Infectious Disease Doctor

What infectious disease doctors make

Job Bank's page for infectious disease physicians pools every specialist physician and lists a median of about $311,000 a year. CIHI (Canadian Institute for Health Information) does not break infectious diseases out; it reports average gross payments of about $445,000 for internal medicine and its subspecialties (2023 to 2024). Those are billings before overhead. Infectious diseases has no procedures and many salaried academic jobs, so it sits toward the lower end of internal medicine, with most netting roughly $260,000 to $350,000. This is an estimate. It varies by province and by how you bill.

During residency

Paid employees with benefits and a union contract. Quebec pays the least, Alberta and Ontario the most.

Paid for thinking

No scopes, no stents. What you sell is judgment: which bug, which drug, for how long. Hospital-based work has almost no overhead, so most of what you bill is take-home.

What it costs to get there

Undergrad degree (3 to 4 years)

$7,000 to $10,000 a year

Medical school, the MD (doctor of medicine), 3 to 4 years

$15,000 to $28,000 a year

MCAT (medical school admission test), applications, interviews

$2,000 to $5,000

Licensing exam (the MCCQE, the national medical exam) and two Royal College exams (internal medicine, then infectious diseases)

$1,500 for the MCCQE, plus two Royal College exam fees of several thousand dollars each

Roughly, all in

$78,000 to $172,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is a three year undergraduate degree at the cheapest domestic tuition, three years at a lower cost medical school, and the exam fees. The high end is a four year degree, four years at an expensive medical school, the MCAT (medical school admission test) with applications and interviews, the MCCQE (the national Canadian licensing exam), and two Royal College specialty exams, first internal medicine and then infectious diseases. Neither figure includes the five residency years, which are salaried, so you earn while you finish training. Most graduates still leave medical school owing $80,000 to $150,000 because living costs sit on top of the tuition counted here.

Typical debt at the end of medical school is $80,000 to $150,000. Five paid residency years help you pay it down.

Benefits

• Pension often, if salaried

  Many infectious disease doctors hold hospital, university or public health contracts with benefits. Ontario residents are in HOOPP (the Healthcare of Ontario Pension Plan) during training.

• Union contract during residency

  Provincial residents' associations negotiate pay, call limits and leave.

• Malpractice coverage

  Through the CMPA (Canadian Medical Protective Association), mostly reimbursed by the province. Fees are low for a non-procedural specialty.

• Global work

  Infectious disease training travels. Outbreak response, tropical medicine and international health jobs are real options.

The path

You become an internal medicine doctor first, then an infection specialist.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. You need a very high average for a science undergrad.

2. 2

   Bachelor's degree

   3 to 4 years

   Any major works, but microbiology is a natural fit. Keep a GPA (grade point average) above 3.8, volunteer, do research. Write the MCAT (medical school admission test).

3. 3

   Medical school, the MD (doctor of medicine)

   3 to 4 years

   Acceptance rates are 5% to 15%. Classes, then clinical rotations.

4. 4

   Internal medicine residency

   3 years

   Matched through CaRMS (the residency matching service). Hospital wards, the ICU (intensive care unit) and clinics. In year 3 you apply to the subspecialty match.

5. 5

   Infectious diseases residency, then certification

   2 years

   Hospital consults, HIV (human immunodeficiency virus) and tuberculosis clinics, the microbiology lab, infection control and antibiotic stewardship. Pass the Royal College exams to become FRCPC (Fellow of the Royal College of Physicians of Canada) and register with your provincial College of Physicians and Surgeons.

High school courses that help

• Biology

  Bacteria, viruses, fungi and parasites. This is the subject.

• Chemistry

  How antibiotics work and why they stop working. Required for nearly every pre-med path.

• Calculus and functions

  Outbreak math and drug dosing.

• Geography and history

  Where a patient has travelled is often the biggest clue.

Time and money, at a glance

Years after high school

11 to 13

Med school acceptance rate

Roughly 5% to 15%

Subspecialty match

Less competitive than cardiology or gastroenterology

Total tuition

$90,000 to $150,000

Paid while training?

Only during residency, 5 years of it

Heavily regulated

You need a licence from your provincial College of Physicians and Surgeons to practise, and Royal College certification in both internal medicine and infectious diseases. Both are national credentials, so moving provinces is mostly paperwork. Quebec requires working French. Medical microbiology, the lab side of the same field, is a separate Royal College specialty; some doctors train in both.

Focus areas that shape the job

• HIV (human immunodeficiency virus) care

  Long-term clinic patients on lifelong treatment. Calm, steady, deeply appreciated work.

• Infection prevention and control

  Stopping outbreaks inside hospitals. A leadership job with a pager.

• Antibiotic stewardship

  Policing how the whole hospital uses antibiotics so they keep working.

• Public health and outbreak response

  Working with provincial or federal public health on epidemics, vaccines and travel disease.

Nice-to-haves before med school

• Research or lab experience

  Microbiology labs love undergrad volunteers.

• Travel and languages

  Global health work and travel medicine both reward them. French opens Ottawa, New Brunswick and Quebec programs.

• Loving puzzles

  This is the most detective-like specialty in medicine.

• Calm under pressure

  Outbreaks are chaotic. The infectious disease doctor is the one who stays steady.

A typical day

A stack of hospital consults: a fever after heart surgery, a traveller back from Thailand with chills, a patient in the ICU (intensive care unit) whose antibiotics are not working. You take long histories, check the lab's cultures, look at wounds and X-rays, and pick the drug. Afternoon clinic for HIV (human immunodeficiency virus), hepatitis or tuberculosis patients. A meeting with the infection control team about a hospital outbreak. Call is mostly phone advice, sometimes all night.

The honest trade-offs

Work life

Typical hours

45 to 55 a week including call

Remote work

Some, phone consults and virtual clinics

Physical demand

Low to moderate

Unionized

Residents yes, attending doctors no

Similar paths

• Internal Medicine DoctorThe hospital doctor for adults with complicated problems, and the gateway to a dozen specialties. Four to five years of residency.
• MicrobiologistWork with bacteria, viruses and fungi in a hospital, a brewery, a water plant or a vaccine lab.
• EpidemiologistTrack where disease comes from and how it spreads, using data instead of a stethoscope. A master's degree, then government or research work.

Thousands of Canadian deaths a year from resistant bugs

The Public Health Agency of Canada estimated that in 2018 more than a quarter of bacterial infections in Canada resisted at least one first-line antibiotic, and that about 14,000 deaths that year were linked to resistant infections. Infectious disease doctors lead the fight to keep antibiotics working.

Toronto was hit by SARS (the 2003 respiratory virus outbreak)

In 2003, Toronto was the only city outside Asia with a major SARS (severe acute respiratory syndrome) outbreak. Hundreds of people were infected and dozens died. The response was led by infectious disease doctors, and it rebuilt how Canada handles outbreaks.

The pandemic's public face

During the COVID (coronavirus disease) pandemic, the doctors explaining things on the news each night were mostly infectious disease specialists. It is the one medical specialty where a public health emergency can make you famous overnight.

A disease with a treatment that stops spread

Modern HIV (human immunodeficiency virus) treatment lowers the virus so far that a person cannot pass it on. Infectious disease doctors turned a death sentence in the 1980s into a manageable, lifelong condition.