Infectious Diseases Fellowship

Microbiology Course

During the first year of fellowship, all first year fellows participate in a microbiology/infectious disease bootcamp. This experience is four weeks of didactic and hands-on learning divided between courses in clinical microbiology and hands-on experience in the clinical microbiology lab, as well as seminars focusing on the practice of infectious diseases. The microbiology didactic portion serves as an introduction to practical bacteriology, virology, mycology, and parasitology, as well as principles of antimicrobial function and therapy.  Fellows will rotate between diagnostic benches, learning the techniques used to diagnose infectious diseases in a practical and hands-on fashion. The bootcamp is divided into two two-week blocks, the first session is held in July, and the second session in January of the first year of fellowship.

Seminars and Conferences

Weekly lectures on core topics in Infectious Disease will be presented to the faculty, fellows, residents, and students by Infectious Diseases, Microbiology, and other faculty.  Faculty and fellows also present at monthly ID journal clubs.  An informal case conference is held twice monthly to discuss unusual or challenging cases seen on the inpatient services or in outpatient clinics, and are also attended by and conducted by ID faculty and fellows.  Twice per month the faculty and fellows of the Division of Infectious Diseases at the Feinberg School of Medicine and the Lurie Children’s Hospital pediatric ID division meet to present at joint ID case conferences with a formal case presentation given by one member of each division.  A once monthly research forum is presented by faculty or fellows in the Division or by visiting professors to showcase cutting-edge research being performed in the field of Infectious Diseases.

Conferences

• Infectious Disease Case Conference: Each consult team presents 1 - 3 interesting or puzzling cases; all are invited to present unique or difficult cases from the outpatient clinic. The emphasis is on generating discussion and sharing the most unusual or difficult cases. Case presentations can be made verbally. PowerPoint is recommended for lab data, radiographic images, and histopathology and microbiology images. No handouts are required. No formal presentations (i.e., lectures) are necessary, but if fellows find some interesting study or related information, they are encouraged to share it.

• Joint NMH/Lurie Children's Hospital Infectious Disease Case Conference: Cases are presented as “unknowns” by ID fellows and discussed by attendings. The presenting fellow then gives a brief formal discussion of the issues raised by the case. First year fellows present on average one case per month.

• Infectious Disease Journal Club: Assigned fellows and faculty (two/per session) bring an informative, topical or controversial journal article to discuss.

• Infectious Disease Research Forum: Research concepts, ongoing projects and completed research are discussed.

• Infectious Disease Fellows Core Lecture Series: A range of core curriculum topics including HIV/AIDS, antimicrobial resistance, infection control, and clinical, epidemiological, and basic research are presented by the infectious disease faculty. The fellows participate in the selection of the topics for this conference.

• Clinic Staff Conference: Fellows join the supervising attending physician, the clinic nurse manager, HIV advanced practice nurse, clinic nursing staff, clinic social work staff, and clinic pharmacist to review patients receiving outpatient parenteral antibiotics and other complicated active patients followed in the clinic.

• Antibiotic Formulary Subcommittee of the Pharmacy and Therapeutics Committee: Monthly one hour meeting to discuss issues of antibiotic use and antibiotic resistance in the hospital.
• Clinical Skills Lecture Series: A series of lectures focuing on interdisciplinary skills outside of Core Infectious Diseases.  Topics range from performing specific tasks such as interpreting test results to interprofessional skills like patient communication.
• Pathology Rounds: Held quarterly, fellows will present cases and review the pathology slides with the Northwestern Memorial Department of Pathology. This activity will provide fellows with exposure to pathologic findings in infectious diseases.
• Microbiology Rounds: Held quarterly, fellows will present cases and review case-related microbiology results with the Northwestern Memorial Department of Microbiology. This activity will provide fellows with the exposure to the microbiology lab, the various techniques in the microbiology lab, and provide education on interpretation of microbiology test results as related to specific cases.

The second and optional third years of the program are devoted to a mentored basic, translational, or clinical research project selected by the Fellow and approved by the Infectious Diseases Fellowship Committee. The goal is to develop the research skills needed for a successful career in academic medicine.

