Infectious disease (ID) is much more than simply collecting blood cultures; it’s a dynamic and exciting specialty that offers the opportunity to work with patients of all ages, varying acuities, and diverse clinical presentations. If you are seeking a specialty that combines intellectual challenge with the ability to make a real difference in patient care, ID could be the perfect fit for you.
In this article, we will explore the unique aspects that make ID such a compelling field, including the variety of clinical encounters, the potential for research, and the diverse career pathways available. We will also discuss strategies for enhancing your portfolio.
- What makes ID a great career choice?
- A Day in the Life of an Infectious Disease Physician
- Training Pathway to Become an Infectious Disease (ID) Specialist
- Application Process
- How to Get Started and Build Your Portfolio in Infectious Disease
- Useful Resources for Aspiring Infectious Disease Specialists
What makes ID a great career choice?
What makes ID a great career choice?
Whether you prefer to focus on patient management in a hospital setting, delve into research, or work in outpatient care, ID offers a flexible and rewarding career with opportunities for personal and professional growth.
Why ID?
- Diverse and Engaging Daily Work: ID specialists encounter a wide variety of cases each day, as infections can present in many forms across different patient populations. This means no two days are the same, keeping the work both dynamic and rewarding.
- A Detective’s lens: ID offers an exciting range of levels of acuity. On one hand, ID specialists may need to provide rapid, critical input to guide sepsis management or advise other specialties in urgent situations. On the other hand, other cases allow the time to carefully gather clinical clues, interpret investigations, and develop a thoughtful management plan. This dynamic blend caters to those who enjoy piecing together diagnostic puzzles, whether under time pressure or in a more measured, reflective setting.
- Multi-system Patient Care: ID cases could present across various organ systems, and therefore, we collaborate closely with specialists from multiple disciplines. By leveraging the expertise of each specialty, we develop the most effective and tailored treatment plan for our patient.
- Holistic Patient-Centered Approach: ID physician has a broad and in-depth knowledge, allowing them to have a realistic and holistic patient-centered approach to care. By carefully selecting diagnostic methods and treatments tailored to the individual, they minimise unnecessary testing and interventions. This approach not only reduces the physical and emotional burden on patients, but also helps with effective resource management, ensuring care is both compassionate and effective.
- Opportunities for Long-Term Patient Continuity: In certain cases, such as with chronic infections like HIV or hepatitis B, ID specialists build ongoing relationships with patients, offering the opportunity for continuity of care and the satisfaction of guiding patients through their treatment journey.
- High Treatment Success Rates: Many infections respond well to treatment, leading to positive outcomes and patient recoveries. This provides a gratifying aspect to ID work, as specialists often see their patients improve significantly.
- Constantly Evolving Field: ID is at the forefront of medical advancements, especially with the rise of antimicrobial resistance, emerging pathogens, and vaccine development. This rapid evolution keeps the field intellectually stimulating and full of learning + research opportunities.
- Working in tandem with Public Health: ID specialists often work closely with public health and help contribute to national health policies. This public health impact is especially fulfilling for those interested in shaping health outcomes on a larger scale.
- Opportunities for Practical Skills: ID practitioners frequently gain hands-on experience with procedures such as lumbar punctures and central line insertions, adding a practical skill set to their repertoire.
Overall, a career in ID offers a unique combination of clinical variety, intellectual engagement, and personal flexibility, making it an exciting and fulfilling path for those interested in a specialty that combines patient care with the evolving science.
A Day in the Life of an Infectious Disease Physician
As mentioned, ID offers an array of opportunities and case diversity, so a “typical” day varies widely and can be customized to suit each physician’s interests. Here’s a snapshot of what a day might look like:
Mornings: Ward Round or Clinic
The day often begins with a ward round, where the ID physician visits inpatients with complex infections, collaborating with a multidisciplinary team (MDT) that includes nurses, pharmacists, allied health professionals, and medical students. This team approach ensures comprehensive care, especially for patients with multifaceted needs.
