Inpatient Rotations and Experiences

Fellows rotate on the inpatient ID consult service with 2 fellows covering each 4 week block. The consult team is a multidisciplinary team comprising of fellows, ID attending, residents, medical students with ID trained pharmacist support. Teaching on the service consists of daily attending rounds and discussions, bedside instructions and chalk talks.

A direct care team staffed by 1-2 APP provides support and off loads consults from the fellow led ID consult service. This offers fellows a more appropriate balance of educational and service obligation with a well feasible workload.

Fellows rotate on the transplant ID service for one 4 weeks block each year of the fellowship. This team consisting of a transplant ID attending and APP is responsible for consultative care for a variety of pre and post solid organ transplant patients. The team offers multidisciplinary care in close collaboration with the transplant surgery service, other consult services, case management, nutrition services and pharmacy.

Fellows rotate through the microbiology lab for 4 weeks in their first year. During this time ID fellows spend time at the different benches in the laboratory (urine, blood, respiratory, body fluid, and anaerobic cultures, mycology/AFB) and also become familiar with molecular diagnostics (Biofire, MALDI-TOF) which are present on site. Fellows will learn the basic principles and practices of clinical microbiology and the capabilities of our laboratory from medical technologists and laboratory faculty. They will participate in daily stewardship rounds with ID pharmacists and director of the micro lab. Another unique aspect in the presence of the fungus testing lab at UT Health San Antonio. This is a world renowned facility offering fungal diagnostics, susceptibility testing of antifungal drugs and drug levels. They also perform screening and testing of newly licensed antifungal antimicrobics for the pharmaceutical industry and serves as the contract laboratory for clinical efficacy studies involving these agents in therapeutic and clinical trials in humans. Fellows can rotate at this site and also collaborate on research projects.

Multiple inpatient electives are offered at University Hospital including but not limited to critical care ID in the medical ICU with critical care and ID trained staff and Pediatric ID.

Consults stem from common conditions in the Veteran population including diabetes related complications, bone and joint infections, malignancy and other immunosuppressive conditions predisposing to infectious complications. The consult team comprises of 1 ID attending and fellow with occasional trainees rotating at this site.

Fellows partake in a 1 week rotation at the VA during their second year. This rotation has been designed to introduce ID fellows to the core concepts of hospital epidemiology and infection control to prepare trainees in becoming hospital epidemiologist and ASP champion. The goal is to gain practical training in healthcare epidemiology, quality improvement, antibiotic stewardship and obtain tools, resources in a mentored setting. This is guided self-study rotation with one-on-one mentorship form ID faculty structured around IDSA’s Advanced Antimicrobial Stewardship (AS) curriculum which the fellows will complete during this rotation.

Fellows participate in a 1 week rotation conducted at the VA and University Hospital during their 1st year. The aim of the rotation is for fellows to develop a better understanding of Hospital Infection Prevention and Control policies and strategies and become better prepared to address IP challenges  with the goal to prevent hospital infections and improve quality of health-care. The fellows will attend various infection control prevention and leadership meetings, review guidelines and have self study topics followed by faculty debrief.

Below is a sample schedule for 1st and 2nd year fellows: