This rotation is a one to four week structured clinical experience under direct supervision designed to provide the resident experience diagnosing, treating and caring for patients with infectious diseases. During this rotation, residents will rotate through a variety of infectious diseases clinics and related services during the outpatient segment. Residents will also spend time on one of the inpatient consult services. There are multiple educational opportunities throughout this block, listed in the schedule below.
Develop an understanding of the infectious diseases seen in hospitalized patients
PGY-2: Understand the principles of assessing and managing both common and complex presentations of infectious diseases in hospitalized patients.
PGY-3: Develop advanced processes to recognize and treat complications of infectious diseases in hospitalized patients and in patients with multiple medical problems
Competency: Patient care, Medical knowledge
Developing diagnosis skills
PGY-2: Effectively use the bedside clinical examination and demonstrate subtle clinical findings in patients with infectious diseases
PGY-3: Learn how to correlate bedside clinical findings with imaging and other data in patients with infectious diseases
Competency: Patient care, Medical knowledge
Understand the differential diagnosis of common infectious diseases
PGY-2: Develop a differential diagnosis for common clinical scenarios in patients with infectious diseases
PGY-3: Recognize unusual presentations of common clinical situations in patients with infectious diseases
Competency: Medical knowledge
Learn pharmacological management of common infectious diseases
PGY-2: Learn the medications used in management of infectious diseases, understand how to manage complicated clinical problems, and develop specific therapeutic strategies in patients with infectious diseases
PGY-3: Learn how to develop personalized care plans for patients infectious diseases and intersecting clinical problems
Competancy: Medical knowledge
Effectively consult on inpatients, develop, and execute assessment and management plans.
PGY-2: Learn to be an effective infectious disease consultant. Recognize how to prioritize patient problems. Develop management plans for inpatients with infectious diseases.
PGY-3: Understand interactions between patient infectious diseases and other medical issues and develop advanced strategies to prioritize management
Competency: Patient care
Effectively execute day-to-day management of patients
PGY-2: Manage patients with infectious diseases, including daily assessment and assessment of progress. Understand how to adjust patient treatment plans based on patient progress and determine the need for additional assistance such as subspecialty consultation
PGY-3: Recognize how to manage complex infectious diseases and manage both expected and unexpected complications.
Competency: Patient care
Interdisciplinary care and discharge planning
PGY-2: Learn how to communicate effectively with the interdisciplinary care team and anticipate patient needs for discharge and effective follow-up Recognize the unique needs of infectious disease patients and help integrate patient needs with available resources
PGY-3: Learn how to manage advanced situations such as end-of-life decisions, complex transitions of care and advocate for patients when resources are limited
Competency: Patient care, System-based practice
Rational ordering of lab tests and imaging studies
PGY-2: Learn how to interpret laboratory findings and imaging seen in patients with infectious diseases
PGY-3: Gain advanced knowledge of high value principles in the ordering of laboratory studies and imaging for evaluation of infectious diseases
Competency: Practice-based learning and improvement, Medical knowledge
Familiarity with the electronic health record and optimization of its use
PGY-2: Understand how to effectively use the electronic health record in the care of patients with infectious diseases
PGY-3: Develop an understanding of advanced medical informatics in the care of patients with infectious diseases by utilizing additional resources in the EHR
Competency: Systems-based practice
Communication and teamwork
PGY-2: Develop effective and timely communication strategies with the interdisciplinary care team for patients with infectious diseases
PGY-3: Use advanced communication methods to engage and coordinate care with the interdisciplinary care team for patients with infectious diseases
Competency: Professionalism, Interpersonal and communication skills
Increase working knowledge of common infectious diseases and understand specific treatment strategies, with a focus on clinical manifestations of various organisms, microbiological/immunological testing, antibiotic regimens, and evidence-based practice, in accordance with current guidelines. Conditions that may be seen include (but are not limited to) HIV/AIDS associated conditions, tuberculosis, nosocomial infections, fungal infections, parasitic diseases, viral diseases, multi-drug resistant organisms.
Become familiar with the diagnosis and management of patients with HIV or AIDS. Understand the management of HIV/AIDS associated conditions, including cryptococcal meningitis, progressive multifocal leukoencephalopathy, Kaposi’s sarcoma, CMV colitis, and immune reconstitution syndrome. Understand the principles and side effects of HAART therapy.
Develop skills in interpretation of culture results while understanding the concept of MIC, breakpoint, resistance mechanisms.
Understand principles of management of various nosocomial infections in ICU patients as well as those status post orthopedic, urologic, or surgical procedures.
Become familiar with the work-up of fever of unknown origin.
Become familiar with the diagnosis and treatment of chronic infections, such as osteomyelitis and endocarditis
Become familiar with the principles of antimicrobial stewardship and how to implement them in daily practice.
Increase working knowledge of infectious complications and management of patients who are immunosuppressed secondary to history of solid and/or liquid organ transplantation.
You will be rounding on new consults and follow-up COVID+ patients virtually (from home) on Monday, Tuesday, and Thursday. On Wednesday and Friday, you will have Jeopardy in the AM and in-person VA ID clinic in the afternoon.
