Fellowship Director: Susan Seo, MD
The Infectious Diseases Service at MSKCC provides comprehensive training of internists in the subspecialty of Infectious Diseases. Clinical training occurs predominantly on the in-patient Infectious Disease consult service at Memorial Hospital of MSKCC and in the out-patient clinics. Infectious Disease fellows perform approximately 250 to 300 consultations per year on a wide range of infectious diseases and are supervised and taught on a daily basis by faculty members. The infectious disease consult team consists of an Attending Physician, two Infectious Diseases fellows and, frequently, medical residents and students from Weill Medical College of Cornell University and other medical schools.
In-Patient Service
The Infectious Diseases Service rounds on a daily basis, following complicated cases through the course of their infection. Formal attending rounds are conducted Monday through Friday. Weekend coverage is provided by the fellow and attending on call for that weekend. At rounds, all new consultations are presented and the management of each patient on the service is reviewed. Pertinent articles and teaching points are discussed as well.
At the end of morning attending rounds, the ID service team rounds through the Clinical Microbiology Laboratory to review all new positive blood cultures, new viral cultures, significant cultures from non-sterile sites, and other findings pertinent to patient care. Charts of all patients with positive blood cultures are reviewed by ID fellows on the clinical consult service to make certain that patients are receiving appropriate antibiotic management.
An important responsibility of Infectious Disease Fellows is providing consultative advice to Employee Health Services following needlestick or other occupational exposures. Issues such as beginning prophylaxis for an exposure to HIV are complex and are made with the input of the ID attending.
New York Hospital: Inpatient
Fellows typically spend 1-2 months on the in-patient service at New York Presbyterian Hospital, Cornell Campus (NYP). After orientation, fellows enter the regular consultative rotation, including call for nights and weekends. Care is supervised by the ID attending of record at NYP.
Outpatient Clinic
Approximately 200-250 patients are followed in the infectious disease clinic, which meets regularly on Tuesday afternoon and Friday morning. Additional clinic time is available should a patient need more immediate evaluation. More than half of the patients are HIV infected and are followed for primary management of HIV, second opinions, and AIDS clinical trials. Other patients include those seen after in-patient consultation for such diseases as osteomyelitis, endocarditis and tuberculosis. Finally, non-cancer patients with possible Lyme disease, chronic fatigue, FUO, fungal infections, or hepatitis are seen.
The care of all out-patients is supervised by an attending physician. The fellow sees patients first, performs a history and physical examination and then reviews radiographs and laboratory results. Upon deriving an assessment and plan, the patient is presented to the attending physician and the attending and fellow see the patient together, review pertinent findings, and formalize the treatment plan until the next visit.
New York Hospital: Traveler's Clinic
During the second year of fellowship, fellows attend several sessions at the NYP Division of International and Infectious Diseases International Traveler's Clinic. ID fellows are supervised by a specialist and encounter a range of clinical issues and problems, including pre-travel vaccination and post-travel infectious diseases.
SUNY-Health Sciences Center, King's County: STD Clinic
During the second year of fellowship, fellows attend several sessions at the STD Clinic at King's County, under the supervision of Dr. Michael Augenbraun and other ID specialists. Fellows see and evaluate a range of STDs in men and women, learn the differential diagnosis of common presenting complaints, such as genital ulcer and urethral discharge, and their diagnosis and management.
Clinical Microbiology Rotation
The Clinical Microbiology Laboratory is directed by Dr. Timothy Kiehn. Infectious Disease fellows spend one month in the first year of fellowship rotating through the Clinical Microbiology Laboratory to learn the basics of bacterial, fungal and viral identification and determination of antimicrobial susceptibility.
Clinical Methodology Course
First year fellows are eligible to apply for the NIH-sponsored Clinical Methodology Course. This 2-year course consists of educational programs designed to train fellows to be clinical researchers. A variety of topics are covered, including epidemiology, informed consent, and ethics.
Hospital Infection Control and Epidemiology
Hospital infection control is directed by Janet Eagan, RN, MPH and Dr. Kent Sepkowitz. All MSKCC Infectious Diseases Fellows attend the monthly infection control meetings and, while on service, participate in daily infection control related decisions. In addition, interested fellows may participate in outbreak investigation, surveillance, employee health related problems, and other activities of the infection control group.
The CDC offers an annual 4-day course in conjunction with SHEA entitled "Training Course in Hospital Epidemiology". Interested fellows may attend this course free of charge.
Journal Club
A weekly journal club is held in conjunction with the fellows and faculty of the New York Presbyterian Hospital-Cornell fellows and faculty. Journals are assigned to participants on a rotating basis and articles selected for discussion.
Research-in-Progress
A research-in-progress meeting is held monthly . At each session, a fellow or faculty member presents results from ongoing work in an informal setting. Work is critiqued and constructive criticism is given.
In addition, fellows are welcome to attend any of the numerous other scientific conferences held at MSKCC.
