Specialty Profiles

What it's like to be in infectious disease: Shadowing Dr. Schmitt

As a medical student, do you ever wonder what it’s like to be an infectious disease (ID) specialist? Here’s your chance to find out.

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Meet Steven K. Schmitt, MD, an ID specialist and featured physician in AMA Wire’s® “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties.

Read his insights to help determine whether a career in infectious disease might be a good fit for you.

“Shadowing” Dr. Schmitt

Specialty: Infectious diseases (ID)

Practice setting: Hospital clinic 

Employment type: Employed by hospital/integrated health system (Cleveland Clinic)

Years in practice: 21

A typical week in my practice: 

If you like diversity in your career, the typical ID day is for you. In a typical day, I provide inpatient and outpatient care. I have the privilege of participating in the education of students, residents and fellows. I have the opportunity to help mold the future of health care by administration at the system level in Cleveland (I am involved in professional development of physicians) and advising/policy work for professional societies, primarily the Infectious Diseases Society of America. And yes, it is not uncommon for all of these elements to be part of the same day.

In a typical week, I will attend on either a general infectious diseases consultation service or a bone and joint infection consultation service. Typical work weeks are 50-80 hours—less when not attending on an inpatient service, and more when covering a weekend. 

The most challenging and rewarding aspects of caring for patients in ID:

ID specialists are often asked to be medical detectives, evaluating nonspecific symptoms such as fever [among] returning travelers or hospitalized patients. In many cases, the patient has been seen by several physicians prior to consultation with an ID specialist. In addition, we are often asked to consult regarding postsurgical infections and spend a large amount of time educating the patient and family. 

The most rewarding part of the specialty is using our detective skills to diagnose and treat an infection that others may not have considered, returning the patient to health.

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Four adjectives that describe the typical physician in ID:

Collegial. Compulsive. Integrative. Communicative.  

How my lifestyle matches or differs from what I envisioned in med school: 

I have had “the fever” for ID since childhood and had a pretty good preview of the lifestyle of general ID consultation from working in an ID department for two years prior to medical school. 

What I had not counted upon was the evolution of ID practice to include sub-subspecialties, such as bone and joint infections. In addition, I had not fully appreciated that ID training and practice entails a level of systems thinking that lends itself well to care transitions, epidemiology, health care administration and public health leadership. 

Three skills every physician in training should have for ID but won’t be tested for on the board exam: 

Compulsivity. Collegiality. Communication.

One question physicians in training should ask before pursuing ID:

Do I want to build the skills to lead in diverse domains, such as clinical care, medical education, epidemiology, public health, research and health systems administration?

Three books every medical student interested in ID should read:

  • Microbe Hunters by Paul de Kruif (this book made me an ID specialist at age 13). 
  • The Hot Zone by Richard Preston
  • The Plague by Albert Camus

Online resources students interested in my specialty should follow:

Six quick tips I'd give students who are considering ID: 

  1. Seek out great mentors and mentor others.
  2. Develop good work habits, [such as taking the patient’s] history and looking at imaging studies yourself. Also talk to patients, family and colleagues directly; there is no substitute for direct communication.
  3. Finish what you start.
  4. Network relentlessly.
  5. Treat everyone with respect.
  6. Take care of yourself, your family and colleagues first. Good health and good relationships set the groundwork for a great life in medicine.

If my life in this specialty were a song, it’d be: 

“Fever” by Peggy Lee (1958). Peggy Lee brings passion to her classic version of this song. If people sense your passion for what you do, you are more than halfway to success.

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