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Infectious disease doctors: Looming shortage as specialty among lowest paid

By David Pendered

A shortage of doctors who specialize in infectious disease is looming at a time these specialists are needed to help manage the COVID-19 pandemic and are among the lowest paid of all medical specialties, a doctor at Duke University reports.

Emory, midtown 550

All eight positions for specialty training in infectious disease were filled this year at Emory University School of Medicine, which oversees care at Emory University Hospital Midtown. Credit: Kelly Jordan

Here’s the pay differential, according to the 2019 Compensation Report by doximity:

  • Nationwide, average annual compensation for the 20 lowest-paid specialties: infectious disease specialist – $262,000 (12th lowest paid), and $186,000 (lowest paid) for a pediatric infectious disease specialist;
  • Nationwide, average annual compensation for 20 highest-paid specialties: Neurosurgery, $617,000 (highest paid); radiology, $429,000 (No. 10); obstetrics and gynecology, $335,000 (No. 20).

Infectious disease doctors are internists who are certified specialists in diagnosing and treating infectious diseases associated with bacteria, parasites, fungi – and viruses, such as the new coronavirus that causes the sometimes-fatal COVID-19.

The potential shortage of infectious disease specialists has three causes, according to a report published May 7 in the peer-reviewed medical journal, The Lancet, by Dr. Syed M Qasim Hussaini, of Duke’s Department of Internal Medicine:

  • The specialty may not be attracting a sufficient number of young doctors to meet future demand;
  • Older specialists are soon to retire at increasing rates, as doctors over age 55 comprise a significant proportion of infectious disease specialists;
  • Immigration policies affect the placement of non-citizen physicians, who represent a third of the infectious disease specialists.

To explain why this specialty is significant, Hussaini concludes his published comment with these observations:

  • “Given increasing global travel, continued emergence of new infectious diseases, antibiotic-resistant organisms, and a growing population, the role that infectious diseases specialists will have in the health of everyone in society will only increase. …
  • “[A] more concerted effort might be needed to ensure a pipeline of future infectious diseases physicians in the USA that must include value-based reimbursement, pioneering policy interventions such as loan repayment eligibility for these physicians, and comprehensive immigration reform. Any less would endanger high value care in the US health-care system and under-prepare the country for future pandemics.”

Young doctors make clear through their choice of specialties their lack of interest in specializing in infectious disease.

Hussaini ran the numbers and concluded there’s a national vacancy rate of 21 percent in openings this year for physician fellowships in infectious disease training positions.

This rate compares to a vacancy rate of less than 0.1 percent for cardiologist positions – paid $454,000 a year, according to doximity; and less than 1 percent for oncology – paid $383,000 a year, doximity reports.

In Georgia, 10 of 11 openings are filled for specialist training in infectious disease, according to the 2020 report by the National Resident Matching Program.

Emory University’s medical school filled six of six openings in adult, and two of two in pediatric, infectious disease specialty training. Mercer University’s medical school filled one of one opening for adult specialty training. The Medical College of Georgia filled one of two openings, according to NRMP.

Looking to the future, Hussaini observed that the pay differential may be addressed by newer payment models established by Medicare.


David Pendered

David Pendered, Managing Editor, is an Atlanta journalist with more than 30 years experience reporting on the region’s urban affairs, from Atlanta City Hall to the state Capitol. Since 2008, he has written for print and digital publications, and advised on media and governmental affairs. Previously, he spent more than 26 years with The Atlanta Journal-Constitution and won awards for his coverage of schools and urban development. David graduated from North Carolina State University and was a Western Knight Center Fellow.


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