Clinical Experience

Consult service

Pediatric Infectious Diseases Fellows will spend most of their clinical training on the inpatient consult service. Children’s Mercy has 366 pediatric beds with a 43-bed PICU, 24-bed CICU, and more than 80-bed NICU, both with ECMO capabilities, and serves as the only free-standing children's hospital in Kansas City. There are ~16,000 admissions annually to Children's Mercy Kansas City from 150 surrounding counties and the Infectious Diseases Team is consulted on approximately ten percent of the patients or 1,500 consults a year. The General Infectious Diseases service provides care to both healthy and medically complex children with infectious diseases. The Immunocompromised Infectious Diseases service provides care to children with primary and secondary immunocompromising conditions, including children receiving biologic medications, bone marrow and solid organ transplants, cellular therapy, and chemotherapy as well as those with primary immune deficiencies.

Clinic

Fellows will spend 1-2 half days in clinic per month providing care for new referrals and hospital follow-ups as well as subspecialty experiences in our multidisciplinary HIV clinic, international adoption, antibiotic allergy delabeling and travel clinic. Fellows will spend time with each of the faculty in clinic and are exposed to perinatal HIV exposure, TB, HIV, fever of unknown origin, and many other infectious diseases which typically generate outpatient consultation. Fellows will also see follow-up patients from the inpatient consult service to allow for continuity of care for the patient and to develop an understanding about a disease process from beginning to end. Fellows will have the opportunity to interact with the various infectious diseases attendings and nurse practitioners on this rotation.

Microbiology lab

Fellows will spend one month in their first year in the microbiology lab. They will spend these weeks learning about the blood culture system, performance of identification and susceptibilities, viral identification techniques, fungal identification, ova and parasite identification, and specific techniques for identification of fastidious organisms. The fellow will work on a microbiology project during the microbiology lab rotation and will present findings to the microbiology lab personnel and infectious diseases faculty at the end of the month.

Infection prevention and control (IC)

Fellows will spend one month with the Infection Prevention and Control Team during their fellowship. Time will be spent on environmental rounds, investigating outbreak and exposure situations both in the community and in the hospital setting. Fellows will also complete the online Society for Healthcare Epidemiology of America (SHEA) Infection Prevention and Control course during the rotation. Fellows will also develop and complete a quality-improvement project with the help of the IC staff during the Infection Prevention and Control Month and will present their findings to the infection prevention and control team. There is an opportunity for an advanced rotation for those interested in this specialty area or other pediatric quality and safety roles.

Antimicrobial Stewardship

The fellows will spend one month with the Antimicrobial Stewardship Team. The fellows will utilize this time to learn about the theories and approaches behind effective stewardship as well as the reasons for its importance. Fellows will be expected to evaluate the reason for use of monitored and non-monitored therapies for hospitalized patients and make specific recommendations to the primary teams. Fellows will have the opportunity to interact with infectious diseases pharmacists, pharmacy residents, and pharmacy students on this rotation. There is an opportunity for an advanced stewardship rotation, which includes further didactic and practical experience for those interested in this as a career path.

Research

As fellowship progresses, fellows will spend an increasing amount of time focusing on their scholarly activity. Fellows will have a scholarship oversight committee that aids in developing project ideas, starting the research process, seeking available funding, and creating a timeline for completion to meet ABP requirements infectious diseases boards. Fellows will have the opportunity training in statistics, quality improvement, research design, and grant writing.

Overview of curriculum

Fellows will have up to six months of clinical consult service time in the first year, typically split into 2 week blocks, and the remainder of the time is split between the last two years. Fellows are the primary call physician during their clinical service time with faculty backup.