Infectious Diseases Fellowship Columbia - Rotation Schedule

Infectious disease fellowship rotations

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 – Prisma Health - Richland; VAH – Columbia VA Healthcare System)
IP – Infection Prevention
Micro – microbiology
Res- Research
Transp – Transplant
USS – ultrasound

Ambulatory clinic

Prisma Health Immunology (PHI) has approximately 2000 HIV-infected individuals and provides medical care, medical case management, substance abuse screening, referral and treatment, medications assistance, mental health services, perinatal HIV prevention case management, and HIV discharge planning from the SC Department of Corrections.

Fellows will manage newly diagnosed HIV patients and those with complicated/uncomplicated opportunistic infections utilizing interdisciplinary approaches to patient care. 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 discussions and formal HIV lectures incorporated into the didactic sessions.

At the PHI, in addition to HIV treatment and prevention, fellows will manage a variety of infectious diseases, ranging from general ID to viral hepatitis, complex surgical, neurosurgical, cardiovascular and orthopedic infections, tropical/travel medicine, and zoonoses. Fellows will oversee their OPAT patients with the OPAT team (nurse and clinical ID pharmacist).

Hepatitis C

The PHI 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 hepatitis C tele-consults for providers across South Carolina, including rural South Carolina. The PHI houses an on-site FibroScan machine. Fellows receive hepatitis C training and experience through three modalities:

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. We provide referrals to our local substance use disorder clinic.
South Carolina AETC : Provides a southeast telehealth 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 three times per month. Fellows can review the cases and round with the PharmD prior to the conferences.
Hepatitis C didactics: Includes case-based discussions genotype and formal hepatitis C lectures throughout the training.

Antimicrobial Stewardship Program (ASP)

The Antimicrobial Stewardship Program, or ASP, is a robust multidisciplinary program (Antimicrobial Stewardship Center of Excellence). 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 infectious diseases PharmD. Fellows will be mentored as future ASP leaders.
In addition to daily ASP rounds, fellows participate in interdisciplinary meetings
Throughout the fellowship, fellows will complete IDSA Stewardship modules as well as participate in stewardship didactics.
Fellows also participate in the development of ongoing projects, protocols, guidelines and clinical pathways. Click here to see the resource page ASP Resource Page .

Infection prevention (IP)

A robust multi-hospital IP program which encompasses the inpatient setting as well as the affiliated 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 will also meet one-on-one with the IP attending and be mentored as future IP leaders.
Fellows complete the IDSA SHEA online Infection Control modules
Fellows have opportunities to participate in ongoing IP projects and the development of protocols

Microbiology

Prisma 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.
Additional microbiology experience through case discussions and didactic teaching with clinical microbiologist.

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 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 can attend global health weekly conferences with the Family Medicine Global Health program.

The Carolina Survivor Clinic

The only refugee clinic in South Carolina is managed by 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.

South Carolina Department of Corrections

UofSC Infectious Disease Division provides all the HIV, hepatitis, C, infectious diseases (including tuberculosis) and antimicrobial stewardship for persons in the prison system.
This includes services to over 20,000 prisoners, approximately 300 HIV infected and approximately 600 Hepatitis C infected prisoners.

Ultrasound

The UofSC Ultrasound Institute is the only one of its kind in South Carolina that offers an ultrasound fellowship for medicine physicians or primary care physicians. Learn more »

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 year, 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.