Overview
The two-year fellowship program in the Division of Infectious Diseases is designed to expose fellows to a wide range of clinical and laboratory experience.

Educational Goals
The educational objectives of the Infectious Diseases training program include the acquisition of competencies in the care of patients with Infectious Diseases. The training program will ensure that trainees acquire and demonstrate the necessary knowledge, skills and attitudes that characterize the practice of Infectious Diseases. These fundamental objectives will enable them to contribute to the well being of the patients and communities they serve. The program endeavors to prepare trainees to become quality care providers for patients, advocates for the public’s health, researchers and lifelong students, as well as teachers.

Clinical Training
Fellowship training occurs over a two-year period. Designed to develop Infectious Diseases specialists equally capable of pursuing a career in academia or private practice, fellows obtain their training at Loyola University Medical Center and Hines VA Hospital and the suburban Cook County STD clinic in Maywood, Illinois. LUMC and HVA share a common campus in Maywood, Illinois, adjacent to the Stritch School of Medicine of Loyola University of Chicago. The Cook County clinic is within two miles of the campus and is less than ten minutes away by automobile. Training in these venues allows the fellow to be exposed to the best of both public and private medicine; it allows the fellow to be exposed to the best of both public and private medicine; it provides access to a diverse, multi-cultural population of patients. The spectrum of illness experienced by this population ranges from the mild outpatient treated infectious process through the more complicated hospitalized patient and beyond to those technologically-dependent patients who require intensive care services for their survival.

Inpatient Consultative ID
Fellows spend equal periods of six months of consultative Infectious Diseases at both LUMC and HVA. While at either hospital, fellows supervise the Infectious Diseases consult team under the direct observation and guidance of an Infectious Diseases attending. Beginning in their first month of training, fellows are expected to provide comprehensive, appropriate and compassionate care to patients. They should gather essential and accurate information about their patients; make informed decisions about diagnostic and therapeutic plans; demonstrate the ability to effectively communicate with patients, families, and colleagues; and be able to counsel and educate patients, families students and junior house officers. Monthly assessment of the consult experience is provided by the fellows for both the rotation and the attending teaching ability. Fellows are evaluated monthly on their performance by the attendings.

Outpatient Clinics
All first year fellows spend one-half day per week in the HVA Infectious Diseases clinic as well as one-half day per week in the LUMC – HIV clinic. Second year fellows spend one-half day per week in the HVA Infectious Disease clinic and six months in the LUMC – HIV clinic and six months in the LUMC General Infectious Diseases clinic. These clinics are attended weekly by each fellow for the duration of the training period. Each clinic is attended by one or more Infectious Diseases attending and concurrent teaching as well as supervision occurs prospectively for each patient visit. As these are continuity of care clinics, the fellows are assigned to see and follow patients on return visits until such time as either the fellow completes the training program or the patients complete their course of therapy and are discharged from the clinic. Approximately 20% of the fellow’s clinical training occurs in the ambulatory care setting.

In addition to the above weekly clinic, each fellow spends one-half day per week for 16 weeks each year attending the suburban Cook County Sexually Transmitted Disease clinic. Fellows act in a supervisory role to monitor and teach junior house staff and students who provide initial primary care to the STD clinic patients. Monthly assessment of the clinic experience is provided by the fellows.

Clinical Microbiology Laboratory Practicum
At the onset of their first year of training, all fellows attend and participate in a month –long practicum in Clinical Microbiology. Under the supervision of a Ph.D. microbiologist, fellows learn and practice the fundamentals of clinical microbiology. This is done so that fellows may gain an understanding of the capacity of the laboratory with respect to the diagnostic services it can provide. In addition, the practicum expands the knowledge base of the fellows in the area of clinical microbiology and establishes them as better subspecialists trained to interpret laboratory results and apply them to the clinical setting. The course supervisor provides feedback to the fellow and the Program Director on the fellow’s performance.

Hospital Infection Control Training
Sub specialists within Infectious Diseases are expected to be knowledgeable in hospital infection control. Often, they will assume a level of responsibility for Infection Control as a member of a hospital staff. To provide the necessary training and exposure to the knowledge base within this area, each fellow is expected to attend daily rounds with a nurse epidemiologist under the supervision of the physician, Chief of Infection Control, for a period of one month. This may occur in either year of training. During this phase of training, the fellow is exposed to the principles of Hospital Infection Control, learns and applies the fundamental standards of measurement and methods of surveillance. Fellows may participate in an epidemiologic investigation of an outbreak. The fellows are invited to attend the Hospital Infection Control meetings, monthly and to contribute to the minutes of those meeting with their findings.

Finally, all fellows are provided full support to attend the Society for Hospital Epidemiology (SHEA) course on Hospital Infection Control. This is a four-day intensive lecture and workshop experience to strengthen the fellow’s knowledge base in Hospital Epidemiology.

Fellows are graded on their performance during the Infection Control rotation with an adaptation of the ABIM evaluation form.

In addition, we have developed an in house lecture series in the area of Hospital Infection Control to initiate fellows to the principles and practices of Infection Control.

Formal Education and Conferences
Fellows attend a variety of conferences weekly. Both within the Division and extra-Divisional conferences are included. The Department of Medicine supports a weekly Grand Rounds, a clinico-pathological conference and an Autopsy Review Conference.

Division –level conferences include the weekly clinical case discussion or Interest Rounds. Fellows coordinate the presentation of current or recently seen patients and prepare or oversee the preparation of a literature review for each case discussed.

In this role, fellows learn not only how to monitor and use the literature for their education, but they also learn to mentor and support the student-learner as well as junior-level house officers.

The monthly conferences conducted by the Division include:

• Journal Club - During these meetings, both a fellow and an attending discuss in detail pertinent recent articles in the Infectious Diseases literature. Discussion and critique follows immediately with other attendings and fellows joining on an ad hoc basis.
   
• Research Conference - This monthly conference is given to the review of current research projects being performed by members of the Infectious Diseases faculty and fellows. The papers presented are original work within the Division and may be of a basic, clinical, health-services research or epidemiologic nature. Second year fellows present quarterly on the progress of their research projects(s). All fellows attend and enter into a discussion of the work presented.
   
• Basic Science Conference - This is a seminar series with both intra- and extra-divisional speakers. Topics discussed are outside of the immediately clinically applicable and may include such diverse discussions as the impact of HLA type on HIV viral load to basic immunology.
   
• Fellows Seminar – Each fellow presents quarterly a state of the art review on a focused topic within Infectious Diseases. Use of IT support, such as PowerPoint, is strongly encouraged and supported by the Division. A review file is kept for each session, which includes readings for the topic area. Fellows have ready access to the file.

ID Fellow Rotations

1st Year

• 11 months clinical consult rotation divided between Hines and Loyola
• 1 month clinical research
• 2 half day outpatient clinics

2nd Year

• 2 months clinical consult rotation divided between Hines and Loyola
• 2 months Pediatrics
• 1 month Infection Control
• 8 months research of their choosing – end result will prepare paper for presentation at national meeting and for major journal
• 2 half day clinics