Alternatively, the morning may be dedicated to outpatient clinic visits, where the ID physician sees patients with chronic conditions such as HIV, tuberculosis, or other challenging infections like endocarditis. These clinic sessions allow for continuity of care and long-term patient management.
Once a week: Case Review
For around an hour, the department gathers for teaching rounds or case discussions, where ID physicians share intriguing cases or emerging findings with colleagues. This collaborative environment is key to staying updated in a rapidly evolving field and learning from complex cases seen in recent weeks.
Afternoon: Bacteremia Round, Specialty Advising or Research
The afternoon offers a variety of responsibilities for an ID physician. One common activity is the bacteremia round, where the physician reviews and manages cases of bloodstream infections, working closely with other departments to fine-tune treatment plans. During this time, they may analyze lab results, adjust antibiotic regimens, and consult with other specialties to provide expert guidance on infection control—especially in complex or resistant cases.
For those engaged in research, this time could also involve projects on pressing issues like antimicrobial resistance, emerging pathogens, or public health initiatives, all of which contribute to advancing the field.
Alternatively, for ID physicians dual-accredited in microbiology, the afternoon may be devoted to lab work. This could include reviewing culture reports, identifying pathogens, and evaluating antibiotic sensitivities, ensuring optimal treatment strategies are tailored for patients.
In summary, an ID physician’s day is a mix of patient care, diagnostics, interdisciplinary collaboration, and continual learning, making it a richly varied and intellectually rewarding specialty.
Training Pathway to Become an Infectious Disease (ID) Specialist
- Medical School and Foundation Training
- A) Medical School (5-6 years): Complete a degree in medicine.
- B) Foundation Year Training (2 years): Gain general medical experience in a structured training program that includes rotations across various specialties.
- Internal Medicine Training (IMT)
- After foundation training, you’ll need to enter Internal Medicine Training (IMT), which lasts 2 or 3 years depending on whether you are entering Group 1 or 2 specialty. This program provides a good foundation in internal medicine, preparing you for specialty training.
- For a comprehensive guide to applying for Internal Medicine Training (IMT), see this page by our colleagues at Mind the Bleep: Internal Medical Training
- Specialty Training in Infectious Disease (ST3 and Beyond)
- Once you’ve completed IMT, you can apply to one of two pathways:
- A) Group 1: Infectious Disease training with General Internal Medicine (GIM).
- Three years of IMT required prior to Group 1 application
- Applicants will need to pass their MRCP PACES prior to their group 1 applications
- Group 2: Infectious Diseases with Microbiology or Virology.
- Only two years of IMT prior to these programs
- A) Group 1: Infectious Disease training with General Internal Medicine (GIM).
- Note: There are no longer any single accredited specialties
- Once you’ve completed IMT, you can apply to one of two pathways:
- Advanced Specialty Training (ST5-ST7)
- A) ID with IMT/GIM: If you’re dual-accredited with General Internal Medicine, all necessary exams are generally completed by this stage.
Images were taken from Curriculum for Infectious Diseases Training Implementation August 2021
- Microbiology/Virology Training: Those pursuing microbiology will need to pass FRCPath Part 2 in Medical Microbiology by ST7.
Images were taken from Curriculum for Infectious Diseases Training Implementation August 2021
- Microbiology/Virology Training: Those pursuingvirology will need to pass FRCPath Part 2 in Medical Virology by ST7.
Images were taken from Curriculum for Infectious Diseases Training Implementation August 2021
Application Process
The application process for infectious disease specialty training follows a points-based scoring system, similar to Internal Medicine Training (IMT). Here’s how it works:
- Points-Based Long listing
- Candidates are scored on a variety of criteria, such as academic achievements, clinical experience, and additional qualifications. This point-scoring system is used to create a longlist of eligible candidates. More details on the specific scoring system can be found here: Application Scoring.
