The University of Florida’s Infectious Diseases Fellowship Program currently offers 16 elective experiences. These electives allow our Fellows to customize their educational experiences to meet their career and specialization goals.
First year Fellows take 6.5 elective “blocks” (a little over 3 months’ worth of electives) and are required to take 1 “block” (two weeks) each of the Microbiology and Transplant ID electives.
The second year Fellows take 10.5 elective “blocks” (a little over 5 months) and are required to take the VA Tropical Medicine & Global Health Elective.
Our electives take place at either the University of Florida, UF Health/Shands Hospital (“Shands” electives), or the Malcolm Randall Veterans Administration Hospital (“VA” electives). At each site, faculty preceptors communicate directly with the Fellow concerning their goals for the rotation, and typically tailor the experience accordingly.
During electives, Fellows are expected to attend their continuity clinic and all scheduled fellowship didactic experiences.
Ambulatory
During the Ambulatory ID Elective, Fellows will have the opportunity to focus on outpatient infectious disease (such as hepatitis C treatment, HIV, travel medicine, Hansen’s disease, and pulmonary mycobacterial diseases) that they would like exposure to above and beyond that experienced in the inpatient setting or in their continuity clinic. The ambulatory experience is tailored by the Fellow: they choose which outpatient clinics they would like to participate in.
Fellows are expected to attend their continuity clinic and all scheduled fellowship didactic experiences (infection prevention and control, case management, board review, grand rounds (medicine and ID), and Wednesday didactics during this elective.
Outpatient Clinic Options for Ambulatory Elective
HIV
During the Outpatient HIV Elective, Fellows will have exposure to patients living with HIV infection being treated longitudinally in a multitude of outpatient settings, including: an academic medical center (Shands), the Malcolm Randall VA Medical Center, Florida Department of Health Clinics, and a Federally Qualified Healthcare Center. This rotation will build on the knowledge fellows have gained through providing HIV care during inpatient rotations and their Continuity Clinics and will provide unique exposure to patients who experience social disparities of health and are receiving care through the Ryan-White CART Act funded clinics. The ambulatory HIV rotation will continue to develop competencies in systems-based practice and interpersonal/communication skills by delivering care within a multidisciplinary team.
Tuberculosis (TB)
During the Tuberculosis (TB) Elective, fellows will have exposure to TB infected patients being treated longitudinally in a multitude of settings (Shands hospital based clinic, Florida Department of Health Clinics, and through the Florida Department of Health teleradiology and telehealth system. Participants will be part of a multidisciplinary team including physicians, pharmacists, case managers, social workers, nurses and clerks providing specialty care to these patients. The TB rotation will continue to develop competencies in systems-based practice and interpersonal/communication skills by delivering care within a multidisciplinary team.
Microbiology
The ID Fellowship Microbiology rotation is a required 2-week rotation experience in the first year of fellowship. This rotation is intended to introduce fellows to the microbiology lab leadership and staff and to help them gain a general understanding of the processes involved in microbiology lab testing and how the clinical decision-making process applies to proper laboratory functioning. Fellows will also be exposed to clinical microbiology topics such as current testing strategies at Shands at UF and will self-review microbiologic diagnostic strategies that are important for understanding of diagnostic tests that may be utilized at other facilities but are no longer used at Shands, such as stool studies. Fellows may elect to additional microbiology rotations focusing on specific areas of interest in the microbiology lab.
Shands ID Inpatient Transplant Team (Tx)
Two weeks of this rotation are required for first years, and any additional experiences are elective. This rotation focuses on prophylaxis and treatment of infections complications that occur in patients who have undergone lung, heart, liver, kidney or pancreas transplantation. Fellows will be on the inpatient service team for one of our two Transplant ID Teams. Fellows on this rotation will learn immunosuppressive drugs, including indications and potential complications. They will also learn to develop differential diagnoses considering potential surgical complications, exposure to immunosuppressive agents, prophylaxis or treatment of infections detected in the organ donor, and prophylaxis or treatment for opportunistic infections.