First Year

During the first year, the fellow can explore research opportunities in the departments and schools of Northwestern University. The objective is to match fellows to appropriate mentors and projects. The mentor provides research training and advice. Alan Hauser, MD, PhD, serves as the Director of Fellowship Research Training and together with an individual’s research committee helps to mentor each fellow throughout the course of their research training.  During the first two to three months of fellowship training, Research Forums will be presented by groups of faculty in or affiliated with the division of Infectious Diseases for the purpose of giving overviews of their work and presenting possible research projects for Fellows to pursue in their second and third years of fellowship.

Second and Third Years

The Division of Infectious Diseases was recently awarded a prestigious T-32 training grant by the National Institutes of Health with generous matching funds provided by the Northwestern University Department of Medicine.  These awards support two of the three positions in each of the second and optional third years of research training. In addition, these grants cover the cost of tuition to complete the two-year Masters of Science in Clinical Investigation degree program.  For the past 20 years, one fellow each year with a career focus on HIV/AIDS care or research has been supported by a generous grant from the Design Industries Foundation Fighting AIDS (DIFFA) and is designated as the DIFFA Chicago Fellow.  Other funding opportunities are available to support qualifying ID fellows during their research years, including training grants in the Department of Microbiology-Immunology and the Comprehensive Transplant Center. ID fellows have been successful in applying for individual training grants through the NIH and other funding sources.

Selected research projects of current and former ID fellows include:

•   Mechanisms of Acinetobacter baumanii virulence in pneumonia and bloodstream infections
•   Contribution of Hepatitis C co-infection to HIV progression 
•   Quantiferon testing performance in solid-organ transplant recipients
•   Genomic basis of strain-to-strain variations in Pseudomonas aeruginosa virulence
•   Control of multi-drug resistant Acinetobacter baumanii
•   Molecular epidemiology of HIV infection in black men who have sex with men
•   Strategies to increase postpartum retention in HIV care
•   Clinical trial evaluation of the efficacy of two drug antiretroviral therapy as compared to three drug regimens for HIV treatment
•   Comparison of clinical features, virulence, and relapse among Mycobacterium avium complex species
•   Examining genetic variation of the rtxA1 gene that encodes the cytotoxin "multifunctional-autoprocessing RTX" (MARTX) in Vibrio vulnificus
•   Detection of new genes or mutations associated with antimicrobial resistance in carbapenem-resistant Enterobacteriaceae (CRE) isolates
•   Substance abuse and cardiovascular disease risk in HIV-infected men
•   Structural brain abnormalities and neurocognitive changes in very early HIV infection
•   Differences in patient care practices for outbreak prevention among surgical units

Inpatient Consult Service

Fellows divide their time on inpatient service between three consult services:

• The Medical Infectious Diseases Consult Service. This service provides infectious diseases consultation for patients on the general medicine, medicine subspecialty, neurology, dermatology, and psychiatry services and for those patients in the medical intensive care units with infectious disease complications. The consult team consists of an attending physician and an Infectious Diseases Fellow and may include Medical Residents and Medical Students. The service provides ~120 inpatient consults/month.
• The Surgical Infectious Diseases Consult Service. This service oversees the care of patients on the general surgery and surgical subspecialty services, surgical intensive care units, hematology/oncology, obstetrics/gynecology, and rehabilitation medicine with infectious disease complications. The service provides care for patients with pre- and post-operative complications caused by infection. The consult team consists of an attending physician and an Infectious Diseases Fellow and may include Medical Residents and Medical Students. The service provides ~90 inpatient consults/month.
• The Transplant Infectious Diseases Consult Service. This multidisciplinary service oversees the care of solid organ, bone marrow and stem cell transplant recipients with infectious disease complications. The consult team consists of an attending physician and an Infectious Diseases Fellow and may include Medical Residents and Medical Students. The service provides ~120 inpatient consults/month.

