Inpatient Rotations

The first year fellow will spend about 9 months on the clinical inpatient consultative rotation.

Goals: To introduce the Fellow to the fundamentals of infectious disease diagnosis and treatment for patients hospitalized with infections including elucidation of the infectious disease problems, clinical differential diagnosis of those problems, microbiology of the infections and approach to diagnosis and therapy. Diagnosis and care will be provided to patients with a wide array of infections and in all stages of illness.


Antimicrobial agents:

  • mechanisms of action
  • adverse reactions
  • drug monitoring
  • appropriate use and cost containment
  • home intravenous antibiotic management
  • chemoprophylaxis and immune prophylaxis

Clinical syndromes including:

  • upper respiratory tract infections
  • community and nosocomial pneumonia
  • pleural space infections
  • peritonitis
  • skin and soft tissue infections
  • intraabdominal and gastrointestinal infections
  • endometritis
  • bacteremia
  • urinary tract infections
  • post-infections, wound infections
  • endophthalmitis, uveitis
  • bone and joint infections
  • endocarditis, pericarditis
  • soft tissue infections
  • central nervous system infections
  • catheter-related infections
  • hepatitis
  • sepsis and septic shock
  • infections in the elderly
  • febrile patient in the intensive care unit
  • immune compromised host (neutropenia, transplantation, leukemia, lymphoma, immune suppressive agents)
  • post operative patient with infection
  • fever assessment and fever of unknown etiology
  • the pregnant patient with fever
  • patients with HIV/AIDS related infections
  • infections in the patient with IDU

Teaching environment:

Daily inpatient rounds with the ID attending. This includes review of the Fellow's presentation, clinical bedside examination, review of all laboratory data and radiology tests. The Fellow's assessment of the problems and plans are critiqued along with antibiotic management and written consult notes.

  • Antibiotic restriction program
  • Informal "curbside" consultations
  • Monthly conferences
  • Monthly lectures

Mix of diseases:

There are about 110 consults per month including those from medicine, general surgery, orthopedics, neurosurgery, vascular surgery and ob-gyn. Patients with diseases in all categories listed above are seen.

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

  • Patients from all socioeconomic strata are seen
  • Patients and diseases as above
  • Wound assessment and exploration
  • Gram stain

Reading list:

  • Mandell's text according to disease encountered
  • Core curriculum conference
  • Journal club
  • Case conference

Pathological material: Gram stains are reviewed on interesting patients. Pathological specimens can be reviewed with the pathology department as needed.

Evaluation: Immediate feedback on each patient presentation. Written evaluation by the ID attendings on service. The fellow will also provide written evaluations of the rotation to the fellowship director.