Infectious Diseases

Rotations Schedule

Sample Block Schedule  

Example - ID Fellows Rotation Schedule
July Aug Sept Oct Nov Dec Jan Feb Mar April May June
PGY 4
 Res VAH PHR VAH USS/
Global Health/
Hep C
  PHR Res ASP/IP   PHR Micro/Res   PHR Peds ID
PGY 5
Res   PHR Res USS/
Global Health/
Hep C
VAH Res   PHR Res/ Travel Med. ASP/IP Transp VAH Res
Continuity Clinic, 1-2 per week (Hep C clinic on Thursday pm)

ASP – Antimicrobial Stewardship
Hep C – Hepatitis C
Inpatient (PHR – Palmetto Health Richland; VAH – Dorn VA Medical Center)
IP – Infection Prevention
Micro – microbiology
Res- Research
Transp – Transplant
USS – ultrasound

 
Main ambulatory focus: HIV
  • HIV accounts for 60 percent of the patients in the fellow’s ambulatory panel 
  • Fellows see newly diagnosed HIV patients and those with complicated/uncomplicated opportunistic infections utilizing interdisciplinary approaches to patient care
  • Services offered are comprehensive, including medical case management, substance abuse screening, referral and treatment, pharmacy, nutrition, mental health, perinatal HIV prevention case management, HIV discharge planning from the SC Department of Corrections, and HIV prevention methods including PrEP
  • At the completion of the program, fellows will be able to manage complex HIV patients with multiple mutations and social barriers
  • Additional learning occurs through genotype meetings and formal HIV lectures incorporated into the didactic sessions 

Hepatitis C

The Immunology Center (IC) is the premier hepatitis C referral center of the Midlands of South Carolina, providing hepatitis C evaluation and treatment for mono-infected and HIV/hepatitis C co-infected individuals.  In addition we provide bimonthly hepatitis C tele-consults for South Carolina.  We have a newly developed rural hepatitis C referral program.  The IC houses one of two FibroScan machines in the State of South Carolina. Fellows receive hepatitis C training and experience through three modalities: 

The Hepatitis C telehealth conference (SCHTI)
  • This is a southeast initiative where complex cases are submitted to our team (attending and PharmD). Cases are diverse, includes discussions with management plans and short didactic sessions via teleconference, which is held twice monthly. Fellows can review the cases and round with the PharmD prior to the conferences.
  • Patient care: Fellows see both mono infected as well as HIV co-infected patients. These hepatitis C referrals are seen and managed with the hepatitis C support team (the attending, ID PharmD, and nurse).  Fellows work with a team to manage social and economic barriers to care
  • Hepatitis C didactics: Includes case-based discussions genotype and formal hepatitis C lectures throughout the training.

 Antimicrobial Stewardship Program (ASP)

A robust multidisciplinary program with infectious diseases, infection prevention, and pharmacy to provided ASP services for three major hospitals in the PH system. In addition the USC Division of Infectious Disease ASP leads the statewide stewardship initiative in collaboration with the Department of Public Health, the School of Pharmacy, and the Antimicrobial Stewardship Collaborative of South Carolina (ASC-SC).
  • Fellows gain an understanding of the hospital antimicrobial formulary, local antibiograms and antimicrobial stewardship protocols and procedures to optimize the use of antimicrobial agents
  • Fellows have a 2-4 week-rotation with the ASP team each year of their fellowship.  During this rotation the fellows will work one-on-one with the ASP director and/or infectious diseases PharmD.
  • In addition to daily ASP rounds, fellows participate in interdisciplinary meetings   
  • Fellows also participate in the development of ongoing projects, protocols, guidelines and clinical pathways   
Click here to see the ASP team’s resource page.

Infection Prevention (IP)

A robust multi-hospital IP program which encompasses the inpatient setting as well as the affliated ambulatory sites.
  • Fellows will rotate for 2-4 weeks with the IP team, gaining practical experience in IP and hospital epidemiology
  • Fellows develop an understanding of the protocols and procedures including the handling of an outbreak investigation and preventative measure in the inpatient and outpatient setting
  • Fellows attend and participate in IP nurses’ rounds and departmental meetings
  • Fellows complete the IDSA SHEA online Infection Control modules   
  • Fellows have opportunities to participate in ongoing IP projects and the development of protocols 

Microbiology

Palmetto Health’s Microbiology Department is a state-of-the–art lab which provides services to multiple hospitals within the South Carolina midlands. In addition to routine microbiologic procedures, the microbiology laboratory has several state-of-the–art rapid diagnostics tools including FilmArray® (blood-BCID, respiratory, meningitis, and GI panels), Gene Xpert® (C.diff, MRSA, and MTB), VITEK 2®, Affirm®, BacTAlert®. During the microbiology rotation, fellows receive practical experience in microbiological specimen processing, laboratory techniques and procedures.
  • Areas of focus in clinical microbiology include bacteriology, mycology, parasitology, virology, and rapid diagnostics.
  • Experience will include identification of microorganisms, utilizing media culture, staining techniques, blood culture technology, antimicrobial and antiviral resistance susceptibility testing/interpretation, biochemical tests, and serologic identification assays.

Global Health 

This rotation exposes fellows to the challenges of managing patients with social and economic barriers as well as treating tropical infections
  • Fellows will have a 2 week rotation with additional time available, depending upon interest. 
  • Locations for the global health rotation include the Carolina Survivor Clinic, Travel Medicine Clinic  (http://familymedicine.med.sc.edu/travel.asp) and South Carolina Department of Corrections
  • Opportunities for overseas exposure are available.
  • Fellows will attend the Department of Health TB training course, have opportunities to participate in the TB telehealth via skype with an Ethiopian center.
  • Fellows will attend Global Health weekly conferences with the Family Medicine Global Health program.
The Carolina Survivor Clinic
  • The only refugee clinic in South Carolina housed at the USC Immunology Center and is managed by an infectious diseases faculty
  • 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 (read more here
South Carolina Department of Corrections
  • USC Infectious Disease Division provides all the HIV, hepatitis, C, infectious diseases (including tuberculosis) and antimicrobial stewardship for persons in the prison system
  • This include services to over 20,000 prisoners, approximately 300 HIV infected and approximately 600 Hepatitis C infected prisoners.

Ultrasound

The USC Ultrasound Institute is the only one of its kind in South Carolina that offers an ultrasound fellowship for medicine physicians or primary care physicians.  Click links to learn more about the Ultrasound Institute:  http://ultrasoundinstitute.med.sc.edu/ and https://www.youtube.com/user/iusc1/videos
  • Fellows spend 2-4 weeks on this rotation receiving practical experience in the use of ultrasound in physical examination and infectious diseases diagnosis with handheld ultrasound, or Vscan (provided by department)
  • Fellows are expected to attend and participate in daily ultrasound meetings
  • Fellows also participate in a web-based ultrasound courses and video conferences
  • Optional 2 day workshop and ultrasounds augmented physical exam training is available

Other specialty rotations

Transplant
  • In their second years  fellows spend one month rotating at Emory University Hospital with the Transplant Infectious Diseases Consult service
  • Fellows receive exposure to patients with solid organ transplantation, diagnosed with leukemia or lymphoma undergoing chemotherapy, bone marrow  or stem cell transplantation and patients with cystic fibrosis
  • Fellows attend daily clinical microbiology rounds throughout the transplant rotation
  • Didactic sessions on transplant and immunosuppressive agents are provided throughout the fellowship training

Pediatric Infectious Disease

  • First year of fellowship fellows spend one month with the Pediatric Infectious Disease Department at Palmetto Health’s Children’ Hospital. The rotation involves a combination of pediatric inpatient consults, Pediatric antimicrobial stewardship (ASP) and outpatient HIV/infectious diseases pediatric clinic
Critical Care Track
Sample Rotation Schedule