What Influenced your decision to go into Infectious Disease?

[njslex16]

Was it your micro class or your experience on the wards with this branch of medicine? If you've made to a fellowship/ID physician, how would you describe a typical day in your life as an ID doctor? Thanks!

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[NDESTRUKT]

You have to want to be mostly thinking and writing notes. There are zero procedures I can think of (unless you consider swabbing a wound a procedure). There are many opportunities to work in the micro lab as well.

I think the concept and learning portion of infectious disease is as interesting or even more interesting than any other specialty but seeing it in real practice is kind of boring. That's just my opinion.

 

[IMdocT]

i'm not a fellow or ID, but i can tell you what i saw on the ID rotation. like any specialist, ID usually works in a group practice. they have clinic and hospital work. hospital work is seeing new or following up on consults.

clinic work is mostly following up on the hospital patients who got discharged and you need to see them to evaluate if treatment is successful or if antibiotics need to be extended in duration or switched.

consults in the hospital are fairly broad although repititious. there's a lot of cellulitis, meningitis, pneumonia, sepsis, and uti's in old ppl. sometimes you will see rare infections. some attendings consult you for everything ID even when it's not necessary, some attendings consult you for real ID issues such as cultures growing resistant organisms or complex infections or multiple antibiotic regimens. you will share call days with the other partners in the group. people rarely call you in the middle of the night, as ID consults can usually wait until the morning. the workload varies, some places can be super busy, some not as much.

i agree that i haven't seen many procedures done. on my ID rotation, all lumbar punctures, thoracenteses, paracenteses, joint aspirations, abscess aspirations, etc were done by the primary service or the primary service consulted someone else. blood cultures might be one that you do if the ancillary staff doesn't handle them. ID works closely with the micro lab pathologist. they will often go over to radiology to ask the radiologist to personally go over films.

the work can be interesting. you have to consider the source of the infection, the route of entry, the possible organisms, the possible sites of infections, decide how you're going to confirm the diagnosis, decide on antibiotics, duration, consider side effects and contraindications, adjust everything as new information comes out. you have to really think through the problem. essentially what you're doing is answering these questions and telling the primary service what you think should be done. and just as with any specialty, you get to focus on one group of problems instead of all of the patient's problems.

 

[ForeignBody]

i'm not a fellow or ID, but i can tell you what i saw on the ID rotation. like any specialist, ID usually works in a group practice. they have clinic and hospital work. hospital work is seeing new or following up on consults.

clinic work is mostly following up on the hospital patients who got discharged and you need to see them to evaluate if treatment is successful or if antibiotics need to be extended in duration or switched.

consults in the hospital are fairly broad although repititious. there's a lot of cellulitis, meningitis, pneumonia, sepsis, and uti's in old ppl. sometimes you will see rare infections. some attendings consult you for everything ID even when it's not necessary, some attendings consult you for real ID issues such as cultures growing resistant organisms or complex infections or multiple antibiotic regimens. you will share call days with the other partners in the group. people rarely call you in the middle of the night, as ID consults can usually wait until the morning. the workload varies, some places can be super busy, some not as much.

i agree that i haven't seen many procedures done. on my ID rotation, all lumbar punctures, thoracenteses, paracenteses, joint aspirations, abscess aspirations, etc were done by the primary service or the primary service consulted someone else. blood cultures might be one that you do if the ancillary staff doesn't handle them. ID works closely with the micro lab pathologist. they will often go over to radiology to ask the radiologist to personally go over films.

the work can be interesting. you have to consider the source of the infection, the route of entry, the possible organisms, the possible sites of infections, decide how you're going to confirm the diagnosis, decide on antibiotics, duration, consider side effects and contraindications, adjust everything as new information comes out. you have to really think through the problem. essentially what you're doing is answering these questions and telling the primary service what you think should be done. and just as with any specialty, you get to focus on one group of problems instead of all of the patient's problems.

I'll be an ID fellow next year and like this poster have done several ID rotations and I'd say this is pretty accurate in my experience also.