Infectious Diseases Fellowship Program

Introduction

The Infectious Diseases Fellowship Program began July 1, 1975. To date, more than thirty physicians have completed our Fellowship Program. All applicants must have completed a three-year Internal Medicine residency in an accredited medical school in the United States. Foreign medical graduates must have passed the USMLE Part I and II, as well as completed a three-year Internal Medicine residency in an accredited medical school in the United States. One position each year is determined by the NRMP Residency Match Program.

The Division offers a clinical fellowship program approved for four positions. The educational program utilizes clinical material and faculty at four core hospitals, the University of Louisville Hospital, UofL Hospital - Jewish Campus, North Healthcare Hospitals, and the Department of Veterans Affairs Medical Center. The educational program also utilizes clinical material and faculty at the Department of Public Health’s Sexually Transmitted Disease Prevention Specialty Clinic and Tuberculosis Clinic. This allows for a broad exposure in disease pathology and patient mix.

The goals of the fellowship program are:

  • To provide acute care experience in the management of hospitalized patients with infectious diseases
  • To provide continuing care experience in the management of HIV/AIDS patients
  • To provide experience with a hospital program for improving the use of antimicrobials in hospitalized patients
  • To provide ambulatory care experience in the management of patients at risk for tuberculosis and patients with tuberculosis
  • To provide primary ambulatory care experience in the management of sexually transmitted diseases
  • To provide supervised clinical research experience for each trainee at the local, national, and international level
  • To provide experience with the microbiological diagnosis of infectious diseases
  • To provide experience in the management and operation of a hospital infection control, prevention, and epidemiology program
  • To provide experience and education in the process of quality improvement
  • To provide supervised basic research experience
  • To provide experience with the molecular methods used by the clinical microbiology laboratory

 

Overview

The program extends over 24 months and meets or exceeds minimal criteria by the American Board of Internal Medicine for fellows successfully completing the Program to be eligible to sit for the Certifying Examination in Infectious Diseases. During these 24 months, the fellow will have a continuous ambulatory care rotation consisting of two one-half days per week. This allows for the fellow to follow a group of patients on a regular basis. The teaching staff consists of Dr. Julio Ramirez, Dr. Raul Nakamatsu, Dr. Forest Arnold, and Dr. Paula Peyrani.

Each fellow has increased responsibility with each year. Second year fellows are "on call" for the Public Health Clinics and are considered junior faculty in the I.D. clinics where residents present patient cases to them for review. Second year fellows also arrange the fellow/resident night call schedule, attend at least one major meeting, participate in the Infection Control Committee for at least one hospital, and maintain the I.D. Patient Management Conference notebook. Basic research time varies depending upon the fellows' interest and career goals. A minimum of 22 clinical months is provided. The Infectious Diseases faculty and Program Director provide monthly and semi-annual written evaluations for each fellow, along with structured feedback. These evaluations are kept on file. The Program Director meets weekly with the fellows to discuss strength and weaknesses in areas of concern and to provide feedback as needed.

Additional requirements include:

  • Organizing lectures to Internal Medicine residents
  • Organizing and moderating the weekly I.D. Journal Club
  • Advising and assisting first year fellows in the preparation and submission of a manuscript for publication
  • Organizing the Clinical Research Conference on Mondays

 

Curriculum

  • Inpatient care at four hospitals
  • Infection Control and Prevention
  • HIV/AIDS outpatient care at University of Louisville Hospital and VA Medical Center
  • Clinical microbiology at University of Louisville Hospital
  • Pharmacy at University of Louisville Hospital and VA Medical Center
  • Tuberculosis outpatient care at the Public Health Department
  • Molecular diagnostics at the Infectious Diseases Reference Laboratory and the VA Medical Center Laboratory
  • Sexually transmitted diseases outpatient care at the Public Health Department
  • Basic research at the University of Louisville Hospital and the VA Medical Center
  • Clinical research at the University of Louisville Hospital and the VA Medical Center

 

Research

The fellowship program now offers an educational opportunity on infection control and epidemiology beyond the standard hospital setting. The fellows have a rotation in Infection Control with the opportunity to become familiar with hospital epidemiology. The Division has created a city-wide infection control group. Members of this group include infection control representatives from several hospitals, long-term care facilities, and home health care agencies.

The fellowship program now offers an important educational opportunity in the area of international clinical research. The fellows are actively involved in the clinical research protocols in the Division of Infectious Diseases. There is a strong research emphasis and fellows are expected to participate in research activities throughout their training. A state-of-the-art basic research reference laboratory with faculty devoted to basic research is available for training in a wide variety of areas involving studies at the molecular, cellular, and patient levels. The Division has created an international organization for the study of community-acquired pneumonia. The Division is currently involved in a multicenter, international trial to define the actual care of community-acquired pneumonia. Using internet technology, we are working in collaboration with investigators from more than 15 countries. A detailed description of the Community-Acquired Pneumonia Organization (CAPO) project can be found at here.

The fellowship program now offers an opportunity for our fellows to be educated in the process of quality improvement. The Division of Infectious Diseases is progressively more involved in quality improvement activities at the two primary teaching hospitals, the University of Louisville Hospital and the VA Medical Center. Both hospitals have agreed to implement a quality improvement project in the area of nosocomial-acquired pneumonia. The Division oversees the project implementation, development of interventions for improvement, and evaluation of the impact of the project on clinical and economic outcomes.

At the University of Louisville Hospital, the Division implemented a hospital antimicrobial management program with the goal to improve the use of antibiotics in the hospital setting. The University of Louisville Hospital now has an Infectious Diseases Doctor of Pharmacy with the goal to help in the activities of the program, to create an Infectious Diseases rotation for pharmacy students, and to work with the Division in the area of antibiotic research. The fellowship program now offers a higher level of education and research in the area of hospital antimicrobial management.

Training is bolstered by a weekly Infectious Diseases Journal Club for discussion of the current literature. A weekly Infectious Diseases Grand Rounds is held with a guest speaker for didactic lectures. At the conclusion of their training, fellows will be prepared to begin a successful academic or clinical career in Infectious Diseases.

To see a list of our current fellows click here!