Elective Months

The Fellow will have two months of elective time during their first year. The timing of these months is to allow a change in venue from the more intense inpatient consultation rotation.

Goals: To provide more outpatient clinical ID, HIV/AIDS care and international travelers clinic experience, allow time to develop second year research project and introduce the process of quality assessment and cost containment activities.


Outpatient clinic. The Fellow will work one-on-one with an ID attending during a full day of outpatient clinic. He/she will see 10-12 patients with varied infectious disease illness and HIV/AIDS. All patients will be assessed by the Fellow and reviewed with the ID attending.

International travelers clinic. The Fellow will work with the attending or nurse practitioner.Travel itinerary, parasitic, bacterial, mycobacterial and viral risks, malaria prophylaxis and vaccinations will be reviewed for each patient.

Quality assessment (QA). QA can be performed by involvement in ongoing QA projects involving antibiotic utilization, HIV/AIDS care or hospital epidemiology. He/she will learn the fundamentals of continuous quality improvement (CQI). This program will entail developing goals and objectives for quality standards, developing data collection tools, chart review, data assessment and feedback to providers. Areas of QA that the Fellow may participate in include;

  • Working with Lindsay Smith and John Ahern of pharmacotherapy to design, implement and assess quality of antibiotic use. This is an ongoing program of the Infectious Disease Practice Committee (IDPC). Data is used to assess the hospital antibiotic formulary, quality of antibiotic use and to monitor costs.
  • Working with Cindy Noyes on infection control projects. See below.
  • Working with Devika Singh to review HIV/AIDS care.
  • Case and HIV/HCV conference
  • Department of Medicine morbidity and mortality conference

Research development. The Fellow will spend part of the elective month deciding on and early planning for the second year research project

  • Meet with the ID attendings to review ongoing and new projects.
  • Meet with researchers from Microbiology and Molecular Genetics to review ongoing projects
  • Begin background reading and hypothesis development

Teaching environment:

  • Outpatient clinic with direct supervision by the ID attending and nurse practitioner
  • Working with pharmacotherapy
  • International travelers computer program
  • Monthly conferences
  • Working with research mentor

Mix of diseases:

  • General infectious diseases
  • Home intravenous therapy
  • International traveler

Patient characteristics and types of clinical encounters, procedures and services: as above

Reading list:

  • Mandell's text according to disease encountered
  • Medical Management of HIV Infection by John Bartlett and Joel Gallant
  • Article review conference
  • Journal club
  • Case conference

Pathological material: Gram stains and culture interpretation

Evaluation: Dr. Dejace will review progress with each Fellow at the end of the month. Written evaluation will be done. The Fellow will also provide written evaluations of the rotation to the fellowship director.