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| Inpatient
Consultation Service |
A.
Goals and Objectives
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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.
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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.
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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.
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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.
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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
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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.
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Didactic discussions that
are case-based will be undertaken by the Infectious Diseases attending
physician and generally occur daily as each patient is presented.
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Fellows will attend the
weekly ID Clinical Case Conferences, fellow's didactic lectures and
the bi-monthly ID Journal Club.
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The mix of patients will
include the entire spectrum of adult patients with infectious diseases
problems managed in the inpatient setting. Although the majority of
inpatient HIV problems will be encountered on a separate service, some
HIV infection and associated complications will be encountered on the
ID Consultation Service as well. Adult patients at University
Hospitals of Cleveland will be admitted from 3 primary sources: a)
tertiary care referral patients; b)
the Emergency Department which draws from an urban, largely
underserved population; and c) primary care settings. 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.
The principle ancillary
educational material will include “classic” and recent medical
literature which will be applied in each specific case.
C.
Evaluation
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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.
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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.
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