Curriculum - Education

Ambulatory Activities

There are two half day infectious disease clinics per week. An infectious disease fellow attends one of these two continuity care clinics one half day a week throughout their entire fellowship. Patients who have HIV infection as well as other types of infectious disease problems are seen in this clinic. Fellows also attend the hepatitis C clinic a half day per week when they are not on the inpatient consult service.

The attending physician also has the ultimate responsibility for the care of the patients seen in the infectious disease clinic and is physically present in the clinic during the entire clinic. All patients seen in the clinic are presented to the attending who personally sees all patients with the fellow. The fellows present all patients that they see directly to the attending physician. The attending physician actively teaches the infectious disease fellow at the time of these presentations based on clinical issues and teaching points brought up by the patients clinical problems. This teaching usually is a short mini-lecture but also can be short statements of fact concerning the patients problem. Planned lectures addressing a specific point raised by a previous patient in detail are presented periodically. Pertinent medical literature is provided by the attending on an ongoing basis.

Inpatient Service

All fellows spend 12-14 months on an inpatient consult service. The infectious disease hospital consult team consists of the attending physician, the infectious disease fellow, one to two internal medical residents, an occasional other specialty resident and sometimes one medical student. They predominantly function in a consultative role in the hospital setting although a few patients are cared for primarily by this team. Consults are received primarily from internal medicine and surgical primary care teams. All hospitalized patients with complicated infectious disease problems are seen by this team as well as many with more straight-forward problems. The infectious disease fellow assigns each consult that is received either to the internal medicine residents or other trainees, or sees the patients themselves, based on the volume of patients, the residents other obligations such as internal medicine clinic, etc.

On the hospital consult service the fellow has either seen all the patients themselves or had those seen initially by the internal medicine residents presented to them in order to have already formed their own impression and plan for the patient before they are presented to the attending physician. The fellow can initiate therapy if indicated by the clinical situation on any patient before they are presented to the attending physician. All patients, either “new” or old consults being followed by the consult teams, are presented and discussed each day with attending. The old consults are presented and discussed in a more truncated manner than the new ones. The attending physician functions in a supervisory manner with ultimate responsibility for all patients. rounding seven days a week and being available by pager 24 hours a day, seven days a week. The infectious disease fellows and internal medicine residents rotate weekend coverage. The fellows carry an on-call pager and are called initially for all infectious disease questions during the work week and when they are covering during the weekend.

On the hospital consult service the fellow supervises the residents/students care of the patients they are following in a consultative or primary care role. There is also a standard lecture series given to each group of internal medicine residents/students rotating on the infectious disease service at Scott & White.

Waco Rotation

Fellows rotate with a private practice group in Waco, Texas, called, Waco Infectious Disease, Inc., which is a half hour from Temple. The fellows also go to the McClennan County STD Clinic a half day per week. This clinic is supervised by the Waco Infectious Disease group. The Waco rotation is organized similarly to that at Scott & White. There are family practice residents in the rotation but no students.

M.D. Anderson Rotation

Fellows also rotate for a month at M.D. Anderson Cancer Hospital in Houston, Texas, on this rotation they see a wide variety of immunosuppressed patients to include those with bone marrow transplants.

Research

All fellows are required to participate in a meaningful clinical research activity. Areas of active interest is the division at the present time include orthopedic-device related infections, hepatitis C, complex negative staphylococcal infection, disseminated fungal infection, etc. Ample time and faculty supervision is provided for clinical research activities. Support is also available via the Scott & White Research and Education Division for individuals interested in developing original research projects.

Infectious Disease Publications

• 2005-2006: Infections Disease Faculty Publications

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