Faculty Chair:
Stephanie Benson, MD
Contacts:
Obefundi Okoli, MD
Required Experiences:
Memorial Medical Center
Clinic Practice with Dr. Okoli
Optional Experience:
Longitudinal Experiences:
Resident Continuity Clinics will provide longitudinal exposure to common infectious disease disorders and relevant procedures.
Weekly Schedule PGY2 or 3 (subject to change based on preceptor availability):
| Sunday | Monday | Tuesday | Wed | Thursday | Friday | Saturday |
| Clinic | ID | Clinic | ID | ID | ||
| Clinic | ID | Didactics | ID | Clinic |
Requirements:
AOA
Internal Medicine
The program must provide at least thirty-two weeks of clinical training in internal medicine disciplines, including at least eight weeks of general internal medicine experiences during the OGME-1 year. This requirement can be met by either inpatient internal medicine or inpatient family medicine service.
At a minimum internal medicine training must include:
- Twenty-four weeks of inpatient experience.
- Four weeks of training in critical care medicine.
- Didactic and clinical training.
Internal medicine training shall include exposure to the following disciplines, in either inpatient or outpatient settings:
- Allergy and immunology.
- Cardiology.
- Dermatology.
- Endocrinology.
- Gastroenterology
- Hematology.
- Infectious diseases
- Nephrology.
- Neurology.
- Oncology.
- Pulmonology.
- Rheumatology.
ACGME
There must be specific subspecialty curricula to address the breadth of patients seen in family medicine. (Core)
The program must ensure that every resident has exposure to a variety of medical and surgical subspecialties throughout the educational program. (Detail)
Description of Rotation or Educational Experience
The infectious disease rotation is an elective rotation available for all residents. Although a primarily consultative rotation, infectious disease specialists now provide continuing care for many patients with HIV disease. Because the practice of family medicine requires a broad knowledge base of infectious disease, acquiring fundamental skills in evaluating and managing patients in the causes of infection are critical. Developing expertise in evaluating patients with primary infections, such as pneumonia and urinary tract infections; secondary infectious processes, such as catheter related infections and ventilator associated pneumonia, etc; and immuno-compromised patients is stressed. The prevention of infectious diseases by the use of appropriate immunizations and antimicrobial stewardship is emphasized to the residents. Many infectious diseases can be transmitted through occupational exposures and prevented by appropriate environmental precautions.
GOALS
The goal of the ID rotation is to provide learning opportunities that will enable residents to develop or refine the knowledge, skills, and attitudes necessary to:
- Diagnose and treat ID conditions most commonly seen in Family Medicine, as well as those important but rare conditions needing specific care or referral.
- Perform a competent and relevant history and physical examination.
- Perform the diagnostic and therapeutic procedures necessary for adequate care in Family Medicine.
- Feel comfortable with the selection, indications, and contraindications of ID medications and treatments.
Expectations:
Residents:
Residents are expected to arrive to ID and continuity clinics on time and to dress and act in a professional manner. They are expected to contact the ID preceptors’ office prior to their first day on the rotation in order arrange the initial meeting time and location on day one of the rotation, as well as review the curriculum and evaluation for goals,objectives and expectations of both the preceptor and the resident. It is expected that while at the preceptors’ office the residents will be respectful of the office space and personnel. The resident is responsible for maintaining a procedure log as well as completing assigned readings and to participate in both inpatient and outpatient care as expected by the preceptor.
Faculty:
Family medicine faculty will provide precepting of ID cases and procedures as seen in resident continuity clinics. Dr. Okoli will provide precepting during the focused ID rotation. The faculty and preceptor are expected to allow the resident to participate in active patient care and procedures when appropriate. The preceptor should also provide time and allowance for explanation and teaching of ID conditions and their treatments.
Call:
There is no call specific to this rotation.
