Download saudi board of pediatric infectious diseases training program

SAUDI BOARD
OF
PEDIATRIC INFECTIOUS DISEASES
TRAINING PROGRAM
The Kingdom of Saudi Arabia is a very rapidly developing country with
significant improvement of health services. Disorders caused by a variety of
infectious agents constitute one of the major causes of morbidity and mortality in
Saudi children. Furthermore, the field of infectious diseases is one of the very
markedly progressing subspecialties. Over the past two decades, marked progress
has occurred in diagnostic, preventive as well as therapeutic modalities.
Furthermore, the list of newly discovered infectious agents and rapidly changing
disease syndromes, as well as newly introduced antimicrobial agents are ever
.
.
lllcreaslllg.
Based on these, there is a growing demand for a national trallllllg program to
provide pediatricians with all the necessary training towards acquisition of Saudi
Board in Pediatric Infectious Diseases, after which the trainee will be competent
in the management of various infectious disease problems in infants, children and
adolescents and will acquire a mature understanding of the related social
economical and environmental aspects.
The program consists of two years of full-time structured supervised training in
Pediatric Infectious Diseases. This will involve admission to an approved joint
program with rotations in hospitals accredited for training in Pediatric Infectious
Diseases.
1.
Become competent in the management of infections in infants, children
and adolescents.
2.
Acquire adequate knowledge and ability to interpret data originating from
the clinical microbiology laboratory.
3.
Become self-disciplined, self-dependent learners and to serve as
consultants to other services and be able to provide an educational
environment that will promote a high standard of health care.
4.
Perform research and emphasize the research-oriented approach to new
problems.
5.
Reach an international acceptable standard with appropriate attitude and
medical ethics.
A.
B.
Etiology, pathogenesis, natural history, pathology, clinical features and
management of the following:
a.l
Acute illnesses due to a wide variety of microbial agents including
the acute communicable diseases occurring in the normal hosts.
a.3
Common tropical and parasitic diseases, particularly malaria,
leishmaniasis and schistosomiasis.
a.5
Infections in the irnmunocompromised host including patients with
acquired immune deficiency syndrome (AIDS).
a.IO
Infections in children with inborn errors of metabolism, genetic
and other systemic disorders.
The clinical and laboratory approach and differential diagnosis of complex
problems in which infections may playa role, such as:
b.2
C.
acute rapidly progressive illness due to sepsis from an undefined
site and
Principles of epidemiology and public health and their application in the
prevention and control of:
c.l
infection within the community including knowledge about
reservoir, transmission, sanitation and vector control, and the role
of public health authorities at local, national and international
levels; and
c.2
D.
hospital acquired infections including knowledge about
chemoprophylaxis, disinfection and sterilization and infectious
waste management.
General knowledge and technical skills in all principal areas of diagnostic
microbiology, virology and parasitology, including knowledge of
appropriate diagnostic material for most diseases or syndromes and ability
to differentiate normal flora from pathogenic organisms.
e.l
details of humoral, cell mediated and phagocytic responses to
microbial colonization and invasion in the normal and abnormal
host;
e.2
pathogenic mechanisms by which immune responses facilitate or
prevent disease; and
e.3
principles and practice of immunization techniques together with
adverse effects and efficacy of immunizing agents.
G.
An appreciation of the infectious diseases literature with the ability to
critically evaluate it.
H.
Research experience with both clinical and laboratory investigation and
the expectation that these data will be published in a refereed journal.
I.
Educational skills as demonstrated by the ability to teach infectious
diseases to patients, trainees and colleagues as well as the ability to write
informative consultation notes.
1.
Possess a certificate of the Saudi Board of Pediatrics or an equivalent
recognized degree, or has successfully completed the written component
of the Final Saudi Board of Pediatrics.
3.
Provide three letters of recommendation from consultants with whom the
candidate has recently worked with for a minimum period of six months.
4.
Provide written permission from the sponsoring institution of the
candidate allowing him to participate, on full time basis, for the entire
period of the program.
For any hospital to be accredited to participate in the training program in Pediatric
Infectious Diseases, the following requirements must be fulfilled:
1.
