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INFECTIOUS DISEASE ROTATION DESCRIPTION The resident will join the ID in-patient consultation team and attend clinics. Patients are seen as consultation requests. Consults from other physicians are seen and recorded by a house staff member of the team before presentation to the attending physician during the next clinical round. Occasional patients, because of the urgency of their problems, are seen in the Emergency department. The purpose of the 5 half-day clinics is to introduce trainees to out-patient-based general infectious disease problems and their management. Trainees will familiarize themselves with the diagnosis and management of clinical infectious diseases. They will learn a broad overview of antimicrobial therapy and become able to use antimicrobial agents in an effective, safe and cost-efficient manner. Trainees will be introduced to the microbiology laboratory and the appropriate use of laboratory investigations in the diagnosis and management of infections. They will be grounded in the epidemiology, economics and prevention of infectious diseases and in infection control. The Infectious Disease team is normally composed of an attending staff physician and a core medical resident. Approximately 75% of the time an elective PGY-1and/or a clinical clerk are also on the service. There are two different ID Rotations for Medical Residents: In-patient Consults and Out-patient Clinics. 1. Consultations There are no admitted patients to the Infectious Diseases service. Patients are seen as consultation requests from other physicians. In-patient consultations are normally received through the office of the attending physician on service. From there the senior housestaff member is then informed of the name, location and nature of the consultation request. The consult is then seen and recorded by a housestaff member of the team before presentation to the attending physician during the next clinical round. As much as possible consults should be seen the same day that they are requested. In-patient consultations are seen primarily at KGH and occasionally at SMOL. Outpatient consultations are largely seen in the General Infectious Diseases clinics. Occasional patients, because of the urgency of their problems, are seen in the Emergency room. 2. Out-patient Clinics There are half-day general ID outpatient clinics through the week, one held each Monday morning on FAPC Level 4 North, Tuesday morning on FAPC Level 4 North, Wednesday afternoon on FAPC Level 4 North and Thursday morning FAPC level 4 (alternates weekly between North & South). HIV outpatient clinic runs Monday to Friday mornings at Hotel Dieu Hospital -Jeanne Mance 3. A joint Respirology/Infectious Diseases Tuberculosis clinic is held twice monthly on Monday afternoons on FAPC Level 1 North.The purpose of these clinics is to introduce trainees to outpatient based general infectious disease and HIV problems and their management. Most ID clinics will have 2-4 new patients for assessment. In addition, trainees will also be given the opportunity to follow-up previously seen Reviewed & revised: September 2011 in-patients and outpatients in the clinic to evaluate their outcome and response to therapy. Residents and Clerks assigned to the ID Clinic Rotation should carefully review the Clinic Rotation Schedule (emailed at the start of each Resident Block). A schedule outlining clinic assignments for housestaff will be provided by the Divisional Secretary. The goal is to have each member of the Infectious Diseases housestaff team attend at least two clinics per rotation. Housestaff who are post call are excused from afternoon clinics. Housestaff must inform the Divisional Secretary of the days they are post call so the clinic schedule can be adjusted. . Mandatory Didactic Sessions The main teaching rounds that trainees attend while rotating on the Infectious Diseases service are: Round or Conference Time Location Sign-in Rounds Daily at 7:45 AM Richardson Labs Room 104, Thursdays: Etherington Hall Auditorium Dept of Medicine Grand Rounds Thursday at 11:30 AM Richardson Labs Room 104 Medical Mortality Conference Wednesday at 8:00 AM Richardson Amphitheatre Academic 1/2 Days Tuesdays – PGY2 &3 (13:30-15:30) Thursdays – PGY-1 (14:00-16:00) Richardson Labs Room 104 Plate Rounds Daily 1:00 PM KGH Microbiology Lab Douglas 3 Fridays at 12:00 PM KGH - Dietary 3 Conference Room ID Journal Club/Case Conference The content and organization of the Infectious Diseases Case Conference is the responsibility of the senior housestaff member and attending physician on the clinical service. This is usually coordinated with the microbiology laboratory to facilitate presentation of the laboratory aspects of the clinical cases presented from the Infectious Diseases service. Two cases are usually presented. Each trainee is expected to present at least once at these rounds during a 4-week rotation. It is recommended that all case conference be presented with a specific focused question in mind if possible, as opposed to a general review of the topic e.g. epidemiology, diagnosis, therapy, prevention etc. The case conference should be interactive in nature and not entirely didactic. Please have at least 2 specific learning objectives stated at the outset of your presentation. Reviewed & revised: September 2011 It is also expected that you will review current literature to make the presentation evidence based. Please include the specific citations you used in your presentation and be prepared to discuss the quality of the evidence you found. Journal Club is presented by Staff ID Physicians. Plate Rounds are the responsibility of the attending Infectious Diseases physician on the consultation service. These rounds are used to introduce trainees to the many aspects of diagnostic medical microbiology. This occurs through a review of the important positive cultures seen in the laboratory each day and discussion of the pertinent tests from patients seen on the Infectious Diseases consultation service. Trainees on the Infectious Diseases service, the Infectious Diseases attending, the attending Microbiologist, and the senior laboratory staff participate in this round along with the microbiology technologists at the involved bench positions. Reviewed & revised: September 2011