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Medical microbiology is a specialty in medicine that focuses on the diagnosis, prevention and management of infectious diseases. This article will discuss the training these specialists receive and what their daily schedules look like.

Medical microbiologists focus on the growth and presence of microbial infections in patients, their effects on the human body and the way in which these infections are treated. Four kinds of microorganisms exist that cause infectious diseases in the human body and they include bacteria, viruses, parasites and fungi as well as an infectious protein called a prion. These specialists devise treatment protocols regarding infectious microorganisms by studying the characteristics and growth patterns of pathogens, the ways they are transmitted and their mechanisms of infection.

Other duties that a medical microbiologist would perform include identifying potential health risks to certain communities or monitoring the evolution of resistant strains of microorganisms and assisting in the design of health protocols and practices. They are also helpful in controlling or preventing disease outbreaks or epidemics.

Training

The residency programme in medical microbiology takes 5 years to complete. The doctor wanting to specialise in this medical discipline first has to complete a 5-6 year undergraduate degree to qualify as a medical practitioner, and then has to also complete an internship training phase that takes 1-2 years to complete.

Medical microbiologists may want to specialise further and the sub-specialties include training in the specific microorganisms as mentioned above. 

Diagnostic tests in medical microbiology

Diagnosing infectious diseases is done by taking a history from a patient and performing a clinical examination. Certain signs, symptoms and side-room investigations point to obvious infectious. At times, though, this isn't always the case and further investigations are necessary in order to help make the diagnosis. These investigations would include microscopy, culture and sensitivity (MCS) testing of specimens, biochemical tests and genotyping and will be discussed further.

Microscopy

Compound light microscopes are used to assess the presence of a microorganism in a specimen (except for viruses and prions which are too small). Fluorescence and electron microscopes are also used for to observing microorganisms (especially the aforementioned) in greater detail.

Microbial culture 

This test is the primary method used in order to test fluid and tissue samples in order to isolate infectious disease. The three main types of media used to test specimens include solid cultures, liquid cultures (parasites and mycobacteria), cell cultures (human or animal cell cultures to identify viruses). 

Biochemical tests

Biochemical tests used to quickly identify bacteria include the use of enzymatic or metabolic characteristics that result in gases, alcohols and acids to be detected when bacteria are grown in selective liquid or solid media. The bacterium of interest will react with each chemical in a specific way, therefore making its identification easier.

Serological tests use antibodies to bind a causative antigen, and therefore a positive test will confirm the presence of the offending microorganism. Similarly, other tests such as immunoassays can detect the actual antigens from either infectious microbes or the proteins generated by an infected patient as a response to the infection (these tests are generally more expensive).

Polymerase chain reaction (PCR)

Nowadays, quantitative PCR testing is done versus standard PCR testing as the former uses fluorescence techniques and probes to detect the DNA molecules of an antigen, thereby providing a quicker availability of results which are also more accurate and less likely to be false positive due to issues such as contamination. Quantitative PCR testing is the current standard for detecting viral infections such as hepatitis and HIV.

The Schedule Of A Medical Microbiologist

Medical or clinical microbiologists work in laboratories where they work with instruments such as test tubes, Petri dishes, culture media and reagents. They also work with equipment such as centrifuges, the mentioned optical and electron microscopes and gas chromatography machines. It's important to make a note that these specialists risk exposure to illnesses and diseases, high-pressure laboratory systems, noxious fumes and radiation. These specialists also need to have a thorough knowledge of how to use this lab equipment as well as conduct lab tests for the sake of safety. Another important job requirement is to have an understanding of laws and regulations that are related to the medical industry.

Medical microbiologists consult with other physicians so that the latter can get an opinion on a specific infectious disease and how to further manage the problem. This usually occurs when a hospital acquired or resistant strain of microbe is cultured in a patient. Medical microbiologists are also required to participate in rotating night and weekend on call shifts in case a physician needs an opinion on a laboratory result after hours, and so that they can investigate and analyze samples sent in over this time.

Monday 

This day is usually an administrative day that is used to attend hospital and staff meetings in order to sort out clinical and non-clinical issues. The work day consists of investigating and analyzing tissue and blood samples in order to detect specific microbes.

The medical microbiologist will be responsible for assessing the samples and reporting on the findings that were made. They will then read through the report, confirm their findings and sign off on the document. The reports are then made available to the referring doctors by sending them hard copies of the results or making them available to be accessed electronically.

Tuesday to Thursday

Medical microbiologists usually work in groups at laboratories and they will be divided up to attend to specific microorganism laboratories. These are usually divided into bacteriology, virology, Parasitology and mycology (fungi). There will also be a specialist assigned to work in the immunology lab and this will be discussed in another article.

The microbiologist will be performing procedures and using techniques that may be different in each laboratory. For instance, when examining tissue and fluid samples, a specialist working in the bacteriology lab will be initially looking at these samples through a normal optical microscope whereas the specialist working in the virology lab will be using an electron microscope. Performing cultures of these two very different microorganisms will also be done differently and by using different media.  

Friday

This day will follow the same process as with the receding week. Any unfinished administrative tasks are handles and the work week can end. Doctors that are on call for the hospital will be available to take calls from referring physicians.

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