Internal medicine is sexy

One hospitalist gives her top reasons why internal medicine is the most appealing specialty.


Internal medicine is not perceived as sexy. As much as I hate to admit it, it simply is not.

Courtesy of Kimberly Manning
Courtesy of Kimberly Manning.

It used to be sexy. Like back in the day with Marcus Welby (who also saw kids and randomly operated on folks, but ignore that for a moment), the internists used to have swagger. And our specialty? It was…well…sexy.

I don't mean sexy in the literal sense. I'm talking about “sexy” in the form of being chic, coveted, and on the it-list. When it comes to choosing specialties as a third-year in medical school, THIS is why internal medicine (and all primary care specialties) sometimes struggle to woo students. Lack of sexy.

BUT!

This is where I come in. And not just me. Me and several of my fellow internal medicine nerds. Buckle your seat belts, people, because we are determined to BRING THE SEXY BACK to internal medicine.

*coughing spasm*

Okay. At least I am.

Top reasons internal medicine is much sexier than you realize

#8: We can actually help out when someone yells “Is there a doctor in the room?!”

This is a true story, I promise.

My friend and I, both residents in Cleveland, were rolling down Shaker Boulevard when we saw this dude lying on the sidewalk on a side street. Two cars had pulled over and a woman nearby was basically freaking out. So we pulled over to see if we could be of assistance. I mean, seeing as we were resident INTERNISTS and all.

So we walked up to the dude with our ‘scopes around our necks. (‘Cause that's how real INTERNISTS get down.) But just as we did, this fifty-something-looking guy walks up and trumps us.

“Please back up. I'm a doctor!” he bellowed, all loud and authoritative.

So, you know, we backed up. I mean, seeing as Trapper John was flexin’ on us and everything. So then Trapper—I kid you not—put the dorsal side of his hand to the dude's forehead. Like a pulse could be found there. His semiconscious FOREHEAD. I'm not lying.

So my friend and I give Trapper the hairy eyeball at this point, and prepare to move in to see what's up with this man on the sidewalk. My friend looked over at the freaking-out lady and said, “Ma’am, do you know this gentleman?”

And the freaking-out lady was kind of hard to understand, but she did say she knew the dude. So my buddy asked a few more questions while I gave the man a sternal rub to see if he could be aroused. And while all of this was going on, Trapper John was kneeling over the man with his brow all furrowed and two fingers tapping his lips.

“I'm a physician,” he repeated to us, “and I need you kids to call 911 and give a bit of space.”

But by this time, my buddy had determined that the man was diabetic and had gone for a run earlier without eating much. He'd also taken his insulin a few moments earlier. So instead of completely going off on the brow-checking PHYSICIAN for trying to play us, we gave the man some candy to stick in his cheek and instructed the freaking-out lady to give the man some juice. And up he popped like that lady who passed out in “Pulp Fiction” after John Travolta hit her with the epinephrine.

So, all was well that ended well. Dude woke all the way up and acknowledged that he should have eaten before he took a trillion units of insulin. And Trapper John the PHYSICIAN turned out to be a local dermatologist. And while I am certainly NOT hating on dermatologists, I'm just saying that his checking for tactile temperature like Dr. Quinn, Medicine Woman was uuhhhh…not the right move.

So I'm just saying: Internists save people. Sexy, right?

#7: We get to talk about everything.

The liver. The heart. The lungs. The skin. The lady parts and the man parts. The all-of-it. Nothing is off limits, man. But just when the skin gets really, really gross, we call Trapper John for a consult. And hallelujah, we get to do the same for similar things related to the nether regions.

#6: We get cool stuff not just on holidays, but on random Tuesdays, too.

Folks are seriously grateful when you reduce their cardiovascular risk factors. For real, they are. I have had my fair share of delicious baked goods and even received a birthday card with my actual date of birth preprinted on it that a patient purchased for me because she remembered from the year before. The treats I get are homemade and delicious. That's the kind of effect you have when you're in INTERNAL MEDICINE, people.

