Rotation: Infectious Diseases Elective
Site:
- NWTH, BSA, and outpatient offices of named Instructors
Instructors:
- Dr. Rodriquez, Dr. Carlisle, Dr. Milton
Makeup of team (responsibility of each team member):
- Instructor will make assignments for responsibility of the resident. Resident will perform initial evaluation of patient on consult or primary service and discuss findings with the Instructor. The resident physician will be responsible for documenting findings in the medical record in the form of a complete History and Physical exam or Consultation and daily progress notes. Attending/Instructor will ensure quality ID consultations and care and discuss each case with the resident physician.
Days per week (night call):
- Five days per week;(one upper level ICU night call per month possible). Usual time of attending rounds (meeting place): Resident will contact the Attending physician regarding preferred meeting place.
Types of patients encountered:
- Adult patients from a broad range of backgrounds.
- Patients will be seen in hospital ward setting, medical and surgical ICU, long term care and outpatient settings.
Educational goals/competencies:
Patient Care:
The resident physician will use thorough history taking skills, not over relying on old records, to obtain history of present illness and appropriate social, occupational, and travel history of the patient. The resident will complete a thorough physical exam with special attention to areas of concern as directed by history taking. The resident will be able to obtain complete history by spending adequate time with the patient and forming rapport with the patient. Diagnostic tests will be selected based on differential derived after history and physical exam. Skills should be adequate in lumbar puncture, central venous line placements, joint aspiration, thoracentesis and paracentesis as appropriate.
Medical knowledge:
Residents should be comfortable in basic area of the following core areas in ID:
- HIV: basic information regarding HAART, common side effects, drug interactions classes of medications opportunistic infections and appropriate prophylaxis - PCP, CMV, TOXO, Cryptococcus, Candida
- Associated illnesses-lymphoma, Kaposi's sarcoma, cervical cancer modes of transmission and occupational exposure
- Bacterial Endocarditis: diagnosis by PE, history and diagnostic testing. Appropriate treatment and length of treatment.
- Sexually transmitted Diseases: syphilis, gonorrhea, Chlamydia, HSV,HPV, treponema pulliden, trichomonas
- Nosocomial and Ventilator Acquired Pneumonias: importance of gram negative and resistant organisms.
- Osteomyelitis: diagnosis and treatment
- Meningitis: organisms
- Physical exam, diagnostic studies, treatment
- Travelers syndromes/appropriate vaccinations
- The immunocompromised patient
Interpersonal and communication skills:
The resident will be expected to communicate with the patient's primary physician when in the role of consultant. In addition, the resident will demonstrate appropriate rapport with the patient and family members in discussing diagnostic evaluation and treatment. In addition, clear orders, daily notes, discharge instructions will be documented. The resident will appropriately discuss care of the patient with other members of the health care team and address all concerns.
Professionalism:
Residents will be expected to be timely and professional in appearance at all times while on ID service. The resident will demonstrate respect to the patient and members of the health care team. The resident will return pages/calls promptly and adequately address the concern of the caller. The resident should communicate any absences to the rounding attending physician.
Practice based learning:
Residents will read about the problems encountered during their rotation and should discuss any issues which are unclear with the attending physician. Residents should be willing to admit deficiencies and recognize these areas for future improvement.
Systems based practice:
Residents will learn about community resources available for long term wound care and prolonged courses of IV Antibiotics. In addition, the resident physicians should become aware of community resources for HIV/AIDS population and STD clinics. The resident should be aware of the role of the county Health Department in the community, especially regarding epidemics and the reporting of infectious diseases.
Text/references to be consulted:
The infectious disease chapters of Harrison's Principles of Internal Medicine. The infectious disease section of MKSAP. Selected Readings from Mandell's Infectious Disease textbook.