INFECTIOUS DISEASE

Contact: Dan Anderson or Steve Sonnesyn @ (952) 746-8360

You may spend some time with Frank Rhame (Clinic 42 phone 612-863-5336), Jason Sanchez (763-951-2205), or Elliot Francke (phone 612-333-1319) if you choose.

Subspecialty clinic: Thursday AM with Dan Anderson and/or Steve Sonnesyn and they may bring you to their clinic for interesting patients and you may plan some extra clinic time with Dan or Steve in travel clinic, or in clinic with Frank Rhame, Jason Sanchez, or Elliot Francke if they are willing and available.

Resident continuity clinic: Friday AM, a three week minimum notice, given to Anne is required if you are planning on taking vacation time.
Conference: Periodic Interhospital infectious Disease Conference Tuesday 7:30 AM at rotating site

	AM	PM
Mon	ANW Consults	ANW Consults
Tues	Interhospital ID conf (7:30), ANW Consults	ANW Consults
Weds	Grand Rounds, ANW Consults, Journal club	ANW Consults
Thur	ID clinic	ANW Consults
Fri	Medicine clinic	ANW Consults

Performance Expectations:

The resident is expected to come in by about 8:00 AM and round on patients you are following by about 10:30 AM (new consults take priority). The resident may need to stay until 5:00 PM or later if new consults come in later in the afternoon. If the ID problem is straightforward and involves a specific organ system or location, a detailed review of other data not relevant to ID problem need not be done. Otherwise, a complete H &P, chart review (including old charts), and verification of data from outside sources (e.g. calling for culture results from outside hospital) are all necessary to formulate an opinion about the case

Educational Goals and Objectives:

	Educational objectives	Assessment method
Patient Care	1) Hospital and clinic consults and follow up visits will be performed, staffed, and documented in Excellian with appropriate language by the resident 2) A “Mini Consult” may be necessary to avoid giving erroneous information on the basis of incomplete information (the “curbside consult”) and to provide teaching opportunities. Ideally, the primary resident service should present the case, the question should be straightforward, and the ID staff reserves the right to convert to a more comprehensive consult if the case requires a more detailed review and judgment. The exam for a “mini consult” should be limited to pertinent areas, the note should reflect only the limited evaluation, and the patient is not followed after the day of the “mini consult”. 3) Demonstrate ability to obtain appropriate infectious disease exposure risk history including, but not limited to, infectious contacts, animal exposure, geographic risks, activity risks 4) Understand decision-making process in antibiotic usage and choice 5) Demonstrate ability to perform an immunocompetence assessment 6) Understand non-infectious workup of fever and SIRS 7) Obtain all relevant culture information including from outside sources	1) Global faculty assessment 2) Direct faculty bedside observation
Medical Knowledge	1) Review core topics noted below using patient care and didactic opportunities and supplement with independent reading 2) Attend periodic Interhospital ID Conference 3) When appropriate, bring relevant reference articles to the discussion	1) Global faculty assessment 2) On-line Gram stain test
Practice-Based Learning and Improvement	1) Demonstrate insight into knowledge deficiencies and limitations 2) Use information technology to answer clinical questions	Global faculty assessment
Interpersonal and Communication Skills	1) Refine the skills necessary to present patients and topics informally and formally to another physician or group	Global faculty assessment
Professionalism	1) The resident is expected to perform up to 4 consults per day, with no new consults started after 4 PM and follow up on previously seen patients and write follow up notes	Global faculty assessment
Systems-Based Practice	1) Understand systems unique to this subspecialty	Global faculty assessment

Core topics to be covered by patient care, didactic lectures, or independent reading include the evaluation, diagnosis and treatment of:

Infectious organisms and their related diseases
Infections by resistant organisms
Meninngitis, encephalitis, spinal infection, and brain abscess
Upper and lower respiratory tract infections
Diarrhea
Wound infections
Soft tissue, bone and joint infections
Endocarditis
Intraabdominal infections
Urinary tract infection
Sexually transmitted diseases
Postoperative infections
Nosocomial infections
Fever
Also covered: antibiotics and dosing, vaccines and travel medicine.

Procedures: none

Past resident recommendations: Dan and Steve have a number of lectures on such things as resistant organisms, vancomycin and gentamicin dosing and monitoring of levels, etc. If they have time they like to give you a one-on-one talk. Make sure you take advantage of these. Travel Clinic is interesting, the nurses are great.

A word from Steve and Dan:

We expect you to write notes wherein you commit yourselves to a differential diagnosis, work-up and treatment plan, whether or not we come by later and alter it. We believe you learn more this way.

You will only get out of this rotation what you put into it. Enthusiasm and conscientiousness will be rewarded with teaching. If you don’t see much of us, perhaps you don’t appear interested. We won’t put out as much effort to teach if you don’t seem to want it.

We will be glad to give feedback to you, regarding how you are doing. Above all, we want you to enjoy this rotation and learn as much as you can about infectious diseases.