METRO HEALTH INPATIENT CONSULTATION
A. GOALS AND OBJECTIVES
1. Fellows will gain a broad experience in the evaluation and management of hospitalized adult patients with a comprehensive array of acute and chronic infectious diseases problems.
2. Following this rotation, fellows will be able to formulate a basic approach to the evaluation of acutely ill patients with potential infectious diseases including pertinent history and physical exam, appropriate utilization and interpretation of diagnostic tests, and development of a prioritized differential diagnosis based upon history, exam and diagnostic studies.
3. Fellows will develop an increased understanding of the pathophysiology of common infectious diseases in hospitalized adult patients. The emphasis is on case-based bedside teaching.
4. Fellows will recognize and treat common infectious disease problems requiring hospitalization including pneumonia, osteomyelitis, skin/soft tissue infections, endovascular infections, osteomyelitis/septic arthritis, central nervous system infections, intraabdominal and genitourinary infections.
5. Fellows will recognize indications, side effects and drug interactions of diverse classes of antimicrobials utilized to treat hospitalized adult patients.
B. METHODS, PATIENT MIX, PROCEDURES
1. Fellows will have daily bedside rounds with the Infectious Diseases attending and participate in the diagnosis and daily management of acutely ill patients with a variety of infectious diseases.
2. Didactic discussions that are case-based will be undertaken by the Infectious Diseases attending physician and generally occur daily as each patient is presented.
3. Fellows will attend the weekly ID Clinical Case Conferences, fellow’s didactic lectures and the bi-monthly ID Journal Club.
4. The mix of patients at MetroHealth Medical center (MHMC) includes the entire spectrum of adult patients with infectious diseases problems managed in the inpatient setting with the exception of infectious complications in organ transplant recipients. As a result of its role as the regional adult trauma and burn center, and because MHMC houses the tuberculosis control and treatment program for Cuyahoga County, a unique experience in the infectious complications of burns and trauma and an enriched experience in the diagnosis and management of tuberculosis is afforded to fellows rotating on the inpatient ID consult service at MHMC. Adult patients at MHMC are admitted from two primary sources:
- Tertiary care referral patients
- The Emergency Department which draws from an urban, largely underserved population
Fellows will encounter patients in all Departments including: Internal Medicine, Surgery and surgical subspecialties, Neurology, Psychiatry, Dermatology, Family Medicine, and OB/GYN. The number of patient encounters are limited to ensure an emphasis on teaching over service so that educational goals are met.
5. The principle ancillary educational material will include "classic" and recent medical literature which will be applied in each specific case.
C. EVALUATION
1. Formal ongoing feedback by the Attending Physician is required. Fellows will receive evaluation at the end of the month and will be part of the fellow’s permanent file. Also, at mid-month, attending physician will give feedback to the fellows. Fellows will also anonymously complete an end-of-month evaluation form which is available for the attending and program director to review. Specific comments are relayed to the Division Chief.
2. At the end of the month, fellows assigned to the ID Consultation Service, will have a feedback session with the Fellowship Program Director to discuss strengths and weaknesses of the rotation, the service load, the Attending physician and other issues affecting the educational experience of the service. |
