In light of the COVID-19 pandemic, there has been a focus on the shortage of doctors opting to specialize in infectious disease. According to forecasts by the U.S. Health Resources and Services Administration (HRSA), the United States will face a serious shortage of infectious disease doctors with estimates showing that that by 2035 there will be a demand for 15,130 doctors specializing in infectious disease across the nation.1
Carlos del Rio, MD, president of the Infectious Diseases Society of America, said:
This is rather alarming for many of us since it suggests that we will lack the essential number of personnel to treat infectious diseases for many years.”2
Dr. del Rio added that despite an increase in medical school enrollment, 80 percent of U.S. counties do not have one infectious disease physician.3
Only Half of Infectious Disease Medical Training Programs Were Filled in 2022
According to the National Resident Matching Program (NRMP), only 56 percent of infectious disease fellowship programs filled all of their open positions this year. Unlike other subspecialties of internal medicine such as cardiology, critical care, and gastroenterology, where the competition to secure a position is highly competitive, low fill rates in infectious diseases have existed for over a decade.4
Daniel Bourque, MD, program director of the infectious diseases fellowship at Boston University said that his program had multiple positions that were unfilled. None of the program’s three open fellowship positions were filled in the match this year. Dr. Bourque said:
This was a huge surprise. I think seeing the number of spots that went unfilled across the country, in many other very strong programs … it was shocking.5
Slight Increase in Interest in Public Health During the Pandemic
The decline in applicants for infectious disease fellowships in 2022 is more apparent because during the first two years of the COVID pandemic, there was an increase in interest in infectious diseases. This trend was also experienced in other public health related fields, which became known as the “Fauci effect.” Medical educators said they saw an increase of students that were interested in public health specialties and attributed this interest to the COVID pandemic and publicity generated by Anthony Fauci, MD, director of the National Institute for Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), who made frequent public statements and recommendations.6
Money Affects Interest in the Infectious Diseases Specialty
Boghuma Titanji, MD, an infectious disease physician at Emory University in Atlanta, Georgia sa8d that dissatisfaction with salaries is one of the contributing factors to the lack of interest in infectious diseases. She said that the average salary for an infectious disease doctors is about $260,000, which is less than doctors in other specialties.7 Dr. del Rio stated:
When you have significant college and medical school debt, when you graduate with a big debt, you’re not going to go to a specialty that doesn’t pay a lot.1
Dr. del Rio said the politicization might also be playing a role in the declining interest in the infectious disease specialty. “People see the polarization of infectious disease, the attacks, and I think that makes people say, ‘well, why do I want to do this?’” he said.
Decline in Public Trust in Government Health Officials
According to an NBC News poll published in January 2022, public trust in health officials at the U.S. Centers for Disease Control (CDC) has decined significantly, dropping to just 44 percent of all Americans trusting information about the coronavirus pandemic issued by infectious disease specialists at the CDC.9 In a March 2022 Opinion published in The New York Times, a lecturer at the Yale School of Public Health asked, “Can Public Health Be Saved?” and questioned both the CDC’s inconsistent pandemic policy recommendations and the politicization of those recommendations. Pointing out the obvious, he commented that, “The authority of the public health establishment lies in its trustworthiness among the public. Without that, it is ineffective.”10
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1 Medtigo. US Faces Shortage of Infectious Disease Doctors. Dec. 20, 2022.
4 D’Ambrosio A. Only Half of Infectious Disease Training Programs Filled All Fellowship Positions. Med Page Today Dec. 16, 2022.
6 Andrew J. Limits of ‘Fauci effect’: infectious disease applicants plummet, and hospitals are scrambling. Stat News Dec. 7, 2022.
7 Thompson D. America Facing Shortage of Infectious Disease Doctors. U.S. News & World Report Dec. 19, 2022.
9 Chinni D. On Covid, Americans can be stingy with their trust. NBC News Jan. 23, 2022.
10 Hamblin J. Can Public Health Be Saved? New York Times Mar. 12, 2022.