Internist: Job Description, Duties, Salary, and Other Requirements

FT Contributor
An internist shaking hands and greeting a patient.
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Don’t confuse the two: “interns” in the medical field are early in their careers, but “internists” are highly trained professionals who specialize in diagnosing complex medical problems that occur inside the human body.

People also commonly confuse internal medicine and family medicine. Practitioners of both kinds of medicine are often primary care providers for their patients, but family practice physicians treat people of all ages, while internists only see adults.

Nevertheless, internal medicine is a broad-ranging field that encompasses multiple disciplines relating to internal organs. It’s a rewarding occupation and one of the highest-paying jobs in the United States. If you are curious about what internal medicine doctors do and how to become one, here are some essential details to know:

What Does an Internist Do?

The American College of Physicians

 defines internists as “specialists who apply specific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness.” Internal medicine physicians are adept at diagnosing perplexing medical issues and caring for patients with chronic or multiple diseases.

General internists, however, do not perform surgery. Their job is to diagnose problems, coordinate, and manage short- or long-term treatment. Internists cultivate long-lasting relationships with their patients and also specialize in disease prevention.

The day-to-day life of an internist varies. Most practitioners care for their patients in an office or another ambulatory setting. Some work exclusively at hospitals and are often called “hospitalists.” It is also common for internists who see their patients in offices to follow them through hospitalization. If you were to become an internist, performing annual exams for individual patients would be a likely aspect of your duties.

Average Internist Salary

According to the U.S. Bureau of Labor Statistics, the average annual salary for internists was $196,490 in 2018 (with an average hourly wage of $94.47), and the median yearly salary was $194,500. An assortment of other factors, though, such as location and organization, determine what you might earn.

For instance, the states with the highest levels of employment for internists in 2018 were:

  • Texas (4,650 jobs);
  • Michigan (3,050 jobs);
  • Massachusetts (2,680 jobs);
  • California (2,660 jobs);
  • New York (2,260 jobs).

Internists in the highest-paying state out of these three, Massachusetts, earned a mean annual salary of $246,240.

However, none of these states were the highest paying overall. The highest-paying states for internists are:

  • South Dakota ($287,890 annually);
  • Wyoming ($275,350 annually);
  • New Mexico ($267,350 annually);
  • New Hampshire ($265,930 annually);
  • North Carolina ($260,860 annually).

It is important to bear in mind that the highest-paying states had 440 internist positions or fewer. Hence, a higher salary usually aligns with a higher rate of demand in a given area. The Bureau of Labor Statistics’ calculations do not include self-employed internists.

There are also multiple niches internists belong to that affect employment rates and income. Physician’s offices have the highest levels and concentrations of employment with 21,430 jobs in 2018, but internists working in medical and diagnostic laboratories earned an average of $28,360 more per year, at $251,290, though there were only approximately 50 positions.

According to Medscape, which surveyed 19,328 physicians between late 2018 and early 2019, male internists earn 23% more than females, and 59% of internists are men. White internists earned slightly more than Asian internists as well, and there were too few respondents of other races to include in MedScape’s report.

Internist Education, Licenses, Certifications, and Training

An internist’s education is intense. The first step is completing at least three years of undergraduate school before applying to medical school, but you may decide to wait until you have your bachelor’s degree or even a master’s. This latter degree is optional. Calculate if you think the cost of obtaining an advanced degree is worthwhile based on your budget and the programs you wish to apply to. You can choose your specific major, but it’s in your best interest to take classes involving biology and chemistry.

The American College of Physicians notes that four years of medical school is necessary to become an internist, preceding a three-year residency program. Pursuing your undergraduate and graduate degrees may require applying for student loans, so it is wise to educate yourself about how to take advantage of FAFSA and how to relieve yourself of student loan debt as quickly as possible.

You may begin practicing as an internist upon completion of your residency. You may also decide to participate in a fellowship program to specialize in a subfield of internal medicine such as cardiology, endocrinology, immunology, or infectious diseases.

Internist Job Outlook

The Bureau of Labor Statistics reports that the average annual wage for internists decreased from $198,370 in 2017 to $196,490 in 2018. However, the organization projects a 3.7% employment growth rate from 2018 to 2028, so an internist’s job outlook is steady.

The medical field will always need internists. These professionals understand the complicated relationships between organs and how various conditions and diseases affect them, so they are crucial “gatekeepers” before patients visit any other kind of physician.

Should I Become an Internist?

Becoming an internist is an appealing job for many people, but it’s not suitable for everyone. You may have expected the educational requirements and are enticed by its high compensation, but you need the personality for it.

Cultivating long-term relationships with patients is an integral part of the job, so you will need to exercise a great deal of patience and compassion for people in pain. Medscape’s previously mentioned survey indicates that 18% of responding internists said that dealing with difficult patients was the most challenging aspect of their occupations.


  • 31% of respondents noted that gratitude from patients and fostering relationships with them was the most rewarding part of their careers;
  • 23% found joy in finding answers to medical problems;
  • 22% appreciated knowing that they were making the world a better place.

Internal medicine is a challenging field that requires a robust range of knowledge and entails solving complex medical problems. If you are excited about improving patients’ health and are willing to undertake the necessary education, though, becoming an internist can be a fulfilling career.

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