- Shortlisting and Interview Process
- If a candidate accumulates enough points to make it onto the shortlist, they will be invited for an interview. The interview typically consists of four stations for Group 2 specialties, with an additional question included for Group 1 specialties to assess the candidate’s suitability for the role of medical registrar. Example interview questions, format and scoring criteria can be found here under interview & scoring
- Separate Scoring for Group 1 and Group 2
- Candidates applying to both Group 1 and Group 2 programs will be scored separately for each application, and their ranking will be compared against applicants within each individual group. This allows candidates to be evaluated independently for each pathway.
- Eligibility for Group 2 if Group 1 Standards Aren’t Met
- If a candidate applies for both Group 1 and Group 2 but does not meet the Group 1 requirements (medical registrar suitability), they will still be considered for Group 2 positions, as long as they meet the Group 2 criteria.
- Application Tips for Dual-Accredited Programs (Group 1 and Group 2)
- For those interested in applying for both Group 1 (ID/GIM dual-accredited programs) and Group 2 (Microbiology/Virology or dual-accredited ID/Medical Microbiology/Virology), you’ll need to submit two separate applications. However, only one interview is required, and you can duplicate information between applications as advised by the official recruitment website.
Detailed information on ID specialty recruitment, application procedures, and program structures is available on the Physician Higher Specialty Recruitment website: Infection Specialties
How to Get Started and Build Your Portfolio in Infectious Disease
Building a strong portfolio for a career in infectious disease (ID) involves gaining relevant experience, engaging with the ID community, and making meaningful contributions to the field. Here are some steps to help you get started:
- Explore ID Firsthand
- Taster Weeks or Electives: Consider a taster week or elective in ID to get a feel for the specialty. During this time, try to experience a wide range of activities typical of an ID clinician’s day, such as ward rounds, bacteremia rounds, outpatient clinics, and lab work. This exposure will help you understand the day-to-day demands and rewards of ID and if this suits you!
- Engage with ID Societies and Attend Events
- Joining ID-related societies, such as the British Infection Association (British InfectionAssociation) and the Royal Society of Tropical Medicine and Hygiene (RSTMH), provides access to resources, networking opportunities, and updates on current research.
- Look out for society events, conferences, and competitions. These can enhance your portfolio and show your commitment to ID.
- Undertake Quality Improvement (QI) Projects
- Try to initiate or participate in QI projects such as infection control, antimicrobial stewardship, or patient safety, as these areas are highly relevant to ID.
- Apply for Prizes and Awards Early
- Many ID-related awards are available for various stages of training (e.g., medical students, foundation years, specialty trainees). Start your search early and apply for relevant categories as soon as possible. Earning prizes not only boosts your portfolio but also highlights your achievements and dedication to the specialty. Consider non-ID related prizes and award as they are also worth additional points for the long list.
- Be Strategic and Reflective
- While it’s important to think about the points you could gain for applications, aim to learn and develop practical skills through these experiences rather than treating them as checkbox items as these will be useful for your interview.
- Don’t forget to gain as many points as possible even if the activity is not ID related!
Each experience you gain can be highlighted in interviews, so consider what each activity teaches you about the specialty and how it can make you a stronger candidate. Balancing strategic planning with your portfolio will help demonstrate your passion for ID.
Useful Resources for Aspiring Infectious Disease Specialists
- Official Higher Specialty Application Page
The official application portal for higher specialty training in infection specialties offers detailed information on the application process, eligibility criteria, and program structures for both Group 1 and Group 2 specialties. Helpful Resources and Further Information regarding applications – Infection Specialties - Exams and Certification Information
The British Infection Association provides essential information on exams required for infection specialties, including details on the Combined Infection Certificate Examination (CICE) and FRCPath. This resource is valuable for understanding the exam formats, timelines, and requirements as you progress in your training.
Infection Specialty Exams – Basic Information
Written by Dr Justin Ng Tsz Lok (FY2 in ID), Reviewed by Dr Marina Zheleva ST5 in Infectious Diseases and Microbiology
