• Inpatient UIHC Consults. On average, this service handles approximately 120-140 new consults per month. All consults are staffed with a faculty member
• Approximately three months of the first year will be spent on Team 1 inpatient consult service
• Medical Microbiology Rounds twice a week

Goals and Objectives

During this rotation, the first-year fellow is expected to:

• Develop knowledge of infections commonly encountered in a variety of hosts and in variety of organ systems
• Develop a logical approach to the differential diagnosis of various ID syndromes, recognize common clinical manifestations due to particular organisms or syndromes and develop a diagnostic and treatment plan that is effective and cost-conscious
• Obtain a proficient, thorough history and perform a directed physical examination; write concise, meaningful consult notes.
• Provide appropriate inpatient follow up and arrange for safe transitions of care
• Effectively and appropriately supervise and teach rotating internal medicine residents and students
• Develop effective communication skills with referring services and patients/caregivers
• Perform a literature search for medical topics, and meaningfully interpret such literature in the context of a clinical case
• Develop facility in providing parenteral or oral antimicrobials during hospitalization and after a patient’s discharge, and understand the financial and medical issues involved with extended antimicrobial administration
• Acquire leadership skills in directing the consult team (which includes residents, students and pharmacy personnel)
• Develop skills of an antimicrobial steward
• Develop knowledge of methods to reduce the risk of healthcare associated infections and how/when to use vaccines or other prophylactic measures
• Increase medical microbiology knowledge

• Outpatient consults at University of Iowa Hospitals & Clinics, plus UI Hospitals & Clinics inpatient hospitalist consults with 1:1 fellow:staff model or VAMC inpatient consults
• Two to three to four months of the first year will be assigned to Team 2 outpatient consult service (usually combined with VA inpatient consult service)

Goals and Objectives

During this rotation, the first year fellow is expected to:

• Develop fund of knowledge for a wide variety infections encountered in the clinic, as well as in hospitalized patients
• Develop a logical approach to differential diagnosis of various syndromes, develop a diagnostic and treatment plan that is appropriate and feasible
• Provide effective patient follow up
• Develop skills to communicate with the referring services or outside referral entities, both verbally and in writing
• Perform a literature searches to address questions, and apply such literature into a clinical case
• Prescribe parenteral and oral antimicrobials in outpatient and inpatient settings, and understand the medical and issues involved with extended antimicrobial administration
• Apply principles of antimicrobial stewardship
• Successfully oversee transitions of care and manage OPAT patients

• Inpatient UIHC Consults from non-teaching hospitalist services. On average, this service handles approximately 60 new consults per month. All consults are staffed 1:1 with a faculty member
• Approximately 6 weeks of the first year will be spend on a dedicated Team 4/D inpatient consult service rotation.  There may be an additional few weeks on a combined Team 2 clinic/Team 4/D rotation.
• A curriculum for the management of common inpatient ID scenarios will be rolled out in 2023-2024

Goals and Objectives

During this rotation, the first-year fellow:

• Works in an apprenticeship model with the attending to deliver consultative ID care
• Develops medical knowledge base of infections commonly encountered in diverse human hosts and affecting a variety of organ systems
• Develops a logical approach to the differential diagnosis of various ID syndromes, recognize common clinical manifestations due to particular organisms or syndromes and develop a diagnostic and treatment plan that is effective and cost-conscious
• Obtains a proficient, thorough history and performs a directed physical examination; writes concise, meaningful consult notes.
• Provides appropriate inpatient follow up and arrange for safe transitions of care
• Develops effective communication skills with referring services and patients/caregivers
• Performs a literature search for medical topics, and interpret such literature in the context of a clinical case
• Optimizes antibiotic prescribing for inpatients and after a patient’s discharge, and understand the financial and medical issues involved with extended antimicrobial administration
• Develops other skills of an antimicrobial steward
• Develops knowledge of methods to reduce the risk of healthcare associated infections and how/when to use vaccines or other prophylactic measures
• Increases medical microbiology knowledge

Two to four weeks will be spent in the clinical microbiology laboratory with intensive instruction and hands-on experience with a clinical microbiologist.  In addition, twice-weekly medical micro tutorials occur for Team 1 members; all fellows are invited.

Goals and Objectives

By the end of this rotation, the fellow is expected to:

• Understand and recommend various methods of appropriately collecting and transporting various specimen
• Be competent in microscopic examination of specimen
• Understand various staining and culturing techniques for a variety of bacterial, mycobacterial, fungal, and viral pathogens, and the principles and appropriateness of molecular diagnostic techniques
• Be able to interpret susceptibility data, and limitations of testing
• Understand mechanisms of antimicrobial resistance

Teaching Methods

Daily plate rounds with the Clinical Microbiology Lab: Complete bench rotations on checklist. Work with pathology resident on service to organize Micro tutorials with the ID consult Team 1.

Microbiology lecture block, monthly Pathology Department micro conference.

Fellows see patients in follow-up who were previously seen by the inpatient consult service, as well as evaluate new outpatient ID consults in this every other week clinic.

Goals and Objectives:

• Be familiar with management of outpatient IV antibiotics
• Be familiar with the natural course of infections that require treatment for multiple weeks or resolve over lengthy periods of time
• Recognize when the course of illness indicates possible complication of therapy or a suboptimal response that warrants further evaluation or change in therapy
• Gain experience in outpatient evaluation and management of Infectious Diseases

Four weeks will be spent on the ID Transplant service during year 1.  Additional elective rotations are available.

Goals and Objectives

By the end of this rotation, the fellow is expected to:

• Develop unique differential diagnoses and management plan tailored to this is immunocompromised population
• Understand the net state of immunosuppression and how it predisposes to infections
• Understand the principles of and indications for immuno-prophylaxis and chemo-prophylaxis in this population
• Understand the drug interactions, toxicities, and mechanisms of action and input on the immune system of immunosuppressive agents
• Perform an appropriate pre-transplant infectious diseases assessment
• Demonstrate appropriate inpatient follow up care for this patient population
• Communicate effectively with the referring transplant services, both verbally and in the medical record

Mix of Clinical Topics

There are on average about 25-30 inpatient and 6 outpatient consults per month.

Over 600 patients are provided HIV care in the Virology Clinic, part of the Ryan White Program.  An integrated multidisciplinary model is used to manage the complex needs that may be encountered.  Fellows gain experience by managing a panel of patients whom they follow during their fellowship. 

Goals and Objectives:

• Develop competence in the evaluation and management of patients with HIV infection, working within a multidisciplinary team
• Gain competence in the prescribing of ARV for the treatment of HIV infection as well as treatment of HIV/Hepatitis C or HIV/Hepatitis B co-infections
• Be familiar with risk factors for and manifestations, diagnosis, treatment and prevention of opportunistic infections
• Provide preventive care for non-infectious co-morbidities associated with HIV infection