 Outpatient Experiences

• The Infectious Diseases Outpatient Clinic. This outpatient clinic provides clinical continuity care for patients seen on the Medical, Surgical, and Transplant Infectious Diseases Consult Services during their hospitalization and for patients referred by their primary physician for questions about the management of infectious diseases. Consultations are provided for patients with general infectious disease problems, primary care and consultations for patients infected with HIV, and the care of patients with illnesses and infections related to travel to or immigration from the developing world. The clinic has ~10,500 encounters/year.
• The Sexually Transmitted Disease Clinic. This outpatient clinic provides clinical continuity care for patients with sexually transmitted diseases on a walk-in basis. Services include evaluation and treatment of infectious diseases, Hepatitis A and B vaccines, counseling and testing for HIV, and information about safe sex practices. The clinic has ~320 encounters/year.
• The Travel Medicine and Immunization Clinic.   Fellows obtain experience advising international travelers on pre-travel immunization, malaria prophylaxis and appropriate infectious disease prevention.

The Department of Medicine at Northwestern University seeks to attract inquisitive, motivated residents and fellows and is committed to providing them with every opportunity for success. The greatest challenges facing the medical field are complex, and addressing them will require a diverse body of physicians and researchers who can work collaboratively. Northwestern offers unparalleled training and research opportunities and encourages fellowship applications from those who seek to become future leaders in the subspecialties of medicine.  We are committed to and inspired by a diverse and inclusive work environment that allows each trainee to achieve their personal goals.

For more information on Northwestern’s commitment to diversity please see the following resources:

• Department of Medicine Diversity Council
• Northwestern McGaw Underrepresented Residents & Fellows Forum (NMURFF)
• Feinberg School of Medicine Office of Diversity and Inclusion

Evaluation of fellows by the attending physicians is at the conclusion of each clinical rotation.  Additionally, the fellows are evaluated by nursing and support staff, as well as by patients at the Infectious Diseases outpatient clinic.  Evaluation forms are compiled in each fellow's folder after being reviewed by the program director.  In addition, the program director meets with each fellow at least two times a year in January and June.  Discussion during these meetings includes the fellow's progress and prior evaluations.  A principle objective of these meetings is to discuss how the training program can facilitate the fellow's career goals.  The program director and division chief are available for informal discussion of progress and career advice at any time.  At the July meeting of the Committee, the progress of each fellow is summarized by the program director, and recommendations are made for promotion to the next postgraduate year.

In the event that a fellow's progress is judged to be insufficient, a remediation program will be recommended by the program director.  The program will be designed to address the specific areas of deficient knowledge, behavior, attitudes, and/or skills.  If, at the time of re-evaluation, the progress is still judged to be insufficient, the fellow will be placed on probation.  The fellow will be notified in writing of the probationary status, specific areas judged to be deficient, expectations for improvement, methods for regular re-evaluation of progress, and the anticipated date at which time the fellow's status will be reviewed.  The fellow will also be notified in that letter that the fellow has the right to request an appeal of the decision at the departmental level.  This request must be made in writing within 14 days of receipt of the probationary letter.  If this request is made, the Residency Committee will address the appeal according to the process described in the Reference Manual. The Committee will notify the fellow, in writing, of the result of the appeal within five days of completion of the review.  If the action is to sustain the probation, the fellow will also be notified in writing that he/she has the right to appeal the decision at the GME level.

If the fellow does not achieve satisfactory remediation during the probationary period, the Committee will make the decision for non-renewal of contract.  Except in unusual circumstances, this decision will be made and communicated to the fellow in writing at least four months prior to the completion of the current postgraduate year.  The fellow will also be notified in writing of his/her right to appeal as described above.

Application to the Fellowship Program may be made through ERAS beginning in July.  Applicants considered for admission to the Northwestern University Infectious Diseases Training Program have completed training in an approved U.S. Residency Program that provides ABIM eligibility in Internal Medicine.  The completed application should include three letters of reference.  Previous research experience is not required.  Personal interviews take place between August and October in order to accommodate scheduling demands.  Interviews are by invitation only.  The applicant meets with the program director and selected members of the Infectious Diseases faculty and fellows.  The Fellowship Program honors the match date for the National Residency Match Program.

Learn more about the benefits of training at a world-class academic medical center in a diverse and vibrant city of Chicago. Further program details, including the Department of Medicine housestaff manual and a sample training contract, are available on our McGaw Medical Center Graduate Education site. Additional information is available via the links to the McGaw website below.

• Why Northwestern?
• Diversity & Inclusion

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