20
AUG
2014
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Welcome from the Infectious Disease Fellowship Program Director

Welcome to the Orlando Health Infectious Disease fellowship program. We are pleased that you are considering this ID fellowship program. Our program was accredited by the ACGME in early 2008, and our first 2 fellows graduated in June 2010.

Our fellowship's mission is to produce the best possible ID clinicians, who are able to excel in whatever post fellowship career they choose, whether clinical practice, an academic position, the military, or clinical research. We provide comprehensive clinical training, including specialized rotations in pediatrics, wound/HBO and cancer infections, plus experience in an outpatient private practice, public health and travel clinics. Five-six months are protected time for research.

Orlando Health is expanding rapidly, and new programs and affiliations are constantly under development. Our program and Central Florida in general, is an excellent place to train in the exciting field of ID. Throughout this site you will find information on the curriculum, hospitals, clinics, courses and research opportunities available through our program.

For questions, and application information, please contact us at: imid@orlandohealth.com

We look forward to receiving your application to join us.

Sincerely,
Mark R. Wallace, MD
Fellowship Program Director

The Clinical Training Program


Orlando's fellowship training program is accredited by the Accreditation Council for Graduate Medical Education (ACGME). This two year program will lead to eligibility in infectious disease certifying examination.
Clinical training for infectious disease fellows focuses on an in-depth clinical experience that allows fellows to function as the primary consultants in a variety of settings, including inpatient and outpatient consultative services, and as the primary managers for a group of HIV infected patients.

PGY-4

ORMC Inpatient Consult service 6 months
Bone Marrow Transplants - MD Anderson, Houston 1 month
Pediatric Infectious Diseases - Arnold Palmer 1 month
HBO/wound rotation - Lucerne 1 month
Microbiology 1 month
Research Preparation 1 month
Public Health (TB, STD, HIV) 1 month

PGY-5

ORMC Inpatient Consult service 6 months
Research 4 months
Private Practice 1 month
Elective 1 month
  • Outpatient Clinics

    All ID fellows will have at least one clinic per week. They will alternate between general ID clinic (every other week) and a HIV specific clinic (the alternate week). "Off service" fellows (not on an inpatient consult service) will also have a weekly travel clinic.
  • On-Call Rotation

    Fellows on inpatient consult rotations (13 months) will take beeper call during the evenings and will have off every other weekend. During the outpatient and research months (11 months) the fellow will not have any call obligations.

Conferences

The Orlando Health ID fellowship will feature nine conferences, some of which will be in conjunction with the internal medicine residency and some of which will be specifically ID related.

  1. A weekly didactic conference, which covers the basic field of infectious diseases and covers both basic science and clinical topics. Required for fellows and fulltime faculty.
  2. A weekly clinical case conference which features outstanding cases from the inpatient and outpatient services. Focused literature reviews will be presented by fellow and staff. Required for fellows and faculty.
  3. City-wide ID conferences will be held monthly. The best cases of Central Florida will be presented by staff or trainees. Required for ID fellows and staff.
  4. Microbiology conference held 3 times per month, where interesting and educational aspects of clinical microbiology will be reviewed. Required for faculty and fellows.
  5. A twice monthly journal club, with presentations on recent key articles regarding both basic science and clinical perspectives. Required for ID staff and fellows.
  6. A monthly research conference which will feature updates on ongoing research by fellows, faculty and selected affiliated physicians from other departments. Required for staff and fellows.
  7. Medical morning report occurs daily at 11:00. The ORMC on service fellow(s) usually attend to provide input on pivotal ID topics and answer resident/intern questions. Usually attended by the "on service" fellow or "on service" fulltime faculty.
  8. The medical core curriculum lecture occurs daily at noon. ID fellows will attend during the 2-3 ID topics per month, and are encouraged to attend additional lectures as time allows.
  9. Internal Medicine grand rounds occur weekly and fellows are strongly encouraged to attend.

Courses and Meetings

  1. The ID fellows will travel to the National Jewish course in Denver for a one week course, which is considered the outstanding TB learning experience in North America.
  2. ID fellows will also take the online SHEA/IDSA course in hospital epidemiology and infection control.
  3. The NIH research curriculum online course is required. This online unit provides a basic grounding in ethical research.
  4. Fellows will have the opportunity to attend the major national ID conferences (IDSA/ICCAC), and will be given time off to present at other conferences to which abstracts have been accepted.
Committees

Fellows will attend meetings of the infection control and antibiotic utilization review committees.

Description of Clinical Duties

  • ORMC Inpatient Consult Service (12 months)

    The fellow will spend 12 months over 2 years on this pivotal rotation. When there are other trainees on the service (residents, medical students) the fellow will function as team leader and assign cases for them to evaluate. The fellow will dictate all of his/her cases as well as the other trainees after discussion with staff. The fellow will oversee the "junior" trainees and both see and discuss their patients prior to rounds. A weekly case management conference will be organized by the fellow who will present and lead a literature based discussion of at least one case. The fellow will help the junior trainee present at least one case during their rotation. Attendings will expect (and grant) fellows additional latitude to lead the team and take the primary consultative role as they gain experience and knowledge in infectious disease.

  • MD Anderson (Houston) Bone Marrow Transplant

    This rotation will consist of one month of clinical experience on the bone marrow transplant infectious disease service. During that time, the fellow will perform ID consults and follow-up visits under the direct supervision of the MD Anderson infectious disease staff. The fellow will also present and discuss cases, interact with microbiology and radiology services, and attend didactic sessions. The activities at this site will be coordinated by the liaison director in Houston (the infectious disease fellowship director of the parent program).