Patient Care
Goal
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:
Competencies
Provide compassionate and culturally appropriate patient care that recognizes the effect of ID problems on the patient and emphasizes the importance of comprehensive preventative care.
Objectives
In the appropriate setting, the resident should demonstrate the ability to independently perform or appropriately refer:
- Ability to take a complete medical history and perform a careful and accurate physical examination.
- Ability to write concise, accurate and informative histories, physical examinations and progress notes.
- Define and prioritize patients’ medical problems and generate appropriate differential diagnoses.
- Develop rational, evidence-based management strategies.
Medical Knowledge
Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:
Competencies
Be proficient in the diagnosis and treatment of common infectious diseases.
Objectives
Know and apply basic and clinical knowledge in the following areas:
- Expand clinically applicable knowledge base of the basic and clinical sciences underlying the care of medical patients.
- Access and critically evaluate current medical information and scientific evidence relevant to patient care.
- Develop and demonstrate proficiency in understanding basic pathophysiology, clinical manifestations, diagnosis and management of medical illnesses seen in both outpatient and inpatient settings.
- Develop and demonstrate proficiency in recognizing the indications for and basic interpretation of common laboratory, microbiology and diagnostic studies that aid in the diagnosis and treatment of common infectious diseases.
Practice Based Learning and Improvement
Goal
Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning.
Competencies
- Identify strengths, deficiencies and limits in one’s knowledge and expertise
- Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems
Objectives
- Demonstrate the ability to search for up-to-date knowledge of ID treatments and incorporate this knowledge into clinical practice.
- Complete assigned reading topics and apply learned material in the clinical setting
System Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
Competencies
- Coordinate patient care within the health care system relevant to their clinical specialty
- Incorporate considerations of cost awareness and risk-benefit analysis in patient care, especially with the use of antimicrobial stewardship role in infectious disease control.
Objectives
- Make appropriate referrals to and coordinate care with Infectious Disease consultant for those conditions that fall out of the scope of family medicine or do not respond to that treatment which family physicians can provide
- Demonstrate cost effective care and diagnostic testing
Professionalism
Goal
Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
Residents are expected to demonstrate:
Competencies
- Compassion, integrity, and respect for others
- Respect for patient privacy and autonomy
- Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
Objectives
- Display sensitivity for patient privacy and autonomy during exams and procedures
- Engage in interviewing techniques which demonstrate cultural and social sensitivity
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:
Competencies
- Communicate effectively with physicians, other health professionals, and health related agencies
- Act in a consultative role to other physicians and health professionals
Objectives
- Communicate with specialists in a clear and concise manner that facilitates coordination of care
Teaching Methods
Residents will provide medical care to patients under the direct supervision of the attending physician. They will be supervised on all procedures performed. They will participate in weekly didactic conferences. One-on-one didactic sessions with the attending, bedside rounds on all new consults and hospital follow-ups, assigned readings and reviewing articles on the reading list will provide substantial learning opportunities for each resident. During these discussions, physiology, pathogenesis, clinical presentations and natural history of infectious disorders is regularly reviewed. The importance of a careful history and physical exam is crucial for appropriate diagnosis of infectious disorders.
Assessment Method (residents)
Direct observation with a ongoing global assessment based on the milestone evaluation. All procedures will be recorded on New Innovations and independence for each procedure assessed from procedure logs. Evaluation from the community preceptor to be completed at the end of the rotation. Review of documentation by family medicine preceptors as part of continuity clinic supervision.
Assessment Method (Program Evaluation)
Residents will be provided with an evaluation of their experiences and given the opportunity to provide feedback of the rotation during their quarterly IEP assessments.
Level of Supervision
The resident is directly supervised by the attending physician during all procedures performed. An Attending will be available the entire time the resident is on the rotation. An Attending will be available at all times during continuity clinic visits.
Educational Resources
Readings:
Week 1
Week 2
Week 3
Week 4
Sexually Transmitted Infection (STI)
SNMFMRP Curriculum 