The educational objectives of the Infectious Diseases Fellowship training program include development of the core competencies required for expertise in the diagnosis and care of patients with a broad spectrum of infection-related problems. The Fellowship Program Director and Infectious Diseases faculty are dedicated to ensuring that trainees acquire and demonstrate the necessary fundamental knowledge, skills and patient-focused empathetic attitudes that characterize the practice of Infectious Diseases at its highest level. The goal is to provide trainees the role models and learning environment that will prepare them for a lifelong career as excellent diagnosticians, patient advocates, practitioners of public health and epidemiology, researchers and lifelong students as well as teachers who will pass along these traits to future trainees.
Fellowship training occurs over a two-year period. Fellows obtain their training on the inpatient services and in the outpatient clinics at Loyola University Medical Center and the adjacent Edward J. Hines Jr. Veterans Administration Hospital. Training at these venues allows fellows to be exposed to the best of both public and private medicine, by providing access to a highly diverse, multicultural population of patients with a broad spectrum of infectious diseases problems.
Inpatient Consultative ID
There are three, full-time Infectious Diseases Services on which the fellows rotate during the course of their training-- General Infectious Diseases Consultation Services at both the Loyola University Hospital and the VA Hospital and a Transplant Infectious Diseases Consultation Service at Loyola University Hospital. All of these services are staffed by full-time ID Division faculty. The first year of the Fellowship consists of an intensive, 10-month period of training, during which fellows rotate on all of these ID services. During the second year of training, fellows continue development of their inpatient consultation skills during a 3.5-4 month period of inpatient Infectious Diseases consultation service, mentored by clinical faculty. Opportunities are available for experiences in Pediatric Infectious Diseases and other inpatient consultative environments. Fellows are evaluated and counseled through ongoing interactions with attending physicians and regular meetings with the Fellowship Program Director.
In addition to their inpatient consultative experiences, Fellows see patients with ID faculty in one half-day of outpatient ID clinic per week, alternating between Loyola and the VA, during the first year of training. During the second year of training, Fellows continue development of their outpatient consultative and primary care skills through two half-day clinics per week--one at the VA and one at Loyola--with continued mentoring by ID faculty. Specific attention is given to creation of opportunities for continuity care through mentored experiences in "Fellow Clinics" at both Loyola and the VA. Ample opportunities exist at both institutions for fellows to acquire expertise in the care and long-term management of patients with HIV/AIDS and related problems, through teaching interactions with clinical faculty and dedicated support by PharmD staff with expertise in HIV/AIDS patient care. The focus on continuity of care also allows scheduling of follow-ups for continued outpatient care of patients originally seen in the context of inpatient ID consultations.
Clinical Microbiology Laboratory Practicum
At the beginning of the first year of training, all fellows participate in a month-long practicum in the Clinical Microbiology Laboratory at Loyola. Under the supervision of the PhD microbiologist leader of the laboratory, fellows learn the fundamentals of clinical microbiology and the theory and application of rapidly changing diagnostic methodologies. This experience provides fellows with the opportunity to learn the importance of collaborative practice with microbiology laboratory personnel and the basics of diagnostic microbiology technologies. This opportunity also positions fellows to more effectively interpret and use microbiology laboratory data in the clinical setting. Fellows use this expertise throughout their clinical training, as a basis for the important, lifelong practice of collaborative, integrated decision-making using microbiology laboratory expertise and resources.
Hospital Infection Control Training
Hospital Infection Control is an increasingly important subdiscipline within Infectious Diseases. Therefore, it is critical for Infectious Diseases Fellows to have the opportunity to learn the basics of this discipline during their subspecialty training. Because of the universal need of hospitals for this type of support from their Infectious Diseases specialists, expertise and experience in Infection Control provides an important career direction for fellows. In the combined Loyola/Hines VA Infectious Diseases training system, fellows have the outstanding opportunity to work with several faculty with expertise in Infection Control and with two dedicated leaders (one at each institution) of Infection Control programs who provide the learning environment and mentoring needed for fellows to acquire expertise and experiences. Each Fellow will complete the IDSA/SHEA sponsored Infection Control course. And each trainee will also actively participate in Infection Control related activities and projects during their training. There are numerous opportunities for Fellow involvement in infection prevention and outbreak investigations that can lead to research projects during the fellowship.
Antimicrobial Stewardship Training
Evolving patterns of antibiotic resistance, increasing costs of antimicrobial therapy and the availability of new antimicrobial agents create an ongoing challenge to the optimal use of antimicrobial agents in healthcare institutions. The Antimicrobial Stewardship Program at Loyola is led by ID faculty and is a combined effort with ID PharmD staff and hospital pharmacy services, with oversight by an advisory group that represents multiple programs within the ID Division and Department of Medicine. This program collaborates closely with the Clinical Microbiology Laboratory and the Hospital Infection Control Program to consider emerging patterns of antibiotic resistance and hospital-based practices, to develop effective antibiotic monitoring, guidelines and education. The increasing importance of antimicrobial stewardship in the future of medicine makes ID Fellow involvement in Stewardship activities a critical part of the fellowship training program. The related studies, guideline development and analyses of patterns of emergence of resistance provide numerous opportunities for collaboration with colleagues involved in public health and outcomes studies.
All fellows participate in research projects during the course of their training. The primary objective of these projects is to provide opportunities for experiences in a broad spectrum of research activities that can be used to define the roles of research in future career planning and that provides the basic experience for next-steps in development of the research aspects of individual careers. During the first year of training, there is a one month period of research study and planning that is focused on review and analysis of research opportunities, interests and program possibilities. This provides Fellows with the opportunity to learn about the research programs and mentoring available in the combined Infectious Diseases program, to meet with faculty to discuss research possibilities and to begin planning research projects for the second year of fellowship. There is a wide range of basic science, translational and clinical research that can be the source of project development. The numerous research opportunities are enhanced by the existence of an active Clinical Research Office that is highly involved in the support of Infectious Diseases research activities and by the presence at Loyola of Infectious Diseases-Immunology Institute that provides a structured environment in which clinicians and scientists work together with students on research projects. The long-term goal of the research program is to provide fellows with a launching pad for future research and career development in academic Infectious Diseases.
Fellows actively participate in regularly scheduled conferences, including an ID core lecture series, HIV lecture series, Journal club, clinical case conference, autopsy conference and Infectious Diseases-Immunology Institute seminars. In addition, there are regular ID board review sessions mentored by the ID Fellowship Program Director. During the period of training, the fellows enhance their skills in clinical presentations, clinical and research reviews and critical thinking, in the context of diverse conferences and case-based presentations.