Clinical Microbiology Fellowship

The Postdoctoral Training Program in Medical and Public Health Microbiology at UNC Hospitals

Program Description: The major objective of the training program in Medical and Public Health Laboratory Microbiology at University of North Carolina Hospitals is to train individuals who are well qualified to direct clinical and public health microbiology laboratories. When the fellows complete his/her training, he/she should have broad-based knowledge in the field of clinical microbiology and should be developing expertise in diagnostics, laboratory administration, and research. We want to train individuals who will be leaders in the field of diagnostic microbiology with an ultimate commitment to improvement of patient care. The program began in 1976 and 31 fellows from throughout the United States and four foreign countries have completed the program. Of these 31 graduates, 14 are diplomates of the American Board of Medical Microbiology. Many currently hold leadership roles in the field of clinical microbiology both in academia as well as government service. Program graduates serve on the editorial board of several journals including the Journal of Clinical Microbiology, Clinical Microbiology Reviews, and Diagnostic Microbiology and Infectious Diseases. Program graduates are also editors of the Journal of Clinical Microbiology, Clinical Microbiology Reviews, MBio, and Clinical and Vaccine Immunology. Program graduates are authors of chapters in the Manual of Clinical Microbiology and Handbook of Clinical Microbiology, as well as Mandell’s Principles and Practice of Infectious Diseases, Long’s Principles and Practice of Pediatric Infectious Disease, the senior editor of Manual of Clinical Virology, and authors of Cases in Medical Microbiology and Infectious Diseases.

Facilities: The Clinical Microbiology–Immunology Laboratories of the University of North Carolina Hospitals where the fellows will do the bulk of their training occupy approximately 8,000 square feet of floor space. The microbiology, molecular microbiology, and immunology/serology laboratories are centrally located on the first floor of UNCH, and are in close proximity to other clinical laboratories, the in-patient population, clinics, pharmacy, radiographic and anatomical pathology diagnostic services. The microbiology space was renovated in Spring 2012. The fellows are provided their own office on site. The retrovirology laboratory is located approximately 1/5 of a mile (5 minute walk) from the main entrance of UNC Hospitals in the Jones Building. We emphasis the use of both molecular and proteomic techniques in the detection of microorganisms and their antimicrobial resistance mechanisms.

Institution: The UNC Hospitals have a total of 800 beds and are the primary teaching hospitals for the University Of North Carolina School Of Medicine. There are four on campus hospitals, the Memorial Hospital, Neurosciences Hospital (opened in 1996), the Women’s and Children’s Hospital (opened in 2002),and the Cancer Hospital (opened in 2010). UNC Health Care also has affiliated hospitals in Raleigh (Rex Hospital) and Siler City (Chatham County Hospitals). The UNC Hospitals are located on the campus of the University of North Carolina at Chapel Hill. The laboratory supports training programs in Clinical Laboratory Science, Molecular Diagnostics, Clinical Pathology, and Clinical Laboratory Immunology. The Adult Infectious Disease Consult team begins their rounds each day in our laboratories which allows for significant and purposeful interaction with this service. In addition, the CMIL has an open door policy which encourages medical students, residents, fellows, and attending physicians to freely use the laboratory facilities and personnel to assist them, in evaluating their patients. The laboratory directors of the CMIL hold academic appointments in the Departments of Pathology-Laboratory Medicine and Microbiology-Immunology and actively participate in the basic science training of medical students. In addition, other faculty in the School of Medicine actively participate in the training of the fellows in clinical microbiology.

The fellows may freely use the Health Affairs Library which is located adjacent to the hospital. There also are numerous computer workstations available in the library with internet access available to the Fellow. The fellows have free access to electronic journals and have their own computer work station in the fellows’ office. The internationally recognized UNC School of Public Health is located across the street from the UNC Hospitals. The fellows are encouraged to attend conferences and seminars of interest there.

Training: The program will be flexible to insure complete education of the fellow. Bench training is gained by spending time in each laboratory section with the technical staff. As the fellow’s experiences and base of knowledge increases, the fellows are asked to assume more responsibilities in the section. This includes on-call responsibilities. On-call responsibilities require that the fellow be able to perform specialized procedures which may be needed on a stat basis or advise physicians on the use of CMIL resources to establish a specific diagnosis. Upon completion of the fellow’s training in a laboratory section, the fellow is able to conduct all but the most specialized tests in that section as well as to be able to advise the clinical staff on problems dealing with each section.

