Curriculum
Our Infectious Disease curriculum is an important document that defines the educational goals of our Residency Training Program and is intended to clarify the learning objectives for all inpatient and outpatient rotations. Our program requirements are based on the ACGME standards for categorical training in Infectious Disease.
This is a document that will change over time and is developed based on the following principles:
- The Infectious Disease curriculum was developed and updated by broad representation of faculty and residents.
- The Infectious Disease curriculum will clearly define the expectations of junior and senior residents on specific rotations. This is to help ensure that our residents are gradually increasing their responsibility regarding patient care and teaching responsibilities.
- It also reflects the expectations that medical knowledge will gradually increase at different levels and that much of that learning is self-directed. It is also expected, as residents progress through the 2-year training program, that their skills with practice-based learning and the application and improvement or complex systems that we work in continue to improve throughout the 3-year training cycle.
- The primary goal of our Infectious Disease curriculum is to assist in training excellent internists who cans successfully:
- Practice quality medicine in both the inpatient and outpatient setting.
- Pursue subspecialty training.
- Develop skills as an educator.
- Participate in research.
It is our hope that our residents will continually exhibit intellectual curiosity and that they will bring that style of practice to their patient care. This is best accomplished by being well-trained in practice-based training.
It is difficult to convey in a curriculum our very high standard of professionalism and ethical conduct that we model and expect from all our residents.
Graduate medical education by nature involves a great deal or self-directed learning. Our hope is that the curriculum will serve as a helpful template to guide learning and clinical maturation throughout all years of training.
Our electronic evaluation system is intended to reflect on a timely basis fair evaluations of the residents' performances. MedHub also allows us to clearly track development in all the 6 core competencies. Residents are expected to meet minimum standards in the 6 core competencies and are strongly encouraged to develop excellence in all of these.
Those 6 core competencies include:
- Patient Care
- Medical Knowledge
- Interpersonal and Communication Skills
- Professionalism
- Practice-Based Learning
- Systems-Based Learning
It is our expectation that our residents will read Rotation Specific Curricula prior to all rotations. It is also our ongoing intent to develop a posttest after specific rotations to test specific areas of knowledge.
The Infectious Disease Fellowship program offers an opportunity for a Fellow in good standing to transition into a Critical Care track upon completion of their Infectious Disease fellowship program.
Throughout the course of the ID Program, a fellow selected for the Critical Care track will engage with the Critical Care team and participate in Critical Care conferences and internal rotation/s. A minimum of a one-month Critical Care internal elective will be completed during the PGY5 ID Fellowship year.
Please refer to the Rotation Specific Curricula below for further detail.
Transitions of care, if not given due diligence, are associated with adverse events and/or near misses. It is our responsibility as clinicians to ensure that patient care/safety is always given the highest priority. It is, thus, imperative that measures are taken by EPO to ensure that signouts and/or handoffs are performed such that patient safety is assured and the rules of the ACGME (as outlined below) are followed.
Regarding Rotations
The Infectious Disease Fellowship provides a multitude of elective choices that allow the program to tailor an experience to the interest of each fellow. Fellows must request an elective in writing by 12/30 of their PGY4 year. This request will be submitted to the Coordinator for program approval by the PD/Chief. Electives will only be scheduled during PGY5 year. All Fellows must be in good standing to be approved for an elective.
Program Goals & Objectives
During all ID rotations, the fellow is responsible for consultative care of a variety of patients with numerous infectious problems in all stages of disease. Rotations will integrate infectious problems, health promotion, and cultural, socioeconomic, ethical, occupational, environmental, and behavioral issues whenever possible. On each rotation, the fellow is supervised by a staff attending. This attending will complete a written evaluation of the fellow's performance to include an assessment of the clinical competence of the fellow in each of the 6 clinical competencies (Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, Practice-Based Learning, and System Based Practice) and how the goals and objective of the rotation were met.
Fellows are responsible for the consultative care of adult patients, including teenagers and geriatrics of both sexes, on medical wards, surgical wards, and intensive care units.
- Formal instruction and practical experience in hospital epidemiology and infection control.
- Formal instruction and gain practical experience in clinical microbiology.
- Clinical experience in the evaluation and management of HIV-infected patients with major impairment of host defenses.