Shands Infectious Diseases Inpatient Hospitalist Consult Team
This is an elective which can only be taken by second years, typically in the second half of their second year of Fellowship. During this rotation, Fellows will be on the inpatient service team for one of two of our inpatient consultation service teams which take hospitalist consults. They will care for a patient mix that includes the entire spectrum of adult patients, including ICU, immunocompromised (including people with HIV and those taking immunosuppressive medications), and post-surgical patients with infectious diseases.
Shands Pediatric ID
The Pediatric Infectious Diseases elective is intended to expose the Adult Infectious Disease fellow to the spectrum of pediatric infectious diseases including immunodeficiencies, congenital infections, fevers and rashes, HIV prevention and infection and antimicrobial and antiviral treatment in children and adolescents.
Shands Antimicrobial Stewardship
The Antimicrobial Stewardship rotation will provide an environment and set of experiences allowing the ID Fellow to be comfortable designing/redesigning a therapeutic plan and defining desired outcomes for a variety of Infectious Disease Stewardship related issues by the end of the rotation. The rotation will facilitate understanding of PK/PD (Pharmacokinetic/Pharmacodynamic) modeling and dosing and providing patient centered personalized medicine. After their review of individual cases, ID Fellows meet with their Pharm.D. preceptor for “stewardship rounds” each day to discuss the ID Fellow’s therapeutic plan for each patient. The ID Fellow will impact patient care through recommendations on the selection and modification of antimicrobial therapy. ID Fellows will become familiar with literature related to developing and implementing an antibiotic stewardship programs as well as therapeutic guidelines for disease states they encounter. Interested Fellows will work closely with the Infectious Diseases Pharmacist on quality improvement projects such as drug use guidelines and clinical pathways to streamline the antibiotic stewardship efforts.
Shands Hospital Epidemiology & Sepsis
This rotation will afford infectious disease fellows the opportunity to become familiar with hospital epidemiology including the process of outbreak investigations within a healthcare institution, principles of infection prevention, and hospital structural hierarchy and leadership. During the two-week rotation (or more if the fellow desires and scheduling allows), fellows will learn the CDC Infection Control Guidelines as well as recognize Central Line-Associated Bloodstream Infections (CLABSIs), Catheter-Associated Urinary Tract Infections (CAUTIs) and isolation precautions for multidrug resistant organisms (MDROs). These guidelines are the measure by which all health care institutions are evaluated and play an important role in hospital accreditation. This rotation will help fellows prepare for the ABIM Infectious Diseases subspecialty board examination regarding hospital epidemiology.
VA Tropical Medicine, Global Health
The VA tropical medicine elective is a lecture-based 2 week elective and is only available to – and mandatory for – second years. The elective aims to teach trainees the skills needed to diagnose, treat and prevent the spread of diseases common in tropical and developing countries where resources are limited. The elective has lectures about common tropical diseases focusing on their epidemiology, pathophysiology, clinical features, diagnosis, treatment and prevention. The trainees will spend time in the laboratory learning different methods used in the diagnosis of tropical diseases. Small group discussions and flipped classroom methods will be used for lectures. Case reports will be discussed, allowing the trainees to come up with appropriate diagnostic tests and therapies. At the end of the rotation, fellows deliver a short presentation on a chosen topic.
VA Radiology
This rotation allows Infectious Disease fellows to become familiar with different specialties of radiology at the Malcolm Randall Veterans Administration Hospital with a focus on radiographic findings that relate to infectious processes. Fellows will have the opportunity to rotate through different specialties of radiology, including chest/body/musculoskeletal plain film and CT, Nuclear Medicine, and MRI (musculoskeletal and neurological); however, the availability of certain specialties may vary depending on pre-existing radiology schedules. Fellows should make an effort to attend Radiology conferences from 12-1pm Monday-Friday when they do not have other ID conferences to attend. The preceptors will help the Fellow to develop a personalized rotation schedule.
