A World of Opportunities: Career Paths in Infectious Diseases and HIV Medicine
Choosing a subspecialty is the most important career decision a medical resident must make. It is a difficult decision—one that has become increasingly complex over time. Medicine is evolving rapidly, giving rise to a growing number of specialties and subspecialties. Your choice of medical specialty reflects your personal and professional goals as a physician.
Are you looking for intellectual challenge? Do you derive satisfaction from solving problems and helping others? What level of patient interaction do you seek? Does the opportunity for international travel appeal to you? What skills do you possess—analytical, interpersonal, organizational—and how can you best put them into practice as a physician?
Those looking for intellectual challenge, job satisfaction, and a wide range of career options, should consider a career in INFECTIOUS DISEASES (ID), a richly rewarding specialty with a historic place in medicine.
The Global Nature of ID
Infectious disease experts focus on the interface between humans and the microbial world and the associated consequences of infection. Infectious diseases are the third leading cause of death in the United States—170,000 each year—a figure that has nearly doubled since the early 1980s. Globally, infectious diseases rank as the second leading cause of death, over half of which are children under the age of 5. Existing and emerging diseases present a continuous threat to society.
ID specialists have eradicated smallpox worldwide, led efforts to eliminate polio, and developed vaccines that have enabled dramatic reductions in diseases such as hepatitis B and varicella. ID specialists are on the leading edge of some of the hottest topics in medicine today—from treatment for HIV/AIDS patients, to the growing threat posed by antibiotic resistance, to concerns about the appropriate evaluation and response to threats of bioterrorism. They are also leading efforts to strengthen and improve U.S. and global preparedness against pandemic influenza, and they have spearheaded the response to epidemics such as West Nile encephalitis, mad cow disease, and severe acute respiratory syndrome (SARS).
ID specialists develop and employ strategies to prevent and treat infectious diseases. Prevention is accomplished through environmental approaches, prophylactic antibiotics, and—most importantly—vaccines. Treatment involves use of specific antimicrobial agents. ID researchers constantly search for new, more effective therapies. Most notably, ID experts have been leaders in HIV/AIDS research and treatment.
This dynamic and evolving discipline offers exciting opportunities for physicians who enjoy helping others through problem-solving and medical detective work. ID specialists have their choice of careers including HIV medicine, public health, private practice, health care epidemiology, academia, and industry. Few specialties offer so many options. Rewards include the fulfillment that comes from identifying the cause and cure for an affliction, whether it affects an individual patient or an entire population.
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Training Requirements
Adult infectious disease specialists trained in internal medicine in the United States are eligible to become certified after two years of training beyond general internal medicine.
Training Requirements Include:
- One year of clinical activity
This experience must include management of a wide variety of infectious diseases, a continuous care clinic, and ongoing management of patients with HIV disease.
- Research experience
This requirement can be fulfilled through clinical research, laboratory research, hospital epidemiology, or various combinations.
- Exposure to a didactic curriculum of required topics.
- Exposure to clinical microbiology and immunology.
- Participation in clinical case discussion conferences. (required by most programs)
Adult Infectious Diseases Training Programs are listed in the Infectious Diseases Society of America’s IDSA Guide to Training Programs in Adult Infectious Diseases, available at the the Society’s website.
Pediatric Infectious Disease Programs are listed in Training Programs in Pediatric Infectious Diseases, available at the Pediatric Infectious Diseases Society (PIDS) website.
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Job Satisfaction
A recent IDSA survey found a high degree of job satisfaction among the nation’s nearly 8,000 ID specialists. Most respondents cited the intellectual challenge and the diversity of their career as the reason for this satisfaction. Recent graduates had the highest job satisfaction of all respondents.
High job satisfaction, growing demand, diverse career paths, and the opportunity to work on the hottest issues in medicine today make a career in infectious diseases an exciting and rewarding choice.
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Broad Selection of Careers
Most ID specialists complete their training in internal medicine, although some train in pediatrics, obstetrics/gynecology, or another primary care discipline. The training and experience of ID specialists cover a unique cross-section of medicine. Many ID physicians follow several paths during their careers, applying their knowledge and experience to new and diverse challenges. For more information and help in finding your new career in ID, visit the ID/HIV Career Center.
HIV/AIDS
The HIV epidemic is perhaps the most challenging health care crisis facing the world today. More than a million Americans are living with HIV/AIDS, and there are 40,000 new infections every year. Globally, more than 40 million people are living with the disease, with developing nations accounting for 95 percent of the 5 million new HIV cases annually. In the last 10 years, however, physicians with specialized training in infectious diseases have helped to bring about dramatic progress in the development of treatments to extend health and life for people with HIV disease. ID specialists also play a key role in HIV clinical care, improving the lives of those living with this disease.
Research and Public Health
Many ID specialists choose to work for public health agencies such as the Centers for Disease Control and Prevention (CDC) in Atlanta or the National Institutes of Health (NIH) near Washington, DC. Both organizations have extensive programs for training and career development. CDC focuses on the epidemiology and public health aspects of ID, including the design and implementation of effective prevention strategies. NIH is primarily devoted to the development and support of basic and translational clinical research. State and local health departments also employ ID specialists, as do international research programs run by the World Health Organization, United Nations, and others.
Private Practice
This category is the largest and most rapidly growing area of practice for ID specialists. ID physicians in private clinical practice focus on patient care, expecting to see a broad spectrum of infectious diseases in both the outpatient and inpatient settings. As in the area of academic medicine, ID specialists in private practice can expect to play a major role in antibiotic formulary selection, hospital infection control and employee health, and local community infectious disease issues. Some ID specialists in this category practice both infectious disease and general internal medicine.
Health Care Epidemiology
Health care-associated infections—infections that patients acquire during the course of receiving treatment for other conditions or that health care workers acquire while performing their duties—are a major public health problem in the United States. In U.S. hospitals alone, health care-associated infections account for an estimated 2 million infections, 90,000 deaths, and $4.5 billion in excess health care costs annually. ID specialists working in health care epidemiology are dedicated to improving the quality of patient care and the safety of health care workers by leading efforts aimed at infection control and prevention in hospitals and other settings.
Academic Medicine
ID divisions are represented in every medical school in the United States and in many private hospitals. On average, ID divisions with fellowship training programs employ 11 full-time faculty. This career choice often includes a rewarding mixture of research, teaching, administration, and clinical practice. At many academic centers, HIV/AIDS has become a major component of clinical care and research. Other components of academic medical practice may include hospital infection control, pharmacy committee service, advising international travelers, or supervising a field study abroad.
Industry
The demand for medical personnel in the pharmaceutical industry is projected to grow by more than 40 percent over the next decade. In order for drug manufacturers to develop or improve anti-infective agents, they need to employ infectious diseases specialists. ID experts play a role in every aspect of the drug development process, from selection of targeted pathogens to clinical research to outcome evaluation and leadership. Industry positions include both scientific and management tracks. Pharmaceutical companies employing ID specialists range from large international manufacturers to small start-up biotechnology firms.
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Related Information
IDSA Guide to ID Training Programs
PIDS Training Programs in Pediatric ID Guide
ID/HIV Career Center
"What is an ID Specialist?" Brochure
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