SIU School of Medicine

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Division of Infectious Diseases

Resident Information

CONTACT INFORMATION

Contact the attending physician on service based on faculty call schedule from July 1 - June 30. Office manager available in room MMC Room or phone 545-9148.

Supervisor:

Janak Koirala, MD
A486 Memorial Medical Center
Telephone: 545-9148

Secretary:

Nancy Mutzbauer 545-9148

Faculty:

Janak Koirala, MD
Vidya Sundareshan, MD
Shingo Chihara, MD
Isha Tyagi, MD
Scott Bergman, PharmD

EDUCATIONAL PURPOSE

To gain clinical experience and acquire knowledge about diagnosis and management of infections caused by all types of microbial agents. The resident will see new patients as well as follow-ups during this experience.


TEACHING METHODS

Conferences:

Microbiology Bench Rounds – Tuesday at 9:30 am in MMC Main Laboratory
ID Clinical Conference 1300 1st, 3rd, 5th Tue MMC D229
2nd, 4th Tue SJH Pavillion, Room 3A155
ID Journal Club 1700 Thursday MMC D488
Required Departmental Conferences
Rounds: Daily—at times scheduled by attending physician

Fundamentals of Infectious Diseases:

1. During the rotation, the residents will be taught “fundamentals of infectious diseases” by the faculty during group discussions. This will include discussions on interpretation of microbiology laboratory data.

2. “Clinical Cases Conferences” Infectious diseases clinic case conferences are held every Tuesday (1-2:30 pm) 12 months a year. During these conferences, the fellows and residents present interesting/difficult cases they are currently following and managing on the inpatient/consultation service along with the faculty member on service. The resident, in addition to presenting the cases, prepares a clinical case summary and obtains and distributes pertinent literature to attendees. The fellow helps the residents in presentations of cases. These are very well attended conferences by infectious diseases faculty (the departments of internal medicine and pediatrics) and trainees: and community I.D. physicians; diagnostic microbiologists and microbiology technologists from both hospitals; microbiologists from the basic science departments, infection control directors and staff from SIU and two hospitals in town; I.D. research coordinators, I.D. nursing staff, internal medicine residents and rotating medical students. The third Tuesday of each month, a joint I.D. - Pulmonary medicine case conference is held; where both I.D. and Pulmonary fellows and other trainees and the faculty from both divisions present and discuss infections of the respiratory tract. On the days we have I.D. visiting faculty for departmental grand rounds, the cases are discussed by the visiting faculty member.

“Journal Club” I.D. Journal Club is held every Thursday (4:00 – 5:00 pm) 12 months a year. These sessions provide a forum for fellows, rotating residents/students, graduate students, and post-doctoral fellows to present papers from the most recent issues of major journals. The faculty members on service help them with the selection and usefulness of the papers they present. This Journal Club is attended by faculty, graduate students, researchers, and post-doctoral fellows in addition to pediatric and adult I.D. faculty.

Residents should adhere to the following process during the rotation:

Experience #1 - Infectious diseases inpatient and consultation service

1. Properly ascertain the urgency of a consultation or promptly evaluate the consultations assigned to the resident.

2. Evaluate and discuss the patient with the attending physician as soon as possible in case of an urgent consultation, otherwise re-evaluate and discuss with the attending during regularly scheduled rounds for the day.

3. Leave a written consultation note in the progress note with emphasis on impressions and recommendations. Dictate a full consultation note structured as impression, recommendation, data base and pertinent references.

4. Discuss the recommendations with the referring service and write orders for antimicrobial agents and monitoring labs as and if needed.

5. Provide feedback to the residents from other services who are following the patients seen in consultation on I.D. service.

6. Evaluate, manage and follow I.D. service inpatients along with the attending physicians. Seek appropriate consultation from other services.

7. Supervise medical students on I.D. rotation. Evaluate patients initially seen by students and discuss differential diagnosis and management options.

8. Review all microbiology data from the computer and/or by personal or telephone contact with the diagnostic microbiology staff. In case of further questions or discrepancies, clarify from microbiology laboratory physician supervisor.

9. Conduct procedures e.g. PICC line placement, lumbar puncture, bone marrow aspiration/biopsy - aspiration of superficial abscess and other skin lesions as needed under the supervision of attending physician.

10. As soon as time permits, consult I.D. textbook (Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases) and/or pertinent literature on serious, difficult, or unusual clinical presentations.

11. Prepare case presentations and/or help medical students prepare presentations for the weekly clinical conference.

Experience #2 - I.D. Outpatient & Ambulatory Clinics Including Travel Medicine Clinic

1. The resident will see patients in the outpatient clinic two half-days a week during the rotation.

2. Emphasis on HIV experience - 10% time

3. Follow and monitor patients receiving home or office antibiotic therapy.

4. Perform outpatient procedures - PICC line placement, lumbar puncture and bone marrow aspiration/biopsy under the supervision of the faculty.

5. Supervise medical students on I.D. rotation. Observe medical students during history taking and physical examination.

Experience #3 - Sexually Transmitted Diseases Clinic

1. The resident will attend the STD Clinic operated jointly by the Division of Infectious Diseases and the Sangamon County Department of Public Health once a week during the rotation.

2. After initial supervision, the residents will see patients on their own and consult with the attending physician as is and when needed.

3. The resident will have discussions with the lab personnel, epidemiologists, social workers and field staff of the public health clinic to gain experience in the laboratory diagnostics and public health measures utilized for prevention of transmission of STDs.

4. Learn to do and interpret gram staining for STDs, dark field microscopy for syphilis, RPR for syphilis, wet mounts for Gardnerella and Trichomoniosis.

Experience #4 - Microbiology Rounds

These rounds are held every Tuesday morning from 9:30 am to 10:00 am in the microbiology laboratory of Memorial Medical Center

MIX OF DISEASES, PATIENT CHARACTERISTCS and TYPES OF CLINICAL ENCOUNTERS

PROCEDURES

Aspriation of superficial abscesses
Wound Care

SERVICES

Inpatient Consulations
Outpatient Clinic
HIV Clinic
Travel Clinic
STD Clinic

READING LIST

In an attempt to further define core literature for residents and fellows, we are including a listing of reference materials.

PATHOLOGIC MATERIAL

Reviewed on a case by case basis with attending physician and pathologist where appropriate to patient care. Particular training in gram staining for STDs, dark field microscopy for syphilis, RPR for syphilis, wet mounts for Gardnerella and Trichomoniosis will take place at the STD clinic.

METHOD OF EVALUATION

During the last week of each rotation, the attending physician will complete the resident’s evaluation and discuss it with the resident before submitting it to the residency office. Also, during the rotation, the resident will receive feedback from the supervising faculty member as well as other faculty members during conferences, journal clubs, and STD clinics.

The supervising faculty member will provide constant feed back to the resident in the outpatient arena. Formal evaluations of outpatient performance will be made on the same form as the one used for inpatient consultation service.

LEVEL OF SUPERVISION BY FACULTY

Residents with little experience in the skills needed will observe and practice physical exam skills under direct supervision of attending physicians and fellows, while those with more experience will work with patients in concert with attending physicians and fellows.

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