Full accreditation for Pediatrics training by the Saudi Council for Health
Specialties
The fellowship program director should be a Pediatric Infectious
Diseases consultant certified by the Saudi Board of Pediatrics or its
equivalent in general pediatrics and preferably certified or at least
eligible for certification by an international recognized scientific
body in the field of Pediatric Infectious Diseases with a minimum
of three years of post training experience and a background in
research with a record of publications.
b)
A minimum of two full-time Pediatric Infectious Diseases
consultants (including a program director) who have had at least
two years of fellowship training in an accredited infectious
1.
Adequate number of consultations involving immunocompetent
and immunocompromised children (at least 250 consults per year)
to ensure adequate exposure to infectious diseases problems in
various hosts. A record of these consultations should be
maintained.
11.
In-patients, intensive care (including neonatal intensive care) and
ambulatory care facilities.
111.
Fully equipped, high standard and staffed microbiological
laboratory facilities with the ability to perform diagnostic
bacteriology, parasitology, virology, mycology and specialized
serological tests. In addition to a laboratory facility capable of
performing diagnostic immunologic and molecular tests.
IV.
Supportive services such as a diagnostic and interventional
radiology unit and a pathology laboratory.
a.
Library facilities with ready access to all major infectious disease
journals and literature search facilities.
Pediatric Infectious Diseases program is a two year program, during which the
trainee rotates through various rotations. Those rotations include clinical services
(14 months, including 2 months in adult services), microbiology(4 months),
infection control (1 month), clinical immunology( 1 month), research(1 month)
and an elective rotation (1 month). The candidate is eligible for one month annual
vacation.
1.
acquire a broad overview of basic sciences of infectious diseases
(e.g., microbiology, immunology, pathogenesis, pharmacology,
etc).
2.
have adequate knowledge of common pediatric infectious disease
problems.
Consultation Service( minimum)
General Microbiology, parasitology
Virology-Molecular, serology
T.B/ Mycology
Vacation
6 months
6 weeks
3 weeks
3 weeks
1 month
The rest of the first year will be left for the program director to
assign the fellow to any rotation of the program.
1.
acquire a high level of understanding of basic sciences and its
application to management of infectious disease problems.
2.
learn the approach to investigate and manage complicated and rare
infectious diseases
During this year, the trainee will have a month of training in the
microbiology laboratory (2 weeks bacteriology, 1week virology and a
week in TB/ Mycology). He/She will also complete the rest of rotations
not done during the first year. The elective rotation may be spent for
tropical medicine or other aspects of infectious diseases felt necessary by
the program director.
The program should offer a broad range of clinical experience. In addition
to consultations in the general and subspecialty pediatric services, the
program should also offer consultations to the surgical subspecialties, the
Pediatric and Neonatal Intensive Care Units and the various
transplantation programs. Exposure to adult infectious diseases is
undertaken through rotations in an Adult Infectious Diseases Training
Program or an organized adult, infectious diseases service supervised by a
qualified Adult Infectious Disease specialist.
Trainees should have the opportunity to assume responsibility for patient
care over a sufficiently long period to observe the natural history of the
disease and the benefits and complications of therapy.
Organized outpatient clinics should be available for the investigation and
treatment of infections not requiring hospitalization, as well as for followup of inpatients after discharge from the hospital.
Trainees are given the opportunity to observe the infection control unit
organization and function. They should actively participate in the
Hospital Infection Control Program and attend the meetings of the
Hospital Infection Control Committee. The trainee is expected to learn:
•
the role of microbiology laboratory in infection control and
surveillance.
•
isolation guidelines and methods of prevention of nosocomial
infections
•
epidemiology and laboratory investigations of nosocomial
outbreaks, including biotyping, phage typing, plasmid analysis,
etc.
Trainees should spend 4 months full-time in diagnostic microbiology and
molecular techniques under the supervision of a certified microbiologist in
an accredited laboratory for training in Medical Microbiology.
•
Routine techniques including use of different culture media,
specimen collecting and primary inoculation, and various staining
techniques.
•
Bench experience and familiarity with special isolation and
identification techniques related to urine, respiratory, blood, tissue,
and body fluid, enteric and anaerobic bacteriology.
•
Specimen collection, transport and media for fungi and
mycobacteria.
•
Rhodamine staining for AFB and antibiotic sensitivity testing for
mycobacteria.
•
Identification of common fungi including candida, aspergillus,
cryptococcus; fungal serology and antigen detection.
