'It's hard to pay off your medical school loans in this kind of a job': Doctors who can protect the world against pandemics are in short supply

• In situations like the coronavirus pandemic, infectious disease doctors are indispensable experts who help us better understand viruses and the steps that society can take to mitigate damage.
• Infectious disease specialists are some of the lowest paid physicians in the US, according to data from Medscape.
• "There are not enough people like me in the world right now," Dr. Emily Landon, an infectious disease specialist at University of Chicago Medicine, told Business Insider. "It's hard to pay off your medical school loans in this kind of a job."
• "The greatest barrier to going into our field is the financial concerns," said Dr. Thomas File, Jr., president of the Infectious Disease Society of America.
• Read live updates about the coronavirus here.

Experts who can help protect the world against viral pandemics and care for sick patients are in short supply in the US.

The country currently has 8,374 physicians certified to practice infectious disease medicine, according to the American Board of Internal Medicine. And getting new doctors to join the field has been difficult. The number of applicants to infectious disease training programs has declined by around 20% in the past decade, said Dr. Thomas File, Jr., president of the Infectious Disease Society of America (IDSA).

We need a "substantial" number of additional infectious disease doctors to address future needs and possible pandemics, File said.

"We need more public health personnel," File said. "If there's nothing else that comes out of this, it's got to be the awareness and the importance of doing this."

Infectious disease doctors diagnose and treat patients, and also help with responses during crises like the current coronavirus pandemic, alongside other experts like epidemiologists.

Infectious disease specialist are some of the lowest paid doctors in the US

One of the main reasons for the shortage of such experts, some specialists say, is the low pay offered to physicians in the field, relative to other specialties they could go into.

"There are not enough people like me in the world right now," Dr. Emily Landon, an infectious disease specialist at University of Chicago Medicine, told Business Insider.

Landon told Business Insider that one of the key issues she saw in the handling of the current novel coronavirus pandemic was the shortage of people on the ground who could understand the virus and help society prepare for the damage.

"It's hard to pay off your medical school loans in this kind of a job," Landon said.

The median medical school debt in the US stood at around $200,000 in 2018, according to the Association of American Medical Colleges (AAMC), the licensing body for medical schools in the country.

Infectious disease specialists made an average of $239,000 a year in the US in 2019, according to Medscape, whose report ranked the doctors 25th on a list of 29 medical specialties by pay.

It takes five years of training after medical school to become an infectious disease specialist. Becoming an internal medicine doctor takes just three years of added training, but those physicians make more money.

"The greatest barrier to going into our field is the financial concerns," File said.

File said that despite the declining applicants to the field in the past decade, intense recruiting efforts in the past few years have put a pause on the steeper decline. But the field still hasn't been able to increase the number of applicants, he said.

The current pandemic 'illustrates the need that the whole public health and infectious disease infrastructure needs to be improved'

To arrest the decline and get more infectious disease doctors, File said the US needs to reconfigure how it pays doctors, so that those who perform surgeries and procedures don't get paid so much more than those who mainly consult with patients.

The IDSA sent the Centers for Medicare and Medicaid Services a recommendation to consider these changes around six months ago, but the coronavirus pandemic has taken over much of the focus in the time since.

File said he's "moderately confident" that such changes may be considered once the pandemic passes because he feels the current crisis "illustrates the need that the whole public health and infectious disease infrastructure needs to be improved."

Infectious disease doctors have an important role to play, even when there's not a viral pandemic. They often work in hospitals to help figure out to treat patients who are infected with bacteria that are resistant to many drugs, for example.

Read more: American hospitals have lost dozens of medical workers to the coronavirus. Here are some of their stories.

"There's various studies that have been published that say if patients with an infection in a hospital are treated by a specialist, infectious diseases, that they have much better outcomes," File said. "The cure is better, the length of stay is less, the cost is much less, readmission rate is less and mortality is less."

In a New York Times op-ed last year, infectious disease specialist Dr. Matt McCarthy wrote about the impending future crises amid a declining number of infectious diseases specialists.

"Back in the day, there were only a handful of reliable antibiotics to choose from. But as more bugs have emerged, and more have become resistant to standard treatments, we've had to develop new drugs to fight them," McCarthy wrote.

McCarthy ends his 2019 op-ed, just months before the first case of COVID-19 was detected in Wuhan, China, by saying: "We must hurry. Superbugs are coming for us. We need experts who know how to treat them."

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