Clinical Training Curriculum
The Division of Infectious Diseases has a faculty of more than 50 physicians and researchers working on everything from influenza to tropical diseases to emerging infections.
The fellowship program’s clinical requirements are based on the ACGME requirements to become board eligible in infectious diseases. Additional time can be spent in the microbiology laboratory, pediatric infectious diseases and hospital infection control.
Core Inpatient Consultations:
– UNC Hospitals Inpatient Consult Rotation
- Provide care to a broad spectrum of inpatients with infectious complications including bacterial, viral, fungal, parasitic infections or fever of unknown origin
- Develop diagnostic and therapeutic skills as related to the infectious complications of patients who have solid organ transplants, HIV/AIDS, neutropenia, hepatitis, foreign travel, malignancies, dialysis or other immunocompromising conditions
- Develop skill selecting and prescribing antimicrobial agents, with special emphasis on pharmacology
- Gain consultative skill through “first-call”, interacting with all other hospital staff and outside referring physicians
- Develop skills in clinical and diagnostic microbiology through daily “plate rounds”
- Develop administrative and management skills through supervision of house-staff and students
- Develop teaching skills through organization, presentation and discussion in clinical case conferences.
– Immunocompromised Host ID (ICHID) Consult Rotation
The immunocompromised host infectious diseases service at UNC serves several vulnerable patient populations in close collaboration with our surgical and medical colleagues. We provide patient-centered inpatient consultation, where the infectious disease fellow works in close collaboration with a dedicated ICHID attending as well as outpatient follow-up care.
Patient populations that we care for include:
Lung, heart, kidney, liver and pancreas transplantations are all performed at UNC
- Allogenic and autologous stem cell transplant recipients
- Patients with hematologic malignancies such as leukemia and lymphoma
- Patients with burn injuries who are being cared for in the NC Jaycee Burn Center
Infectious Diseases Clinic (1/2 day per week for 2 years) NOTE: UNC has permission for fellows to complete their final 6 – 12 months of continuity clinic in Malawi or South Africa):
- Manage continuous care of HIV patients and become familiar with HAART
- Learn ACP guidelines for adult vaccination and immunization and apply them
- Manage patients receiving out-patient antibiotics
- Provide necessary care to consult patients requiring on-going follow-up
- See new outpatient consults across all specialties including those with post-op wound infections, joint infections, and fever of unknown origin
Malawi or South Africa HIV Clinic (optional up to 12 months continuity clinic):
Note: This is only available to fellows who will be choosing to work in global health as a career and whose research will be based in either of these countries
- Manage continuous care of more than 20 HIV patients over six months and become familiar with antiretroviral therapy (ART), resistance mutations, complications of ART, metabolic complications of HIV, prophylaxis of opportunistic infections and health maintenance of HIV infected patients
- Learn WHO treatment guidelines and apply them
Additional Clinical Rotations
– Durham County Health Department STI Clinic (3 weeks/12 days):
- Develop experience in management of STDs, including recognition of common genitourinary syndromes, and diagnosis and treatment, education and prevention of these infections
- Obtain exposure to communicable disease management at a local health department.
– Pinehurst Infectious Diseases Rotation (FirstHealth Infectious Diseases/Moore Regional Hospital, 2 weeks):
- Learn how to provide first-line ID care in a large community hospital
- Receive focused training on infections in the elderly, as well as fracture-fixation hardware and prosthetic joint infections
- Become familiar with management aspects of private practice infectious diseases
– Antimicrobial Stewardship/Outpatient Parenteral Anti-Infective Therapy (3 weeks):
The goal of the AST/OPAT rotation is to gain familiarity with the process and application of these two important areas of ID practice.
- Become familiar with the conduct of prospective audit and feedback for antimicrobial alerts in a tertiary-care hospital
- Participate in programmatic quality improvement related to appropriate use of antimicrobials in order to improve patient outcomes, decrease the spread of multi-drug resistant organisms, and decrease cost
- Participate in hospital administrative committee proceedings related to AST (e.g. Anti-infective subcommittee)
- Gain an understanding of OPAT fundamentals including screening of referrals to the program, follow-up of patients on OPAT, communications with referring teams, urgent care and end-of-therapy visits.
– Hospital Epidemiology (4 weeks):
The Hospital Epidemiology rotation aims to provide experience with the surveillance, administrative and occupational health functions of the Hospital Epi group as well as management of outbreaks and exposures. Activities during this rotation include:
- Surveillance of healthcare-associated infections, working with the Infection Control Professional and the Public Health Epidemiologist
- Participation in Infection Control Committee meetings
- Participating in needlestick exposure evaluations
- Assisting with Hospital Epidemiology and outbreak evaluations (working with Hospital Epi staff and faculty)
- Gaining familiarity with new healthcare employee evaluations and healthcare provider respirator assessments
- All fellows are required to take the online course offered by the Society for Healthcare Epidemiology of America, which consists of a pre-test, 12.5 hours of lectures and a post-test. There is no cost to trainees for the course.
Seminars and Classes
Infectious Diseases “Boot Camp” (One – Two weeks in July):
This is an intensive set of didactic sessions on all aspects of infectious diseases and is designed to orient new fellows to the hospital, the evaluation system, ID fellowship requirements, and key topics in infectious diseases.
Case Management Conference (Wednesdays, 8 a.m.):
The Case Management Conference is a structured discussion of cases seen by the consult service and on the ID ward and is presented as an ‘unknown’ that is discussed first by a fellow, then by a faculty member. The conference is attended by all the clinicians in the ID division.
ID Fellows Core Curriculum (Three Thursdays a month, 8 a.m.):
The infectious diseases division has a weekly lecture series for its post-doctoral subspecialty fellows as well as students and residents rotating on the consultation service. Topics are spread over a two-year cycle and cover the major core topics assessed on the ABIM Infectious Diseases subspecialty examination including : antimicrobials, HIV/AIDS care, and medical microbiology repeated annually, to accommodate new fellows. All interested students, faculty, and staff are invited to attend. Lectures are held in Bioinformatics 2127 (large conference room). Click here for the schedule.
Journal Club for ID Fellows and Faculty (monthly, Thursday 8 a.m.):
ID fellows present critical review of journal articles from primary literature on Infectious Diseases related science of interest to the individual fellow. Reviews focus on identification of scientific problems and methodologies used to address the question rather than practice of clinical infectious diseases (which is covered in case management and core curriculum conferences). Each fellow typically presents one or two articles/year during their time training.
Friday Morning Conference (Fridays, 8:30 a.m.):
The Center for Infectious Diseases holds a weekly conference for the entire community. This conference has become an important interdisciplinary venue and a place to host international visitors. It is attended by center members from many departments and disciplines. Click here for the schedule.
In-service exam (2 days):
All fellows are required to take the IDSA administered in-service exam annually until they pass their boards. The fee is paid for by the ID division.