•
Stool examination for ova, trophozites, and larvae; concentration
techniques; string test; special stains and serology.
•
Virus isolation for herpes viruses, respiratory viruses, and enteric
vIruses
•
Chlamydia and mycoplasma isolation and antigen detection
systems.
•
Quantitative bacteriology, rapid diagnostic techniques, ELISA,
immunofluorescence, DNA probes, electron microscopy, etc.
Trainees are expected to participate in the research activities of the Section of
Paediatrics Infectious Diseases and by the end of his/her training he/she should:
1.
2.
3.
complete one research project
prepare and submit at least one manuscript to a referreed journal or
present a paper in a scientific meeting locally or internationally
1.
2.
3.
4.
Case presentations and discussions
Infectious Diseases Grand Rounds
Microbiology Plate Rounds
Infectious Diseases Journal Club
5.
6.
7.
8.
Didactic lectures in basic science and core topics such as:
i.
structure of bacteria
ii.
principle of antimicrobial therapy including pharmacokinetics and
pharmacodynamic.
Ill.
host response to infection
Morbidity and mortality meetinglrounds
City-wide Infectious Diseases/Microbiology Club Meeting
National and international symposia/conferences
The fellows should be given the opportunity to develop effective teaching skills.
This should be achieved through daily rounds and informal group discussions in
addition to formal teaching sessions and via the written consultation report.
1.
Trainees are required to take calls for the Infectious Disease Service with
a maximum of two weeks per month including two weekends.
2.
Fellows are entitled to four weeks vacation annually and a maximum of
ten days for both Eid holiday and emergency leave.
3.
Sick and maternity leave should be compensated for during or at the end
of training.
Evaluation of knowledge and performance of trainees through an established
committee using regular written records detailing the progress of each trainee at
least twice per year is required.
1.
Knowledge of history taking in infectious diseases and ability to
perform a comprehensive and accurate physical examination.
111.
Knowledge of basic and clinical aspects of Pediatric Infectious
Diseases.
1.
Il.
Ill.
Formal evaluation forms after each rotation.
Documentation of attendance and participation in academic
activities.
In-training evaluating examination done at the end of the first year.
To be promoted to the second year, the candidate fellow must have passed his/her
general pediatrics clinical examination. By the end of the first year the trainee
should pass the evaluation and examination conducted by the local supervisory
committee. If failed, the trainee should repeat the first year. Failing the second
attempt the trainee will be dismissed from the program.
I.
To be admitted to the final subspecialty examination, the candidate must
be certified in Pediatrics.
II.
Upon the completion of two years of training in Pediatric Infectious
Diseases in an accredited training program, a final certifying examination
will be conducted by Saudi Council of Health Specialist. The components
of the final examination will include:
1.
2.
written examination
clinical/oral examination
Upon completion of the training and passing of the final examination the
trainee will be awarded the Certificate of "Saudi Subspecialty Certificate
in Pediatric Infectious Diseases".
(i)
(ii)
(iii)
(iv)
(v)
Textbook of Pediatric Infectious Diseases - Feigin & Cherry
Infectious Diseases of the Fetus and Newborn - Remington &
Klein
Pediatric Infectious Diseases - Moffet
Principle and Practice of Pediatric Infectious Diseases - Long &
Others
Principle and Practice of Pediatric Infectious Diseases
(vi)
(vii)
(viii)
(ix)
A Practical Approach to Infectious Diseases - Reese & Betts
Principle & Practice of Infectious Diseases -Mandell
Tropical and Geographic Medicine - Warren & Adel Mahmoud
Hunter's - Tropical Disease
(i)
(ii)
Medical Microbiology - Sherris
Medical Microbiology - Mims
(i)
(ii)
Red Book
MWWR - special issues
(i)
(ii)
(iii)
(iv)
(v)
Seminar in Pediatric Infectious Diseases - 4 issues/year
Advances in Pediatric Infectious Diseases - once/year
Infectious Diseases Clinic ofN.A.
Current Opinion in Infectious Diseases (All issues - August: Ped)
Current Opinion in Pediatrics (February)
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
The Pediatric Infectious Diseases Journal
Clinical Infectious Diseases
The Journal ofInfectious Diseases
The Canadian Journal ofInfectious Diseases
New England Journal of Medicine
Journal of Pediatrics
Pediatrics