    Fellows will have close interactions with residents from internal medicine as well as residents and fellows for other services. The fellows will provide support and teaching to the internal medicine residents assigned to the ID consult team, as well as "situational" teaching for the consulting trainees. Fellows will guide residents, medical students and fellows of other training programs to appropriate educational resources as indicated. The fellows will be supervised by the attendings at MD Anderson under the policies of the parent program.

    MD Anderson is a world leader in bone marrow transplants. Though our principal hospital does not perform transplants, we aim to give our fellows a world class experience. Our new hematology-oncology fellowship program also utilizes MD Anderson for transplant experience, and we have an MD Anderson affiliated cancer center as part of our principal teaching hospital.

  • Pediatric Infectious Disease - Arnold Palmer Hospital

    The fellow will rotate for one month of the 1st year with pediatric ID staff at Arnold Palmer. The rotation will consist of a mix of both the inpatient and outpatient consults as well as follow-up visits. Exposure to HIV and other immunosuppressive disorders will be a critical part of the rotation, as will be exposure to infectious diseases more commonly seen in children. The liaison program director will direct the day-to-day activities of the ID fellows on this rotation. The fellow will be supervised closely by the pediatric ID attending, who will see all new consults and follow-up visits as indicated.

  • HBO/Wound Care Rotation

    Wound care and the use of HBO are almost completely neglected by ID fellowships. Most graduating fellows who enter private practice are shocked to learn that about one- fourth of their work (and income) relates to chronic wound management. We have a one month rotation early in the fellow's training so that this clinical expertise can be applied throughout their fellowship and beyond.

    The wound/HBO clinic is located at Lucerne. The wound and HBO clinics serve primarily outpatients, though inpatients may be transported to the wound/HBO area for evaluation and treatment. The fellow will participate in the evaluation and management of patients referred to the clinic for wound and/or HBO therapy. The fellow will review all new and follow-up patients with the faculty member.

  • Public Health Rotation

    This rotation will provide and in-depth exposure to STDs, TB, and HIV impacting the urban poor. Orlando has one of the highest TB rates in the US, and areas of the city have higher rates of TB than many " third world" countries. This rotation will make a virtue out of this harsh reality, and provide our fellows with extensive training into these critical diseases.

    This will be a one month rotation at the County Public Health Clinic, which serves the indigent population of Orange County, Florida. During the rotation, the fellow will work with the physician staff of the public health clinic in the TB, STD, HIV and refugee clinics. The public health faculty will coordinate and supervise the fellow's experience.

  • Private Practice Rotation

    This one month rotation will take place in the offices of a nearby 4 physician private ID group. During this rotation, fellows will see outpatient consults, and travel clinic patients, learn about the infusion center and home antibiotic issues, and have a chance to understand the financial aspects of private ID practice. All clinical work will be staffed with the onsite clinical ID faculty.

  • HIV Clinic

    The adult HIV clinic provides comprehensive, longitudinal care for HIV infected. Each fellow will have clinic every other week, and will follow a diversified cadre of more than 20 HIV patients throughout his/her fellowship. Onsite faculty HIV experts will see and discuss all new patients, and provide help as needed on follow-up cases as well as ad hoc lectures on key HIV topics.

  • ID Faculty Practice Clinic

    Each fellow will have a general infectious disease clinic every other week. The fellows will evaluate and follow out patient ID consults. Patients will include hospital "follow-ups" as well as newly referred outpatients, including hepatitis B and C patients. Key clinical faculty will be present at all clinics and will staff all new consults in "real time" while the patient is still in clinic; follow-up patients will be discussed with faculty as questions arise.

  • Nonclinical Rotations

    • Microbiology

      The microbiology month will be done in the first 1-2 months of the fellowship, and will provide an in-depth study of the modern clinical microbiology laboratory. Topics covered will provide stain preparation, rapid tests, mycobacteriology, mycology and parasitology. The rotation will be under the guidance of Dr. Kendall Bryant and his team of microbiologists

    • Research

      All fellows will have at least 5 months available to plan, conduct and write up a research project. Broad latitude will be given regarding the type of project, which could range from a "bench" microbiology project to a clinical trial or retrospective review of cases and literature survey. It is anticipated that all fellows will submit at least abstract to a national or international meeting, and that all fellows will submit their work for publication. It is acknowledged that the work might not be published prior to the end of the fellowship, as there is often quite a delay between submission and publication.

      All fellows will complete the NIH online research course, and will present at least once during their fellowship at the monthly research conference.

     

    Vacation and Sick Leave

    Each fellow is entitled to three weeks paid vacation. All vacations must be scheduled in advance with the program director and coordinator to provide appropriate coverage. No two fellows in the same year may take vacation at the same time. No vacations should be scheduled during inpatient consult rotations.

    In the event of illness, it is the fellow's responsibility to inform the program director and coordinator of the problem. Coverage arrangements for inpatients and outpatients will be made on an ad-hoc basis for unexpected absences.


    Application Information

    What you Need to Know to Apply

    The Application Process

    All Applications for the ID Fellowship Program are accepted through ERAS (Electronic Residency Application Service). ERAS is an Internet- based application process developed by the Association of American Medical Colleges to transmit fellowship applications, letters of recommendation, program director letters, medical transcripts and other supporting credentials from applicants, residency programs and medical schools to fellowship program directors using the Internet. For information about the process or to register for ERAS online, visit www.aamc.org/eras.

    Matching with the Infectious Disease Fellowship Program


    The Infectious Disease program will participate in the National Residency Match Program's Medical Specialties Matching Program (MSMP) in Infectious Disease. This is a computerized venue for matching applicant's preferences for fellowship programs with program director's preferences for applicants. For information about NRMP or to register online to participate in NRMP, to www.nrmp.org

     

    Note: All qualified applicants are considered for interviews. However, the volume of applicants precludes us from offering interviews to all qualified candidates