SIU School of Medicine

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Department of Internal Medicine

Infectious Diseases & Applied Microbiology

Rotation Supervisor: Nancy Khardori, M.D., F.A.C.P., Professor of Medicine and Microbiology/Immunology and Chief, Division of Infectious Diseases

Other Division Faculty: Janak Koirala, MD, Cristian Speil, MD, Vidya Sundareshan, MD

Report to Dr. Khardori's secretary: 8:00 am, MMC A-482, 545-0181

Length of Rotation: 1 week, 2 weeks

General Objectives:

Clinical (ID) Objectives

  • Learn the cardinal signs and symptoms of an infectious process in normal and various types of immunocomprised hosts.
  • Learn the diagnosis and management of major organ system infections, including meningitis, respiratory tract infections, endocarditis/endovasculitis, abdominal/pelvic abscess, urinary tract infection, skin and skin structure infection, osteomyelitis and prosthetic device related infections.
  • Learn the appropriate and optimal use of antimicrobial therapy.
  • Learn the methods and approaches used for outpatient, inpatient and post hospitalization management of infectious diseases including long term antibiotic use outside the hospital.

Basic Science (Applied Microbiology) Objectives

  • Learn the mechanism of action and mechanism of resistance for various classes of antibacterials, antifungals, and antivirals.
  • Learn the spectrum of activity and pharmacokinetic/pharmacodynamics of commonly used antimicrobial agents.
  • Review the staining and culture methods in the Microbiology laboratory.
  • Learn the general methods of identification of common bacterial, fungal and viral agents.
  • Learn non-culture methods of diagnosing infectious diseases.
  • Learn the principles and methods of monitoring antimicrobial therapy.

Key Learning Resources:

  • Harrison's or Cecil's Textbook of Medicine
  • Review of Medical Microbiology
  • A group of recent published papers compiled by the Division. Contains literature on all common Infectious Diseases and on antimicrobial therapy. This is given to the students during rotation.
  • Core Curriculum for Tuberculosis and Core Curriculum for STD's - Both are CDC publications. The Division distributes recent copies to the students during rotation.

Expectations of Students:

  • See patients in the outpatient clinic on Wednesday and Friday morning. Complete history and physical on 2 - 3 patients, present the case to faculty and discuss diagnostic tests and management issues.
  • See inpatient consults (not more than 2 - 3 per week). Do a detailed history and physical exam with review of all available records. Discuss the patient during rounds. The patients given to students are screened by faculty and/or Fellow.
  • Attend inpatient rounds in the afternoon with the team of faculty, fellow, residents, senior and junior students. Students are excused around 5:00 pm to give them time to study and review literature. Unless a student expresses a desire to join rounds on weekends they are excused.
  • See patients in the STD clinic once during the week. Students also review on site microbiology diagnosis and write orders under the supervision of faculty or fellow.
  • Present a case the student is following at the weekly Infectious Disease Conference on Tuesday.

Clinical (Educational) Activities:

  • Outpatient and STD clinics
  • Inpatient rounds every day
  • Monday morning (9:30 am) Microbiology Review and discussion at the Memorial Medical Center Diagnostic Microbiology Laboratory
  • Tuesday afternoon (1:00 pm) Clinical Infectious Diseases Case Presentations and Discussions
  • Wednesday afternoon (5:00 pm) Infectious Diseases and Microbiology Journal Club - research oriented.
  • First Thursday (8:00 am) Sangamon County Tuberculosis Rounds - Discuss the diagnosis and management of all tuberculosis cases in the county.
  • Thursday afternoon (before or after rounds) group discussions - didactic review of fundamentals in Infectious Diseases, Microbiology and Pharmacokinetics

Assessment Methods:

  • Direct observation of patient work ups.
  • Questions and discussions during rounds and educational activities.
  • Face to face feedback at the time and following various activities.
  • Completion of clerkship evaluation form.

Assessment of the Rotation:

  • Students are asked at various times during the rotation if they find the teaching methods and opportunities appropriate and useful. The group discussions on Thursdays are based on the needs expressed by the students.
  • Students complete a rotation assessment form that goes directly to the clerkship office.