Specific Goals & Expectations
Infectious Diseases Clinical Service Curriculum
1. Adult Infectious Disease Rotation: During this service rotation, Fellows focus on the Adult Infectious Diseases consultation and ward experience.
A. Adult ID Inpatient Service
Goals: To provide a Fellow experience
in evaluating and managing inpatient infectious diseases in adult patients,
including diagnosis, treatment, and post-treatment stages of management. Fellow responsibilities include
consultation for inpatient primary care services in the overall management of patients
with various infections at all stages of disease. Another objective of this clinical experience
is to develop expertise in recognizing and managing latent or chronic
complications of infection (e.g., such as transmission, reactivation of latent
infection, etc.) Along with these
objectives, the Resident will become skilled in coordinating patient care with multiple
subspecialty and ancillary inpatient services, including surgical services,
orthopedics, oncology and medicine services, while working with Nurse
practitioners, social workers, psychologists, registered dieticians, and
financial case managers. An integral
role of the Fellow will be to supervise and instruct Residents and Medical
Students in the management of the mix and diversity of infections encountered
within the adult patient population in the
Format: Adult ID Fellows will round with an Attending Physician and other members of the ID inpatient consult team daily or as guided by the Attending Physician. The Resident may be asked to provide didactic sessions pertaining to the diagnosis or treatment of infection for purposes of Resident and Medical Student education as identified by the Program Directors and Attending Physicians.
B. Adult ID In-Patient Service Expectations
Each Fellow is expected to meet several performance milestones in the Adult ID in-patient consult service. These include:
C. Acquisition of Skills
The Program instructs cognitive skills relevant to ID / HIV Medicine:
A. Mechanisms of action and adverse reactions of antimicrobial agents; the indications for pharmacologic studies to assess absorption and excretion of antimicrobial agents; methods to assess antimicrobial activity of antimicrobial agents; techniques to determine concentrations of antimicrobial agents in the blood and body fluids; the appropriate use and management of antimicrobial agents in specific clinical settings, including the hospital, ambulatory practice, and the home;
B. The use of procedures for specimen collection relevant to infectious disease diagnosis, including but not limited to bronchoscopy, thoracentesis, arthrocentesis, lumbar puncture, and aspiration of abscess cavities, including soft-tissue infections;
C. Microbial culture techniques and methods for identification in tissues and fluids for bacteria, mycobacteria, fungi, viruse, rickettsiae, chlamydiae, and parasites;
D. Sensitivity, specificity, efficacy, benefits, & relevant risks of emerging technologies such as those for rapid microbiological diagnosis and the use and limitations of imaging techniques in the diagnosis and follow-up of infectious processes;
E. Principles and practice of hospital epidemiology;
F. Principles of chemoprophylaxis & immunoprophylaxis for strategic uses to enhance resistance to infection;
G. Essential mechanisms of action of biologic agents, including treatment regimens such as monoclonal antibiotics, interferons, interleukins, and colony-stimulating factors, and their applications in the treatments and response.
2. Clinical Spectrum of Diseases: The Infectious Diseases Fellow will gain experience in evaluating and managing patients with the following disorders:
3. Types of Clinical Encounters: Clincal experiences include opportunities to observe and manage adult patients with a wide variety of infectious diseases on both inpatient and ambulatory basis. Such opportunities must encompass temporally longitudinal experiences in a continuum of care to observe a course of illness and any acute or chronic effects of therapy. Therapeutic modalities should include management of antibiotic administration in such settings as the hospital, the office, or in conjunction with home-care services. Experience with pediatric infectious diseases is encouraged. The ambulatory care experience affords consultative services and continuing care for HIV-infected individuals as well as in the broader field of general infectious diseases. Fellows will receive formal instruction, clinical experience, or opportunities to gain expertise in the prevention, evaluation, and management of both nosocomial and community-acquired infections (see Clinical Spectrum of Diseases, above).
4. Evaluating Fellow Performance: Following each service period, Fellows are afforded the opportunity for bidirectional evaluation. Each Fellow is to be encouraged to evaluate the Attending Faculty during the specific rotation. Likewise, appropriate Faculty who supervise the Fellow will offer constructive critiques of Fellow performance. The means of evaluation will be through written evaluation, with specific commentaries on strengths and opportunities for improvement, along with an opportunity to discuss their experience during the Fellow / Faculty meetings. Fellows may also provide feedback to Faculty directly. This process on continuous communication offers timely feedback to the Fellow such that: 1) any opportunity for improvement can be identified prior to the next research service period; 2) those activities that are performed at a high-quality level can be recognized; and 3) overall Fellow performance is optimized in real-time.
Harbor-UCLA Medical Center is an active and integral training campus of the broader David Geffen School of Medicine at UCLA
Join us as we meet the challenges of infectious diseases in the 21st century