UH CASE MEDICAL CENTER: CARPENTER SERVICE
A. Goals and Objectives
• Fellows develop experience in diagnosis and management of acutely ill patients with HIV infection, as well as other infectious diseases that require hospitalization.
• Following this rotation, fellows should be able to develop a diagnostic evaluation for the common complications of HIV infection (such as pneumonia, diarrhea, change of mental status).
• Fellows will be able to implement standard therapies for the common opportunistic infections associated with HIV infection.
• Fellows will recognize indications, side effects and drug interactions of medications commonly used in therapy of HIV infection and its complications (including antiretroviral therapy).
• Fellows will recognize and treat common infectious diseases requiring hospitalization including TB, osteomyelitis, pneumonia and fever of unknown origin.
B. Methods, patient mix, procedures
• Fellows will have daily bedside rounds with Infectious Disease attending to participate in the diagnosis and daily management of acutely ill HIV patients with a variety of complications.
• Didactic discussions based around patients but planned to cover main HIV syndromes over the month, occur three times a week, led by the Infectious Disease attending. Topics covered include pathophysiology of HIV and its complications, as well as diagnosis and therapy. • Fellows attend Morning Report, noon conference, Chief Rounds, Grand Rounds, and Morbidity and Mortality conferences during the month.
• Patients are mainly followed in the Special Immunology Unit (outpatient HIV clinic providing primary care to 700 HIV infected persons). Additional patients include newly diagnosed HIV patients from the Emergency Room, patients followed by Infectious Diseases attendings, Infectious Disease referrals from outside hospitals, additionally general medicine patients may also be followed , depending on the Infectious Diseases case load.
• Fellows execute commonly performed bedside procedures including puncture, thoracentesis and central line placement.
• The principle ancillary educational material is a compendium of articles from the most recent medical literature covering HIV pathogenesis and therapy, diagnosis, pathophysiology and treatment of the major opportunistic infections and malignancies. This is present in a binder on the floor at all times. In addition, pertinent articles related to specific patients are provided. .
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. |
