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Geographic Medicine and Infectious Diseases

Infectious Diseases Clinical Training

Overview

Our fellows rotate through our inpatient and outpatient clinics, allowing them to gain experience in the full range of geographic medicine and infectious diseases. Highlights of our clinical fellowship include:

  • At least 6 months of protected time for research and at least 12 clinical months
  • Outpatient clinical training with 24 months of continuity clinic
  • 6 months of research tailored to the fellow’s area of interest
  • At least one sponsored trip to a major infectious disease meeting
  • Opportunity to select a  specific area of concentration:
  • Formal training in how to be a clinician educator, with teaching opportunities
  • Training in how to use an electronic medical record to manage and interact with patients

Clinical rotations at the three program hospitals provide a rich and diverse experience in infectious diseases. Fellows encounter a wide variety of fascinating cases during their clinical training. The infectious disease board certified faculty of each hospital provide supervision of fellows in all inpatient and outpatient settings.  Night and weekend on-call duties are distributed among the clinical fellows for coverage of Tufts Medical Center. There is no in-house overnight call.

Inpatient Training

Inpatient consultation rotations provide broad training, including in community-acquired infections, surgical infections, nosocomial infections, HIV infection and transplantation-related infectious diseases.  Clinical fellows rotate through the infectious disease consultation service of three program hospitals for a total of 12 months.

Tufts Medical Center, a 415-bed tertiary and quaternary care facility which serves local and regional populations, and receives referrals nationally and internationally. In response to our high volume of cases, two fellows rotate each month on the General ID consult service, and one fellow rotates each month on the Transplant ID consult service.  Transplant ID serves the needs of patients receiving heart, liver, kidney or bone marrow transplants, and has a collegial and highly productive working relationship with their medical and surgical providers.

General ID Curriculum
Transplant ID Curriculum
Lahey Clinic Curriculum
Lemuel Shattuck Curriculum

Outpatient Training

Training in the breadth and depth of outpatient infectious disease is an integral part of the fellowship and is achieved through fellow continuity clinic, travel clinic, HIV dermatology clinic, and in specialty clinics at other hospitals during inpatient rotations.

Fellow Continuity Clinic at Tufts Medical Center

All fellows establish a weekly continuity clinic at the Tufts Medical Center Infectious Disease Center in which they follow their own panel of patients for the entirety of their fellowship, with supervision by attending infectious disease physicians.  Fellows gain experience in the management of HIV disease as both a primary care provider and a consultant.  In addition, fellows provide consultation on the entire spectrum of outpatient infectious disease, including pre-transplant infectious disease evaluations, long-term outpatient antibiotic therapy, Lyme disease, and sexually transmitted diseases.

Continuity Clinic Curriculum

Travel Medicine Clinic at Tufts Medical Center

An important aspect of Tufts Medical Center infectious disease training is the opportunity to provide pre-travel counseling and vaccines as well as management of the returning ill traveler.  Fellows are supervised by infectious disease physicians with additional certification in travel medicine.

Travel Medicine Clinic Curriculum

Partner Hospital Specialty Clinics

Lahey Clinic Medical Center
The ID Fellow experience offered at the Lahey Clinic in Burlington nicely complements that of Tufts. It combines exposure to the more community-hospital type of ID experience with different elements of specialty medicine. For example many patients with tick-borne infections are seen during the summer months, and the full spectrum of anaplasma/babesia/lyme and diagnostic & management challenges of these can be seen. The Lahey Urology service is very large and handles complex urologic patients from a wide catchment area. Around 2009 liver transplant services at Tufts were suspended and most of these patients were transferred to the Lahey for ongoing care, where there is still a very active service. The Lahey is also one of the few centers offering percutaneous aortic and mitral valvular interventions. Many patients from these groups of patients require inpatient ID consultation for a variety of reasons. The monthly leprosy clinic is another fantastic learning opportunity for ID fellows to attend. A smaller group of mostly clinical ID attendings allows the ID consult service at the Lahey to run as an extremely efficient, well-oiled machine with the fellow focusing mainly on seeing as many new consults as possible, with many of the follow-ups being taken care of by the attendings. This exposes fellows to a wide breadth of patients and is excellent clinical training.

Lahey Clinic Curriculum

Lemuel Shattuck Hospital
Rotating to the Lemuel Shattuck Hospital (“The Shattuck”) is a unique experience for ID fellows which offers great training opportunities. As a State-run hospital, many patients are sent from all over Massachusetts for treatment of serious infections requiring extended courses of antibiotics. Fellows are exposed to the whole spectrum of serious staphylococcal and other bloodstream infections and the complications that can occur during therapy. There are many cases of endocarditis from a variety of bacteria and fungi. A lot of these are associated with intravenous drug use and dealing with this in combination with the medical problems is a difficult challenge. Historically the Shattuck has been a focus of HIV care in Boston, and this continues today with dedicated HIV inpatient and outpatient services. Many of these patients are complex and grappling with the medical and social consequences of long-standing HIV infection and various infectious and non-infectious comorbidities. Many cases of tuberculosis (including multidrug-resistant  TB) are still managed in the inpatient setting then followed up via the TB clinic. The patients (and staff!) are from a diverse array of social/cultural/geographic/economic backgrounds and this enriches the fellow experience.

Lemuel Shattuck Curriculum