VA MICU
This rotation allows Infectious Diseases Fellows to review intensive care management skills and provide education to the Malcolm Randall Veterans Administration Hospital MICU team with regards to Infectious Diseases topics. During this rotation, fellows will round with the MICU team, discuss the antibiotic choices for patients on the team, and provide education to the team on relevant Infectious Diseases topics. Fellows will also become familiar with infection control policies in the ICU as well as the management of diverse medical issues in critically ill patients, including sepsis, ventilator-associated pneumonia, and ARDS. This rotation will help fellows prepare for the ABIM Infectious Diseases subspecialty board examination with respect to the topics of antimicrobial therapy, infection prevention and control, specific disease-causing pathogens, and general internal medicine (including critical care medicine).
VA Wound Care
During the wound care elective at the Malcolm Randall Veterans Administration Hospital, fellows will learn to recognize various acute and chronic wounds and their causes. Fellows will also learn the appropriate workup and management of these wounds under the supervision of the VA Wound Care Team. Elective time will be spent in the VA wound care clinics as well as on the inpatient wound care consult service.
VA Antimicrobial/Outpatient Antibiotic Therapy (OPAT)
This rotation will provide a set of experiences allowing the ID Fellow to develop comfortable designing and adjusting a therapeutic plan and defining desired outcomes for a variety of Infectious Diseases/Stewardship and OPAT related issues. The rotation will facilitate understanding of Pharmacokinetic/Pharmacodynamic (PK/PD) principles, dosing, and providing patient-centered personalized medicine. After their review of individual cases, ID Fellows meet with their Pharm.D. and/or MD preceptor for daily rounds to discuss the ID Fellow’s therapeutic plan for each patient. The ID Fellow will impact patient care through recommendations on the selection, modification, and duration of antimicrobial therapy. ID Fellows will become familiar with literature related to developing and implementing antibiotic stewardship and OPAT programs, as well as therapeutic guidelines for disease states they encounter. If time allows, fellows will work closely with the Infectious Diseases pharmacists on quality improvement projects such as drug use guidelines and clinical pathways to streamline stewardship and OPAT efforts.
VA Epidemiology
This rotation will allow Infectious Disease fellows to become familiar with hospital epidemiology and the process of an outbreak investigation within a health care institution. During the rotation, fellows will learn the CDC Infection Control Guidelines as well as recognize Central Line-Associated Bloodstream Infections (CLABSIs), Catheter-Associated Urinary Tract Infections (CAUTIs) and isolation precautions for multidrug resistant organisms (MDROs). These guidelines are the measure by which all health care institutions are evaluated and play an important role in hospital accreditation. This rotation will help fellows prepare for the ABIM Infectious Diseases subspecialty board examination regarding hospital epidemiology. A list of resources and reading material will be provided. As part of this rotation, each fellow will also complete the SHEA annual fellows course in epidemiology (https://learningce.shea-online.org/content/online-primer-healthcare-epidemiology-infection-control-antimicrobial-stewardship). Instructions will be provided for reimbursement. In addition, fellows will be expected to attend the monthly IPCC meetings that occur at noon on the 3rd Tuesday of the month. Fellows may also choose a hospital epidemiology project at the VA to investigate, which would ideally lead to a presentation, abstract, poster, or manuscript.
Global Health Observership Columbia
This elective is ONLY available for second years and MUST be planned for in the first year for the second year, to ensure everything is in order for the trip and collaboration. Fellows interested in global health will travel to sites in Colombia under the guidance of Dr. Norman Beatty. Fellows participating in this rotation will be exposed to people living with tropical infections.
Global Health Observership India
This elective is ONLY available for second years and MUST be planned for in the first year for the second year, to ensure everything is in order for the trip and collaboration. Fellows interested in global health will travel to sites in India under the guidance of Dr. Hanumappa Sudarshan of the Karuna Trust. Fellows will study the health of people living with infectious diseases in rural areas in India.
For program inquiries, please send an email to:
idfellowship@medicine.ufl.edu