During the first year of training the fellow along with the clinical pathology residents meet 3 to 4 times weekly for 45 minutes to 1 hour didactic sessions with the faculty. Work rounds are conducted daily with the fellow, residents, supervisors, and directors. Work rounds involve technical/scientific or managerial problem solving. The Fellow has full access to the program director and often consults with the director on a daily basis concerning training issues especially questions or problems encountered during their training.

Technical Training: Training in each of the laboratory’s section will consist of bench training by the technologist and supervisor as well as didactic instruction on the part of the laboratory director to insure that the fellow is technically proficient at performing laboratory procedures offered in each laboratory section. As importantly, this training will enable the fellow to interpret the clinical significance of laboratory results. The fellow must also be well versed in specific safety and quality assurance issues in each one of the laboratory section through which he/she rotate. The rotation schedule is given below and serves as a guideline. Actual rotation schedules may be somewhat modified depending upon the level of experience of the fellow.

 

Laboratory

Length of Study

Bacteriology

24 weeks

Parasitology

2–4 weeks

Mycobacteriology

8 weeks

Mycology (in conjunction with Mycobacteriology)

8 weeks

Immunology

4 weeks

Molecular Microbiology (includes Virology training)

8 weeks

Retrovirology (optional)

8–16 weeks

Hospital Epidemiology

2 weeks

 

The majority of the technical training will occur during the first year of fellowship. After the technical training is completed, the fellow will be expected to begin to assume significant administrative and consultative responsibilities in the laboratory. In addition to on-call responsibilities, the fellow will be expected to lead laboratory discussions and provide didactic teaching for the Infectious Disease Consultation Teams. He/She will also be responsible for coordinating the microbiological services with the Pediatric Screening Clinic. This activity includes organizing continuing education programs for medical students, residents, and staff physicians assigned to this clinic. He/She is also encouraged to act as a resource for other trainees in the medical center.

Several conferences and seminars are available to the fellow to supplement and expand his/her technical training. These include a weekly Infectious Disease conference (Wednesday 8:30–9:30) in which the management of clinical cases are discussed. Fellows frequently present pertinent laboratory findings at this conference. The fellows may also attend a more didactic Infectious Disease lecture Friday mornings from 8:30–9:30. The fellow is considered a member of the CMIL management team and as such attends the CMIL Management Meeting held twice/month.

The Department of Hospital Laboratories sponsors two educational conferences. Resident report, in which a Clinical Pathology resident or Hospital Laboratories fellow (including the Microbiology fellow) briefly discuss an instructive case from each laboratory (Chemistry, Blood Bank, Hematology, Coagulation, and Microbiology). The Department of Pathology-Laboratory Medicine has Grand Rounds most Thursdays from 8:30–9:30 AM. The fellow is encouraged to attend conferences of interest. The fellows are also encouraged to attend Pediatric and Adult Grand Rounds, Clinical Pathology Conferences (CPC), and weekly seminars in the Department of Microbiology-Immunology, Pathology, and the School of Public Health when the topics are appropriate to their training needs. Fellows may also be asked to present pertinent laboratory findings at CPC and Grand Rounds.

The Department also sponsors a molecular pathology course every other year that the fellow attends. He/She also assists with the Molecular Microbiology Workshop given during this course.

In addition to intramural educational opportunities, the fellows also participate in triannual meeting of the NC Biopreparedness Working group that brings Microbiology Laboratory Directors from the state’s major medical centers and the regional and State Public Health Labs to discuss infectious disease/clinical microbiology topics of public health significance.

The fellows are provided with funds to yearly attend one national meeting such as the annual meeting of the American Society for Microbiology or the Clinical Virology Symposium (CVS). The fellow is also encouraged to attend meetings of our regional microbiology organizations, the North Carolina branch of ASM and SEACM.

Administrative Training: The fellow will be expected to become well versed in various aspects of laboratory management and administration. The McLendon Clinical Laboratories faculty offers an intensive course on laboratory management once during the fellows two years of training. This course will include learning basic principles of management and specific aspects of budgeting, personnel hiring and evaluation, principles of quality control, quality assurance (including test utilization),and continuous quality improvement, new test implementation and cost analysis, protocol preparation, safety regulations, and CLIA and OSHA requirements . The fellow also participates as an inspector in all mock CAP inspection and may accompany a CAP inspection team if the opportunity exists. The fellow will become knowledgeable about both the state and federal direct agent rules. The fellow participates in the preparation of the annual budget and attends the bi-weekly management meeting. S/he will also be given the opportunity to prepare quality assurance reports, cost account and prepare protocols for new procedures.