Page the Parkland COVID attending at 8 am on your first day of the week rotation.
The COVID attending will assign you either new consults or follow-up patient and inform you of time for phone rounds.
You will pre-chart and call the patient for the history, write the note using the COVID ID note template (attending will share this with you), except the exam
Parkland-recommend using Engage or call the primary nurse in the COVID TCU to help contact the patient.Late morning/afternoon phone rounds with COVID Attending.
Morning report and Noon conference are still protected learning time for you.
Parkland HIV Consults
Location: New Parkland Hospital (NPH),16th floor, 600 near side. ONE CAN ONLY ACCESS THROUGH PATIENT CARE ELEVATORS on 16-600 (B-Elevators). May move to 14-644 after 2 PM. Please page the on-call fellow through PHHS web-on-call the day before to confirm the timing of rounds and in case you get lost finding the room.
Hours: 8 AM to 5 PM. Monday through Friday. No overnight call/ weekends
1-2 residents will be assigned to this week at any given time
Team Composition: Attending staff, infectious disease fellow, 1-2 residents, APP (NP or PA)
Location: CUH 10th floor, room 10.1603 (room code 13579#). Please page the on-call fellow through UT web-on-call the day before to confirm timing of rounds.
Hours: 8 AM to 5 PM. Monday through Friday. No overnight call/ weekends
1 to 2 residents will be assigned to this week at any given time
You will be rounding on new consults and follow-up COVID+ patients virtually (from home) on Monday, Tuesday, and Thursday. On Wednesday and Friday, you will have a study period in the AM and in-person VA ID clinic in the afternoon.
Page the CUH General ID fellow at 8 am on your first day of the week rotation.
The fellow will assign you either new consults or follow-up COVID+ patients and inform you of time for phone rounds.
You will pre-chart and call the patient for the history, write the note using the COVID ID note template (fellow with share this with you), except the exam.
CUH- BlueJeans app via EPIC. Call room phone directly for floor patients. For COVID ICU patients who are intubated, contact primary ICU nurse to get updates on status.
Late morning/afternoon phone rounds with attending and fellow.
Morning report and Noon conference are still protected learning time for you.
CUH Transplant ID Consults
Location: Previously in CUH 6th floor, room 6.313, recently have been based in CUH 12th floor, room 12.116 Please page the on-call fellow through UT web-on-call the day before to confirm timing of rounds.
Hours: 8 AM to 5 PM. Monday through Friday. No overnight call/ weekends
1 to 2 residents will be assigned to this week at any given time
Team Composition: Attending staff, +/1 infectious disease fellow
Assess acute and chronic infectious diseases in the outpatient setting
PGY-2: Learn to assess acute and infectious diseases and develop an advanced understanding of these disorders in the outpatient setting
PGY-3: Understand the intersections between acute and chronic infectious diseases and subtle variations in presentation
Competency: Patient care
Understand the principles of chronic infectious disease management
PGY-2: Understand the principles of chronic infectious disease management, including problem lists and preventive care, and factors that create competing priorities with chronic infectious diseases. Understand the pharmacological management of chronic infectious diseases
PGY-3: Develop and utilize advanced care processes including consultation and interdisciplinary management of chronic infectious diseases
Competency: Patient care
Learn pharmacological management of common infectious diseases
PGY-2: Understand the medications used for infectious diseases and how to manage complicated health problems and develop specific therapeutic strategies
PGY-3: Learn how to develop personalized care plans for infectious disease patients with intersecting clinical problems
Competency: Medical knowledge
Understand the differential diagnosis of common clinical infectious disease scenarios
PGY-2: Develop an expanded differential diagnosis for common infectious disease clinical scenarios
PGY-3: Recognize unusual presentations of common infectious disease clinical situations
Competency: Medical knowledge
Develop and utilize patient dashboards to engage in population management
PGY-2: Identify noncompliance or patients who are outliers in the patient dashboards
PGY-3: Develop advanced care plans with the interdisciplinary care team to manage infectious disease patients not meeting parameters in the patient dashboards
Competency: Systems-based practice, Practice based learning and improvement
Understand the unique outpatient needs of patients with infectious diseases
PGY-2: Recognize and understand the outpatient needs and community resources available to infectious disease patients
PGY-3: Learn how to work with an interdisciplinary care team to optimize the availability and utilization of community resources available to infectious disease patients
Competency: Patient care and systems-based practice
ID Didactics
Time: Tuesdays 8am, Y buildling (see email sent prior to rotation start)
After didactics, outpatient residents will go to CUH Micro Lab for rounds with the techs 9:30-11am and Micro Plate Rounds from 11-11:30am
Location: depends on which Tuesday of the month it is. For more information, click on the 'Antibiotic Stewardship' clinic page link above this text. (Make sure that you are logged in using utswimres for the link to work).
Location: CUH 7.413 (across the hall from patient room 735 on 7N). Sign in once you're in the office.
Start time: 1:15 pm Tuesdays and Thursdays
Contact #s: Text Swann Waterhouse (214-966-5777) letting her know you will be rounding with the team that day. If no response, please page the CUH Wound Ostomy Charge Nurse pager.