And don't start telling me about how you're an anesthesiologist or some other SWANKY HIGHER INCOME SPECIALTY and somebody did this for you, because clearly the person who did so was high and delirious from your gas machine. Or just happy because they got an epidural. (Yeah. I said it.) See, we internists? We get real love that isn't under the influence of opiates or benzodiazepines.

And that perk makes up slightly for the pay differential. Slightly.

#5: We don't have to spend five hours scrubbing in to do our job.

If you're an INTERNIST, you could be somewhere holding a patient's hand instead of a scrub brush.

See? Yet another perk of the illustriously sexy field of INTERNAL MEDICINE.

#4: We don't really have to study too hard for USMLE Step 3.

All of the uber-specialized folks get all freaked out over Step 3 but not the nerdy internists! We are ALL OVER that sucker. Give us your broadest differential diagnoses, from syphilis to wet beri-beri, and we will destroy it all while the rest put the back of their hand on somebody's nearly unconscious forehead.

#3: We actually know the answers to the questions people ask us at family gatherings.

Hmmm. Now that I think of it, this may or may not be an advantage. Nor does this do much to help the cause of bringing sexy back to internal medicine.

Also, “family gatherings” may include but are not limited to:

Your father calling you from the golf course to talk to the man standing next to the man next to him at the driving range…your fifth cousin twice removed asking you whether or not his “nature not working” has anything to do with not being circumcised…or the lady next door to the lady around the corner from you texting you a photograph of her grandson's nanny because “it look to her like the shingles but she ain't sure.”

#2: The medical students LOVE us (even if they often aren't convinced they want to BE us).

Now this part I'm not saying tongue-in-cheek. INTERNAL MEDICINE people? Maaan, we do a lot of teaching when it comes to medical students.

No one will argue with me when I say that the internal medicine clerkship is considered the bread and butter of clinical training in medical school. Hands down. It's where students become real doctors and where the preclinical pieces get put together and applied. And my fellow I.M. nerds get racks-on-racks-on-racks of teaching awards.

It's also a very necessary part of every other specialty. The very best surgeons, dermatologists, radiologists, anesthesiologists and neurologists have a solid knowledge of internal medicine that they apply to their patients. At least the very best ones do.

So what does that mean? As teaching internists, we have a very, very important job. Our learners take a piece of us and our field into everything they do. No matter what they do. I see that as a tremendous honor and a huge responsibility.

We also get to build some amazing relationships with our patients. And I acknowledge that my colleagues in other fields get to do this, too. But there is something unique about educating patients about the most basic aspects of their health and focusing on the very things that are most likely to either take their lives or disable them. This is what we do. All day, every day.

And that makes us happy. And happy is sexy.

#1: It's a labor of love.

Let's be real. Medical school is expensive. Students go into a lot of debt to become doctors and sometimes—not all the time—their future earning potential gets factored into choosing a specialty. Sigh.

We can't compete with incomes that are quadruple ours. Nope. But can I just say that “a lot of money” is rather relative? Can I also say that six figures is a lot of freakin’ money no matter WHO you are, and that most internists absolutely make that and more? Can I also say what we get in intangible rewards is really substantial? Like really substantial.

The other thing is that we are needed now more than ever. In the U.S., we know that recent legislation will open the floodgates for many people who previously couldn't get primary care. And our population is living longer, too. So now more than ever, our patients need good internists.

But see, it has to be a labor of love. Because internists often end up taking some things for the team. And, no—that part isn't always sexy, yet I have to say it because it's true.

But the rewards? Man. They far outweigh the lumps we take. And the impact we have? On countless levels? The best.

Sure. We can be a bit nerdy at times. We sometimes sit and think about the potential explanations for one abnormal lab result or clinical finding for hours—but you know? Somebody is better for it.

Do not—I REPEAT—do not count us out because you don't think of our field as “sexy.” Instead, join my crusade and stop fighting the magnetic pull you know you feel deep down in your soul to get on the internal medicine bandwagon. Help me help YOU. Help ME help the WORLD.

The doors of the church specialty are now open.