Infectious Disease Specialty Watch

jacoop1
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Hey Guys,
I'm a 5th year med student and I am actually really interested in doing Infectious Disease for specialisation in the UK. A couple of questions!

First of all, is it possible to double specialise in Internal Medicine + ID and get a joint specialisation? Do you think it's more advantageous to find a job (as an internist OR ID specialist) than, lets say, ID alone or ID + Microbio? Is it more competitive to specialise in a joint degree as compared to a single one?

Secondly, I'm reading so many negative comments about the salary of ID in the US. Are they really underpaid / paid much less than other internal medicine specialty in the UK?

Is finding a decent job hard?

Cheers!
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nexttime
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(Original post by jacoop1)
First of all, is it possible to double specialise in Internal Medicine + ID and get a joint specialisation? Do you think it's more advantageous to find a job (as an internist OR ID specialist) than, lets say, ID alone or ID + Microbio? Is it more competitive to specialise in a joint degree as compared to a single one?
Most ID doctors in the UK are joint with acute medicine or microbiology.

Secondly, I'm reading so many negative comments about the salary of ID in the US. Are they really underpaid / paid much less than other internal medicine specialty in the UK?
All specialities are paid broadly the same amount in the NHS, which provides the vast majority of healthcare in the UK. There is some opportunity for private work in ID but not much.

Is finding a decent job hard?
Its a competitive speciality yes.

Lastly, bear in mind that there is not much tropical medicine to be done in the UK. Most infectious diseases wards are full of patients with cellulitis and simple gastroenteritis. Malaria and TB etc are an exception, not the bulk. It is not like working in India or Africa.
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jacoop1
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Thank you!
What about consultation to other physicians in the hospital? I hear they do a lot of consultations especially to pneumologists (pneumonia etc), cardiologists for endocarditis and orthopaedists for bone infections after surgical interventions.

Also are they involved in managing meningitis cases?

(Original post by nexttime)
Most ID doctors in the UK are joint with acute medicine or microbiology.


All specialities are paid broadly the same amount in the NHS, which provides the vast majority of healthcare in the UK. There is some opportunity for private work in ID but not much.



Its a competitive speciality yes.

Lastly, bear in mind that there is not much tropical medicine to be done in the UK. Most infectious diseases wards are full of patients with cellulitis and simple gastroenteritis. Malaria and TB etc are an exception, not the bulk. It is not like working in India or Africa.
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nexttime
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(Original post by jacoop1)
Thank you!
What about consultation to other physicians in the hospital? I hear they do a lot of consultations especially to pneumologists (pneumonia etc), cardiologists for endocarditis and orthopaedists for bone infections after surgical interventions.

Also are they involved in managing meningitis cases?
Consultations are typically provided by the microbiology department. Which as mentioned, many ID doctors are joint trained in.

I haven't talked about outpatient stuff which ID docs do a lot of. Giving long term antibiotics orally or through a PICC is very common e.g. in cases of endocarditis or osteomyelitis. You would probably see plenty of HIV, depending on your locality.

Proper bacterial meningitis as you see in the tropics is still not common in the UK, but when it happens sure maybe.
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jacoop1
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So if I were to specialise in ID + Acute internal medicine I would not be able to provide consultations to any other department in the hospital then? If that's the case medical microbio is essential to increase the range of services ID provides

(Original post by nexttime)
Consultations are typically provided by the microbiology department. Which as mentioned, many ID doctors are joint trained in.

I haven't talked about outpatient stuff which ID docs do a lot of. Giving long term antibiotics orally or through a PICC is very common e.g. in cases of endocarditis or osteomyelitis. You would probably see plenty of HIV, depending on your locality.

Proper bacterial meningitis as you see in the tropics is still not common in the UK, but when it happens sure maybe.
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Democracy
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(Original post by jacoop1)
So if I were to specialise in ID + Acute internal medicine I would not be able to provide consultations to any other department in the hospital then? If that's the case medical microbio is essential to increase the range of services ID provides
In my hospital ID provide the majority of inpatient consults, whilst micro mostly do ITU (but occasionally visit the wards too). ID are actually based at another hospital in my trust so their consultants drive over a few times a week to see inpatient referrals. As nexttime says, very often the ID consultants wil be dual certified in micro too.

I don't think ID participate in the acute medical take though, just fyi. At least not here.

Interestingly, it is the opinion of an ID consultant who gave us teaching a while back that clinical microbiology is on its way out as a specialty and that its responsibilities will be absorbed into ID, hence why their registrars now do Combined Infection Training.
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(Original post by Democracy)
I don't think ID participate in the acute medical take though, just fyi. At least not here.
They did in Oxford and they do in Sheffield. But they didn't get called about inpatient antibiotic choice type questions, only tropical medicine stuff.

I guess its varied then.
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jacoop1
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Thanks a lot guys, you've been really helpful
Last question and I'm good to go
What about Hepatitis B & C patients and HPV cases. Do the ID specialist manage them or are these patients usually managed by a hepatologist / oncologist (respectively)
Also I'd think immunocompromised & cancer patients are being consulted to the ID so this makes a huge part of their job am I right?

(Original post by nexttime)
Consultations are typically provided by the microbiology department. Which as mentioned, many ID doctors are joint trained in.

I haven't talked about outpatient stuff which ID docs do a lot of. Giving long term antibiotics orally or through a PICC is very common e.g. in cases of endocarditis or osteomyelitis. You would probably see plenty of HIV, depending on your locality.

Proper bacterial meningitis as you see in the tropics is still not common in the UK, but when it happens sure maybe.
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(Original post by jacoop1)
Thanks a lot guys, you've been really helpful
Last question and I'm good to go
What about Hepatitis B & C patients and HPV cases. Do the ID specialist manage them or are these patients usually managed by a hepatologist / oncologist (respectively)
Also I'd think immunocompromised & cancer patients are being consulted to the ID so this makes a huge part of their job am I right?
In my experience:

Hep B and C are gastro/hepatology.
HPV is largely covered by the cervical screening program, which is run by GPs who refer on to either gynae or GUM (genito-urinary medicine).
Neutropenic + fever patients tend to come under onc/haem, if known to them. ID could become involved in cases that don't respond to 1st line treatment.

As discussed above its possible there is some variation nationally.
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