Although fully integrated, each institution involved in the fellowship offers unique experiences and programs. The following provides a description of the University and institutions.

University Hospitals, MetroHealth Medical Center, and the VA Medical Center are major teaching facilities for the CWRU School of Medicine. CWRU consists of two undergraduate colleges, Case Institute of Technology, and Western Reserve College; the School of Graduate Studies, and the Schools of Medicine, Nursing, Dentistry, Law, Management and Applied Social Sciences. The unique CWRU medical curriculum is structured mostly around the functions of the human body, teaching the basic scientific principles along the way.

Located in University Circle at Cleveland's eastern edge, University Hospitals is locally, nationally and internationally recognized for its patient care, research and teaching. University Hospitals is a 974 bed tertiary and community care institution affiliated with CWRU's School of Medicine, Nursing and Dentistry. University Hospitals and its research counterpart form Ohio's largest biomedical research center. The teaching hospital atmosphere fosters high level patient care by assuring that all treatments and procedures represent the most advanced medical knowledge and technology available. United under one management are its six specialty hospitals: Lakeside, Alfred and Norma Lerner Tower, and Samuel Mather Pavilion for adult medical-surgical care; MacDonald Hospital for women, Rainbow Babies and Childrens Hospital, and Hanna Pavilion for psychiatric care.

The clinical programs in Infectious Diseases at University Hospitals provide a diversity of inpatient and outpatient experiences for fellows. Approximately 1,000 patients per year are seen on the general consultation services. In addition, 500 admissions to the HIV inpatients service provide an in-depth exposure to opportunistic infections and other complications in these immunocompromised patients.

The Wade Park unit of the VA Medical Center is a 360 bed hospital located in University Circle and provides a full spectrum of medical and surgical care to the veterans of Northern Ohio. Tertiary services include medical, surgical and coronary intensive care units; and hemodialysis unit; a CT scanner; invasive and noninvasive cardiology suites and a 60 bed spinal cord injury unit.

The inpatient consultation team is staffed by faculty and fellows from the combined program and consults between 30-50 patients per month. Cases cover a broad range of common medical and surgical infections, as well as opportunistic infections of immunosuppressed AIDS, oncology, and renal transplant patients.

Infectious Disease faculty based at the VA Medical Center are actively involved in both basic and clinical research. Special interests encompass the basic molecular biology of antimicrobial resistance, the regulation of cellular immunity during tuberculosis, and the molecular biology and immunology of parasitic illnesses, specifically leishmaniasis. The close proximity of the CWRU School of Medicine has encouraged extensive integration with the work of collaborators at CWRU.

The VA Medical Center is situated in the cultural center of Cleveland and is within walking distance of University Hospitals and the CWRU campus.

This three-year NIH supported program provides balanced in-depth experience in clinical infectious diseases and the application of basic science techniques to the understanding of pathogenic mechanisms of microbes and parasites and the host-immune response to infectious agents. The first year program emphasizes clinical training in Infectious Diseases. Inpatient training consists of consultation on the Infectious Diseases services at University Hospitals, the VA Medical Center, and MetroHealth Medical Center. Outpatient rotations (including a continuity experience) provide experience in general infectious diseases including the management of transplant-associated infections, orthopaedic infections, sexually transmitted diseases, HIV infection, tuberculosis, and diseases of travelers. Rotations in the microbiology laboratory provide practical experience in laboratory diagnosis.

The second and third year of the program consist of research in specific areas with the guidance of a faculty member. In addition, the trainee may work on collaborative projects with faculty from basic science departments. There are six major basic research programs available in the training program; retrovirology (HIV/HTLV), mycobacteria (M. tuberculosis/M. avium), helminth, malaria, bacterial host defense, and antimicrobial resistance. The research program for each postdoctoral trainee is developed by an education committee which also monitors progress and assists in career planning. Fellows participate in research seminars, conferences, and journal clubs. Depending on scientific background and individual goals, trainees may enroll in postgraduate courses.

International collaborative research programs exist in Brazil, Mexico, Egypt, Kenya, Papua New Guinea and Uganda. The unique character of this program, in fact derives from the critical blend of faculty with shared backgrounds, interests and commitment to investigation of infectious diseases and from the complementarities between research in the U.S. and overseas.

Applicants for this training program must have completed three years of postgraduate training in internal medicine and/or pediatrics and may have had subspecialty training. The main criteria for selection are clinical ability, a demonstrated interest in research, and a commitment to a research career in Infectious Diseases or Geographic Medicine.

This three year program encompasses the clinical activities as described above. In addition, trainees will be expected to become involved in scholarly research related to the epidemiology of infectious diseases. In this track, the opportunity to obtain a masters degree in epidemiology & biostatistics is available for selected individuals. Course work and thesis supervisors will be provided by faculty members of the Department of Epidemiology & Biostatistics at CWRU which is based both on the MetroHealth Medical Center campus and in the School of Medicine at CWRU. Thesis projects would be integrated with ongoing infectious diseases epidemiological studies which are being conducted by teaching faculty of the Infectious Diseases training program. Possibilities for study include: Tuberculosis/HIV epidemiology in Cleveland and Uganda; studies in Kenya, Papua New Guinea, Egypt on filariasis and schistosomiasis; antimicrobial resistance and hospital-acquired infections in Cleveland.

Fellows may also elect to train in AIDS clinical research. This training program will involve time spent on the HIV inpatient service and in the outpatient Special Immunology Unit. Fellows can also participate in the design, implementation, and analysis of AIDS Clinical Trials through the NIH-funded AIDS Clinical Trials Group. The ACTU at Case Western Reserve University is led by faculty within the Division of Infectious Diseases at CWRU and focuses on clinical trials of antiretroviral agents, cytokines and cytokine modulators. Treatment trials are performed in close coordination with immunology and virology laboratories on campus and fellows will have the opportunity to work closely with these laboratory directors as well as with the clinical trials faculty.

In some circumstances, candidates are selected for clinical training only. This two year program focuses primarily on clinical infectious diseases in both the inpatient and ambulatory setting (particularly related to primary care of HIV-infected persons). Time will be allotted to gain more experience in the evaluation and management of STDs, infections in transplantation, travel medicine, and in infection control and hospital epidemiology. Electives in pediatric infectious diseases can be taken. Scholarly activity (case series, retrospective reviews or focused prospective studies) are also an expectation of this track.

Related Links

Division of Infectious Diseases Research

Division of Infectious Diseases Clinical

Division of Geographic Medicine