Summary

You will perform consultations on patients with a broad array of issues on multiple inpatient services, including medical, surgical, obstetric/gynecologic, and pediatric infectious diseases. Significant time is also spent in the critical care units, dialysis, hematology/oncology, HIV, and transplantation. While working on the ID inpatient consult teaching service, you'll consult on approximately 15-20 new patients weekly (depending on the level of experience), rounding with an ID clinical pharmacist and supervising one or two medical residents and frequently a 4th year medical student. The number of new patients you'll be assigned each day is capped at four to allow adequate time for reading and learning. You will assume increasing responsibilities for the management of clinical cases and for teaching residents and students during the course of training.

The ID fellowship provides problem-specific outpatient experiences through Baystate Medical Practices and Health Centers. In the outpatient environment, you will follow a cohort of patients longitudinally, and provide continued outpatient care for patients you have seen in the hospital. The routine ambulatory experience includes a dedicated Ryan White-funded multidisciplinary HIV clinic, dedicated hepatitis clinic, and general ID clinic. Additional outpatient experiences include the wound care clinic, and tuberculosis clinic. Training on outpatient antimicrobial therapy, sexually-transmitted infections, and travel medicine are provided.

Clinical Responsibilities

Call

• You will take call from home and are on-call one week in three. During the call week, night call rarely requires return to the hospital.
• Weekend call averages 8 hours/day.
• There is always a supervising ID physician available to back you up.

Rounds

• During the two-year fellowship, you spend an average of 12 months on the adult consultation service, 1-2 months on the pediatric consultation service, and 1 month on transplant medicine.
  
  

Teaching and Supervisory Roles

• Baystate Medical Center and the Division of Infectious Diseases value collaboration and consider teaching an integral part of our educational program and an important skill for our fellows.
• You will present in infectious disease conferences and teaching rounds.
• You will be working together with ID pharmacists, laboratory personnel, nurses, and other members of the clinical team.

Clinical Training

• Fellows spend time in the hospital and outpatient clinics to learn the necessary skills in the evaluation and treatment of patients with infections in various clinical settings.
• You'll work closely with infectious disease-trained pharmacists and run the ID teaching service with residents and students on a routine basis in the hospital.
• There are supervised dedicated clinics for general infectious diseases, HIV, and viral hepatitis. Outpatient experience in tuberculosis clinic, wound care clinic, and pediatric ID clinic is also available. Training on outpatient antimicrobial therapy, sexually-transmitted infections, and travel medicine are provided.

Infection Control

• The first month of your fellowship will be spent in infection control along with a microbiology laboratory experience. You'll learn the importance of the interplay of laboratory test information, infection control practices, and antimicrobial stewardship early on in your training.
• You will constantly be interacting with the infection control team and participate in infection control meetings. You can also request further training and time to be spent in infection control depending on your interests and career goals.

Microbiology

• After your initial month in clinical microbiology laboratory and infection control, you will regularly interact with laboratory personnel on matters related to test methods and results that can enhance learning of microbiology at the bedside.
• You will participate in weekly microbiology rounds where you'll learn the basics and updates in microbiology, including rapid diagnostic methods, mycology, mycobacteriology, serology, parasitology, and virology.

Scholarly Activities 

Fellows are expected to participate in clinical research and quality improvement projects, and to publish the results of their efforts. You will likely start work on a research project and quality improvement projects at the start of fellowship under the supervision of a mentor. You will receive education on the principles of quality improvement and patient safety. You are expected to participate in division and hospital-wide quality improvement activities. On average, fellows publish 1-2 papers during two years of training. Typical publications include prospective studies, retrospective studies, case series and reports, quality improvement projects, and reviews of the literature. The fellows are expected to participate and present in the weekly ID conferences and microbiology rounds. The second-year fellow often speaks during the regional ID symposium sponsored by the institution.

Antimicrobial Stewardship 

• The hospital has a robust antimicrobial stewardship program. There is a separate antimicrobial stewardship curriculum and training for fellows.
• You are expected to work with the antimicrobial stewardship team comprised of ID-trained pharmacists and pharmacy residents, and infectious diseases attendings.
• You will regularly attend the meetings of the Committee on Infections, the Antimicrobial Stewardship Committee, and Pharmacy and Therapeutics Committee.