Medical Microbiology

On the one hand, there are challenges due to limited job openings in particular geographic areas; competition for jobs against PhDs, infectious disease MDs, and ABP certified MDs; the predominance of academic positions; and the reality that many private practice groups may not have the financial resources to hire dedicated medical microbiologists. On the other hand, there is an increased need for pathologists trained in both anatomic and clinical pathology with specialty training in microbiology, due to the use of tailored immunosuppression in treating diseases—making expertise in infectious disease pathology extremely valuable.

Medical microbiologists are competing with PhDs, who are often paid less than MD/DO positions, so when money is tight, PhDs may be hired first. If you want to work in private/community practice, you may have to practice more than one clinical pathology subspecialty. Furthermore, working as the only microbiologist in an institution can sometimes be a lonely experience. Finally, COVID-related issues—such as reagent and supply chain shortages—have potentially further complicated the employment landscape for experienced medical technologists in microbiology.

The standard is one year for an ACGME-accredited fellowship, and two years for an ABMM-accredited fellowship.

On-call time varies based on the institution and job responsibilities. Some programs do not have on-call requirements, while others may require availability during off hours and weekends. The nature of on-call duties can also differ; some situations do not require a physical presence in the laboratory, while others—such as identifying blood parasites like malaria—require in-person analysis. The need for on-call coverage may be higher in academic centers and is often associated with frozen sections, which may require a pathologist’s presence.

As in most of the pathology subspecialties, the case volume and ancillary tests run by medical microbiologists depends on the type and setting of the laboratory. Some institutions may perform hundreds of thousands of tests per year, including blood, wound, respiratory, urine, acid fast bacilli, and fungal cultures. In addition, molecular tests (eg, SARS-CoV-2, viral loads for HIV, CMV, HCV, and HBV, as well as testing for gonorrhea/chlamydia, tuberculosis, and C. diff), serologic screening, and testing for various diseases (eg, syphilis, HIV, HCV, HBV, HSV, and others) may be performed.

It’s also possible to not have any cases for microbiology and sign out anywhere from 10 to 30 SPE/hemoglobinopathy cases on any given day. So, there can be a lot of variation based on the section of the lab and your specific job responsibilities.

Medical microbiology interacts with a wide range of health care providers—the scope of interaction extends to any specialty, as infectious diseases impact all systems. These include clinicians from medical technologists on the bench and pharmacists to infectious disease attendings and fellows, pulmonologists, neurosurgeons, and other pathologists. The interactions may involve anything including answering questions, providing directions in interpreting culture results, antimicrobial stewardship, and understanding the limitations of requested testing.

Yes. The American Society for Microbiology (ASM), the Microbiology Society, the Binford-Dammin Society of Infectious Disease Pathologists, and the Association for Molecular Pathology (AMP).

Medical microbiology pairs well with anatomic pathology and cytology, as they involve a lot of microbiology and span both AP and CP. Molecular pathology, gastrointestinal subspecialty for AP, and even immunology—due to all the serologic testing that impacts infectious disease—are also potential subspecialties that could pair well with medical microbiology.

The short answer is no. Medical microbiologists do not typically have face-to-face patient contact. However, there is a significant amount of interaction with various hospital staff, including nurses, residents, physicians, pharmacists, and infectious control experts, so the work isn’t solitary.