The first month of the Division of Infectious Diseases' fellowship subspecialty training teaches basic diagnostic laboratory techniques crucial to the microbiologic diagnosis of human infections. During this month, fellows gain hands-on experience in diagnostic microbiology working side-by-side with experienced technologists under the supervision of the directors of the clinical microbiology laboratories at UMMC and the VA Medical Center.
Fellows participate in two half-day infectious diseases continuity clinics weekly. These outpatient clinics are continuity clinics with every effort made to ensure that fellows follow their own patients throughout the course of their training. Faculty, providing guidance and supervision, participate with fellows in each clinic. There is excellent support staff at both clinics. Dr. Henderson is the director of the UMMC ID outpatient clinics. Dr. Burton is the director of the VA ID ambulatory care clinic.
Ambulatory care facilities are housed in the multidisciplinary University Clinics at the Jackson Medical Mall and VAMC. Infectious diseases continuity clinics convene weekly. Both settings offer full outpatient services including nursing, pharmacy, multidisciplinary consultative services, respiratory therapy, phlebotomy, clinical laboratory, diagnostic radiology, social services, medical records and administrative support. Both the UMMC and VAMC clinics have HIV nurse clinicians and social workers who assist in the management of our growing HIV patient population.
Fellows may elect to participate in the Mississippi State Health Department outpatient clinics (also located at the Jackson Medical Mall for Hinds County) and laboratories directed toward the control of communicable diseases (e.g., sexually transmitted diseases and tuberculosis). Additional facilities include the offices of clinical faculty in private practice settings. Consultation requests from the Emergency Department, Outpatient Surgery and ambulatory clinics of other departments (both pediatric and adult) provide ID fellows with further experience managing infectious diseases in the ambulatory setting.
Further ambulatory care experience is offered through the division’s International Travelers Clinic located on campus in the UMMC Medical Pavilion. Travel clinic evaluations and advisory sessions are scheduled on an as-needed basis. ID fellows and rotating medicine residents are encouraged to participate in travel clinic evaluations under the direct supervision of the attending faculty.
Infectious diseases is primarily a consultative subspecialty. There is, currently, no formal inpatient ID service at UMMC. ID faculty or fellows may, however, admit patients to University Hospital under the primary care of the infectious diseases consult service.
Fellows are expected to evaluate all patients personally, assign patient responsibility to rotating residents and students, supervising the lower level trainees through the consultative process. It may be appropriate for fellows to follow some patients sans resident if the residents appear overloaded. Most UMMC residents are excellent and capable of following a large number of patients without compromising the educational experience.
Fellows teach lower level trainees and are expected to provide the residents and students with relevant literature, lectures and other educational materials that enhance the learning experience. We encourage fellows to develop their own teaching style with the understanding they may ask any of the faculty for advice at any time.
The residents, typically, fill out ID consult forms and daily follow-up notes. Although the attending is ultimately responsible for co-signing these documents, fellows are expected to read other team members’ notes, adding their own “two cents” when appropriate.
Fellows, as experience allows, review gram stains, lab results, path specimens and pertinent X-rays with residents. ID attending may review data, X-rays or specimens with fellows prior to work rounds with the residents.
Faculty doors are always open to fellows for questions and advice.
ID fellows take night and weekend call from home one to two weeks per month. Fellows decide call schedule dates among themselves.
Fellows are an integral part of infectious diseases education at UMMC. Fellows, in addition to assessing patients for their own educational experience, serve as teachers to other trainees such medicine residents and medical students.
Daily interactions with consulting services and patients, provide ample opportunity to hone teaching skills. We encourage fellows, in addition to teaching students and residents, to teach each other interactively.
Fellows, as all sagacious clinicians, are learners as well as teachers and expected to develop progressively higher levels of cognition throughout the fellowship program. Fellows are expected to facilitate the same process in other learners. All physicians must transition from passive learning and fact acquisition to higher cognitive levels essential for the analysis, synthesis and evaluation of clinical data required for medical problem solving. Every consultative interaction has educational underpinnings.
Fellows, at intervals, lead interactive didactic sessions designed to enhance teaching skills. Sessions and topics are announced in advance.