel, validating assays, maintaining accreditation, etc.). There are times when the ID docs will order tests and the results will come back and won't make any sense, either in the context of patient presentation or past labs (ex. serologies that showed inconsistent immunity). That's when the lab gets called. The first step is always invariably redraw the lab/culture or repeat the assay, but if that doesn't resolve the question, the ID docs and the microbiologists will need to have a more in-depth conversation.

I can't speak as much to the PhD training but I've asked this question to a pathologist about the difference between the 2 training tracks. The PhDs are generally really good at the technical aspects of troubleshooting (ex. oh the machine can sometimes mistake X for Y if condition Z is present. I recommend trying to do this other test to see if that gets you the information you need without relying on the thing that's been giving us trouble).

The pathologist can also handle the technical troubleshooting (depending on their own training and whether they have both a MD and a PhD - many do) but because they also have medical training, they can have a more clinically oriented conversation with the ID docs. For example, the ID doc can say this result doesn't make sense to me because the patient is exhibiting symptoms A, B, C. The pathologist can say okay, have you considered diagnosis D because I sometimes have seen this type of value come out of the lab even when symptoms A and B are present. On the flip side of things, sometimes the lab gets an order for an assay or a culture that's either rarely ordered or time consuming or costly, and the pathologist may have to look through the medical record to see if the indication for that order is correct. If it's not, the pathologist and ID docs will have a conversation about what the next best step might be - we order this cheaper thing first, we should order this test that's going to come back a lot earlier since your patient is dying now and the test you originally wanted won't come back for 2 weeks, whatever the case may be.

 

[theepodiatrist]

Is it common to have a lab that has both a medical microbiologist and a pathologist on staff?