- Formal instruction or clinical experience in the evaluation and management of the following disorders:
- Infections of reproductive organs
- Infections in solid organ transplant patients
- Infection in bone marrow transplant recipients
- Sexually transmitted diseases
- Viral hepatitis, including hepatitis B and C
- Infections in travelers
- Clinical experience in the evaluation and management of patients with the following disorders:
- Pleuropulmonary infections
- Cardiovascular infections
- Central nervous system infections
- Gastrointestinal and intra-abdominal infections
- Skin and soft tissue infection
- Bone and joint infections
- Infections of prosthetic devices
- Infections related to trauma
- Sepsis syndrome
- Nosocomial infection
- Urinary tract infection
- Clinical and didactic teaching by the attending through daily rounds totaling 5 or more hours per week.
- Preparing case-based discussion material for weekly management conference.
- Principles and Practice of Infectious Disease 6th ed.
- Current disease-specific articles assessed through computer-based search engines such as Pubmed and Ovid or provided by the attending physician.
- Fellows will be given verbal feedback mid-rotation and verbal/written feedback at the end of the rotation.
- Fellows will evaluate the rotation at the end of the rotation through the computer-based system new innovations.
- Fellows will be evaluated by the six core competencies- patient care, medical knowledge, practice-based learning improvement, interpersonal and communication skills, professionalism, and system-based learning.
Attendings are the primary supervisor for fellows while rotating on the consultative service. There is a rapid, reliable, and continuous communication structure in place for contacting supervisors through the paging system.
Expectations for fellow performance is as follows:
- Patient care
- Fellows are expected to arrive with the basic skills of an internist. During the first year of the fellowship, medical interviews, physical examinations, review of pertinent data, and procedural skills should be thorough and complete. This should transition so that during the second year of fellowship, these areas should include the finer details pertinent to infectious disease without errors. Decision-making should incorporate evidence-based medicine backed by sound judgment relying during the first year of fellowship on significant staff input.
- During the second-year, staff should have less direct input while enhancing the more subtle teaching points of the case. Decisions should be made in cooperation with other consultants and the primary care physicians managing the patients including the wishes of the patient. During this first year of fellowship, it is expected that direct involvement of the attending is necessary during this communication, however, during the second year the fellow should be the primary point of communication.
- Medical knowledge
- Fellows are expected to arrive with the basic medical knowledge of an internist. During the first year of training, fellows are expected to develop the basic and clinical science of infectious diseases. First-year fellows should be able to cite textbook medical literature with a solid understanding of the fundamentals of infectious diseases.
- During the second year of training, fellows should develop an in-depth knowledge of infectious diseases and an ability to quote primary literature pertaining to this knowledge. Second-year fellows should be able to clearly apply that information to management of their patients. During the second year the knowledge base should be more comprehensive with a greater depth especially regarding the relationship and mechanisms of disease.
- Practice-based learning improvement
- During the first year of fellowship, trainees are expected to seek outside feedback with appropriate responses to improve overall healthcare delivery. First-year fellows are expected to use the information technology available at the institutions to improve the care of their patients and for self-improvement.
- During the second year, fellows should constantly evaluate their own performance incorporating internal and external feedback. During the second year, fellows are expected to use information technology for improvement of themselves and their patients as well as the health care system.
- Interpersonal and communication skills
- During the first year of fellowship, trainees are expected to work closely with the attending to provide the highest health care possible to patients and families. This includes listening, narrative, and nonverbal skills. The fellow should incorporate these skills to provide education and counseling to patients, families and colleagues while staying connected with all aspects of health care delivery.
- Second-year fellows are expected to be the primary link to the primary care team, other consultants, the patient, and the patient's family without relying on the attending to perform these facets of medical care.
- Professionalism
- First and second-year fellows are expected to perform to the highest level of professionalism at all times. This should include respect, compassion, integrity, and honesty. They should be committed to self-assessment along with a commitment to their patients, families, and colleagues. They should willingly admit errors. During the first year of fellowship, trainees, with the guidance of their attending, perform the role of teacher and role model as the infectious disease consultant.
- During the second year the fellow should be the primary teacher and role model for the infectious disease consultative service.
- System-based learning
- During the first year of fellowship, trainees should rely primarily on textbooks and review articles to obtain the breadth of knowledge necessary for performing as an infectious disease physician. First-year fellows should become involved in the systems used within the hospitals for improving health care.
- Second-year fellows should rely on primary literature for depth of knowledge. During the second year, fellows should be able to apply these systems to their own practice of medicine as well as improving the entire healthcare system.