Clinical Training: Clinical training is an on-going process in our program. The fellow is expected to participate in the laboratory portion of daily Infectious Disease rounds. S/he will be responsible for teaching basic principles of clinical microbiology to the ID team during the second year of training. In addition during the 2nd year, the fellow will spend one month on the Adult Infectious Disease service and function as a member of that team. In addition, an optional two to four weeks may be spent with the Pediatric Infectious Disease Service. During the second year, the fellow is also responsible for acting as a liaison between the Pediatric Screening Clinic and the CMIL. As part of this duty, the fellow will be expected to attend a Tuesday/Friday 30-minute teaching conference during which cultures taken in the clinic are reviewed as well as common infectious disease problems of children are discussed.

Research: All fellows are expected to perform research. Research opportunities are made available to the fellow upon entering the program. It is our belief that the fellow should learn to integrate research into his/her other commitments. Research can be applied, clinical, or basic. Research opportunities are available with the training staff as well as other University of North Carolina School of Medicine faculty. It is understood that the fellow’s primary responsibility in the first year is to become technically proficient in each laboratory area and that the major time commitment and effort of the fellow is to training. During the second year, a three to six month block of time will be made available for the fellow to pursue various research interests. It is expected that this research will be presented at national meetings and that publications in refereed journals are also expected.

External Rotation: One external rotation is scheduled during the second year of fellowship, a three week rotation at the State Laboratory of Public Health. This rotation will include training for detection of agents of bioterrorism. Additional external rotations at other laboratories are at the discretion of the Program Director and fellow. Previous fellows have rotated at WakeMED, a UNC School of Medicine affiliated hospital and the Clinical Virology Laboratory, Children’s Hospital of Philadelphia. Both of these laboratories are directed by graduates of this program. Our program also presents the opportunity to work in the UNC Center for Infectious Disease Laboratory at Lilongwe Central Hospital in Lilongwe, Malawi.

 

Program Graduates 1987 to 2012:

 

Professional Staff of Training Program:

Peter H. Gilligan, PhD (Program Director) — Director, Clinical Microbiology-Immunology Laboratories; and Professor of Pathology and Microbiology-Immunology, UNC School of Medicine, Chapel Hill, NC.

Melissa B. Miller, PhD — Associate Director (Molecular Microbiology), Clinical Microbiology-Immunology Laboratories, UNC Hospitals; Associate Professor of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, NC; and Diplomate, American Board of Medical Microbiology.

John Schmitz, PhD — Associate Director, Clinical Microbiology- Immunology Laboratories, UNC Hospitals; Professor of Pathology and Microbiology-Immunology, UNC School of Medicine, Chapel Hill, NC; and Diplomate, American Board of Medical Microbiology.

Susan Fiscus, PhD — Associate Director, Clinical Microbiology-Immunology Laboratories; Director, CORE Retrovirology Laboratory; Professor of Microbiology-Immunology and Pathology, UNC School of Medicine, Chapel Hill, NC; and Diplomate, American Board of Medical Microbiology.

David Weber, MD — Hospital Epidemiologist, University of North Carolina Hospitals; and Professor of Medicine (Infectious Diseases), UNC School of Medicine, Chapel Hill, NC.

Scott Zimmerman, DrPH — Director, State Laboratory of Public Health, Raleigh, NC.

Denise Pettit, PhD — Assistant Director, Technical Services, State Laboratory of Public Health, Raleigh, NC.

Myron Cohen, MD — Chief, Adult Infectious Disease Division; Director, Centers for Infectious Diseases; and Professor of Medicine and Microbiology-Immunology, UNC School of Medicine, Chapel Hill, NC.

 

Program Director: Peter H. Gilligan, PhD

Applications: If you are interested in applying to the program for 2015, you must supply us with the following materials by July 1, 2014.

  1. A completed UNC Hospitals Residency application form (will be sent only if you are selected for interview).
  2. Proof of receiving a doctoral level degree. Acceptable degrees include Ph.D., M.D., M.B.B.S., D.D.S., Sc.D., D.V.M., and Dr.P.H.. An official transcript from the school granting your degree is usually sufficient.
  3. Three letters of recommendation BY JULY 1, 2014!!!!!!!
  4. A one-page statement of why you want to participate in this training program.
  5. Your curriculum vitae.

Applications from US citizens and permanent residents (green card holders) are given preference. Foreign applicants may be considered if they have support from their national government or a non-governmental organization. ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED.


For additional information, please contact…

Janice Badstein
McLendon Clinical Labs
UNC Hospitals
101 Manning Drive
1106 East Wing
Chapel Hill, NC 27514

Telephone: 919-966-2318

Fax: 919-966-6407