Infectious Diseases

HomeFellowship Infectious Diseases Clinical Experience

Clinical Experience

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In addition to inpatient adult ID and outpatient clinic (Prisma Health–Midlands/USC Immunology Center), fellows will be exposed to the following aspects of infectious disease:
 
Clinical Antimicrobial Stewardship
The antimicrobial stewardship program is a multidisciplinary team led by the Prisma Health–Midlands/University of South Carolina Division of Infectious Diseases and includes members from the School of Pharmacy, microbiology, infection prevention and representatives from the other related specialties (hospitalist service, general surgery, microbiology and emergency department). 

The Antimicrobial Stewardship Program extends to the three major hospitals with the Prisma Health–Midlands System.  In addition the USC Division of Infectious Disease, in collaboration with the Department of Public Health and the School of Pharmacy, is the lead on the statewide stewardship initiative, Antimicrobial Stewardship Collaborative of South Carolina (ASC-SC).
 
Hepatitis C Telehealth
The Division of Infectious Diseases is the premier hepatitis C referral center of the Midlands. We possess the only publicly available FibrosScan in South Carolina (the only other device within the state is housed at our affiliate, the Dorn VA strictly for use with VA affiliates).  Services include a rural hepatitis C referral program as well as hepatitis C telehealth conferencing (SCHTI) which assists providers across the southeast with complex cases via video case discussion.
 
HIV
The Immunology Center is the largest HIV/AIDS center in the region with approximately 2000 HIV infected patients currently enrolled.  HIV accounts for 60 percent of the patients in the fellow’s panel where they see newly diagnosed HIV patients and those with complicated/uncomplicated opportunistic infections and malignancy. 
 
Bone and joint infections
Prisma Health Richland Hospital, our primary training site, is a level I trauma center as well as a premier orthopedic center.  For any patient seen in consultation requiring outpatient IV antibiotic therapy, fellows are responsible for the continued monitoring and management of therapy in the outpatient setting.
 
Global Health
Fellows are exposed to the challenges of managing patients with social and economic barriers as well as treating tropical infections. This is done locally at three sites (Survivor Clinic, Travel Clinic, and the South Carolina Department of Corrections). In addition, opportunities for international experiences are available.
 
South Carolina Department of Corrections
The USC Division of Infectious Diseases n provides all HIV, hepatitis C, infectious disease (including tuberculosis) and antimicrobial stewardship care for persons within the South Carolina prison system.  This includes services to over 20,000 inmates, of which approximately 300 are HIV infected and approximately 600 are hepatitis C infected.
 
The Carolina Survivor Clinic
The only refugee clinic in South Carolina, is housed at the USC Immunology Center, and is managed by an Infectious diseases attending. Services include refugee screening examinations, diagnosis and treatment of multiple infectious diseases, survivor of torture screening, home visits, and supplemental supportive services including a Scholastic Soccer Project and the USC garden project.
 
Infection Prevention (IP)
A robust multi-hospital IP program covers both the inpatient hospital programs as well as affiliated ambulatory sites (several Palmetto Health sites). Fellows gain practical experience in IP hospital epidemiology and procedures for outbreak investigation and preventative measures are.
 
Microbiology
Palmetto Health’s Microbiology Department is a state-of-the-art lab which provides services to multiple hospitals within the Midlands. In addition to routine microbiologic procedures, the microbiology laboratory has several state-of-the-art rapid diagnostic tools including filmArray (blood-BCID, respiratory, meningitis and GI panels), Gene Xpert (C.diff, MRSA, and MTB), VITEK 2, Affirm, and BacTAlert.
 
Pediatric Infectious Disease
Fellows rotate with the pediatric infectious diseases faculty at our on-site pediatric hospital which serves the Midlands of South Carolina and offers exposure to a wide variety of pediatric infectious disease conditions.
 
Hyperbaric Medicine training
This is an optional on-site hyperbaric training program which provides a comprehensive introduction to the role of hyperbaric oxygen therapy in modern medical practice. Follow this link for more details: https://www.palmettohealth.org/medical-services/other-services/wound-care/hyperbaric-medicine-training-program.

Interprofessional Disciplines

Partnerships
  • Infectious Disease Pharmacy Residency - The Infectious Diseases fellow and the PharmD resident/fellow are trained side-by-side. They share the responsibilities of inpatient and outpatient care, conference preparation, and research projects. Click here to learn about our Pharmacy connection.
  • Case Management and Social Work - Fellows work closely with these disciplines in both the inpatient and outpatient settings in order to coordinate patient care.
  • Mental Health Counselors and HIV Peer Advocates - These  team members work in conjunction with the fellows to provide a comprehensive patient care plan. 
Transition of Care
  • Home health agencies - Discharge planning and transition of care is coordinated with the assistance of the inpatient case management group. 
  • Outpatient antimicrobial therapy (OPAT) - Discharge planning team works with infectious diseases service to coordinate discharge planning with infusion companies and management of OPAT.
  • Combined EMRs (inpatient and ambulatory) - Cerner software is used in both the outpatient and inpatient setting which has been merged into “OneChart.”, allowing for ease of access to patient medical information.

Technology

Rapid diagnostics
Palmetto Health's state-of-the-art microbiology lab has implemented the use of rapid diagnostics which has led to improved patient care outcomes.
  • FilmArray® (comprehensive respiratory, GI, blood culture [BCID] and meningitis panels)
  • Gene Xpert® [C.diff, MRSA, and MTB]
  • VITEK 2®
  • Affirm® (A vaginitis DNA probe for Candida, Trichomonas and Gardnerella)
  • BacTAlert
FibroScan 
FibroScan is a noninvasive method now used to determine the level of fibrosis in the liver.  We house one of two FibroScan devices in the State of South Carolina. Fellows receive training on the use and indications for FibroScan technology.

Ultrasound
The USC Ultrasound Institute is currently the only one of its kind in South Carolina that offers an ultrasound fellowship for physicians. Fellows have the opportunity to advance their skills using handheld devices. Learn more about the Ultrasound Institute:  http://ultrasoundinstitute.med.sc.edu/

TheraDoc and NHSN reporting
Fellows have access to these  systems for ASP, quality, insurance and research purposes.