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April 2014
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From the President: What’s Keeping Young People From Choosing ID?

If you are like me, you cannot imagine working in any area of medicine other than ID. True, our reimbursement is less than some other subspecialties. But what other field is as intellectually stimulating and personally rewarding?

Who, but the ID specialist, solves complex medical mysteries that perplex everyone else? Who explores the fascinating place where the microbial world and the human world interconnect? Who helps relieve human suffering, from the individual patient to the population as whole?

So why don’t more young doctors see it this way? The recent data from the National Resident Match Program are discouraging—in the 2014 appointment year, the number of internal medicine residents applying to Infectious Disease was down from previous years, leaving 41 percent of ID fellowship programs unfilled. Yet the need for ID specialists is strong. Think antimicrobial resistance, ongoing outbreaks of vaccine-preventable diseases, emerging and re-emerging infections, exciting breakthroughs in HIV and hepatitis C, and the emphasis on infection control and quality improvement under health reform.

At the IDSA Board of Directors meeting in March, we discussed at length the future of the ID profession. Several members of the Board shared their inspiration for becoming an ID specialist. Some recalled a specific mentor, while others spoke of a particular case that motivated them because of the intellectual challenge it presented. It is our responsibility, as individuals and as a Society, to understand and address the barriers to choosing ID as a subspecialty. There are several initiatives in which IDSA is engaged to do that.

A research project is underway under the leadership of Wendy Armstrong, MD, of Emory University and Erin Bonura, MD, of Oregon Health and Science University to examine the factors influencing residents’ decisions about applying to fellowship training programs. Researchers will conduct in-depth telephone interviews followed by a national survey of internal medicine residents. The data gathered from this study will then be used to lay the groundwork for national initiatives to address the decline in ID applications.

IDSA will also launch a Mentorship Pilot Program during IDWeek 2014. The goal of this program is to create an opportunity for medical students, residents and fellows to closely interact with leaders in their respective areas of investigation and career interest, in an effort to attract more people into the field. 

IDWeek 2014 will offer several other opportunities to nurture and celebrate the next generation. The popular “Posters in the Park” reception will be another great opportunity for selected students, residents and fellows to have their work highlighted, while providing a networking forum for all. In addition, the meeting will also feature a “Careers in ID” session highlighting the diverse options available to people in our field.

The IDSA Education and Research Foundation also continues to support the Medical Scholars program and the HIVMA Minority Clinical Fellowship program, both of which provide mentorship and funding to those starting out in the field.  Recognizing the great attraction of careers in global health, we continue to provide information for medical fellows interested in participating in observerships overseas.

Through each of these initiatives, IDSA hopes to understand the choices made by young doctors and share with them our passion for the field. I encourage you to work with the Society and within your own community to help us in these efforts. So many of us consider a career in infectious diseases to be a calling. We must invest in the future of the field that means so much to each of us.

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