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Educational Standards
Mayo's Infectious Diseases Program is an educational experience through a balanced didactic instruction and education through direct patient care. The training program is 3 years in duration with a minimum of 12 months that is must be devoted to clinical experiences, both inpatient and outpatient through a continuity clinic and HIV clinic.
Our fellowship program will provide you with a comprehensive knowledge base to prepare you to independently care for patients suffering from infectious diseases caused by various pathogens. The program possesses a well-organized and effective curriculum, both didactic and clinical. The curriculum provides the fellows with direct experience in progressive responsibility for patient management.
In addition, specialized rotations offer experience with patients suffering from infections of diverse organ systems, so you will develop skills in diagnosing and caring for patients suffering from common as well as unusual infectious diseases.
You will rotate through five hospital services, each providing you with a wealth of clinical material. You will gain:
- An appreciation of the biological variables inherent in patients.
- An understanding of the pharmacokinetic and toxic properties of antimicrobial agents.
- An understanding of immunological problems as they relate to the diagnosis and treatment of infection.
- An understanding of the care of the patient within the context of the larger system.
Rotation Schedule
The following is a typical rotation schedule.
* You can extend your research time to 17 months if you use your electives for research.
Rotation Descriptions
Clinical Microbiology
Towards the middle of your first year in the program, you will spend two months studying basic clinical microbiology. You will gain:
- "Hands-on" bench experience in general and anaerobic bacteriology, including blood culturing, antibiotic susceptibility testing, antibiotic assay methods and immunofluorescent diagnostic studies.
- Experience with techniques used in the virology, mycology, mycobacteriology and parasitology laboratories.
- Experience in performing Gram stains and other stain techniques on selected specimens.
- Experience in setting up biological specimens for cultures.
- Knowledge of antimicrobial susceptibility testing.
- Knowledge of antimicrobial assay techniques.
- Knowledge of diagnostic serologic tests.
- Knowledge of molecular biology techniques, including polymerase chain reaction and DNA probing.
Explore the services that our Laboratory Medicine and Pathology staff provides for both Mayo Clinic patients and our referred samples.
General Infectious Diseases Service
The general infectious disease service provides consultation to all of Mayo Clinic's inpatient medical and surgical services. You will gain experience in the diagnosis and management of community acquired and nosocomial infection, endocarditis, surgical infections and other communicable infections. In addition, you will learn about more unusual conditions or infections such as fever of unknown origin, parasitic infections and endemic mycoses.
Electives
You can spend your elective time gaining additional research and/or clinical experiences in:
- Microbiology
- Pediatric Infectious Diseases
- Infection Control
- Off-campus Clinical Rotations
- International Clinical Rotations (Mayo has an exchange program with the Philippines or via the Mayo International Health Program)
- Molecular Biology Course: The Molecular Biology Techniques Class is a six-week didactic and hands-on laboratory training course. It is designed for individuals with little or no previous molecular biology experience, and provides an opportunity to learn techniques in a low pressure environment. The course is structured to allow each student to perform a set of experiments in an up-to-date modern molecular techniques setting.
Transplant Infectious Diseases
Mayo Clinic's Transplant Infectious Diseases Service is an integral member of a multidisciplinary team caring for all solid organ and bone marrow transplant patients. You will develop skills in evaluating the febrile transplant patient, treating and preventing opportunistic infections and using various means for preventing infection in this patient population.
Mayo Clinic doctors perform more than 1,100 transplants per year, making it the largest transplant program in the United States. More remarkable, Mayo's program is among the best in terms of survival rates of patients and organs. The Mayo Transplant Program integrates services for patients and brings the collective knowledge of all Mayo specialists to bear on the most difficult transplant problems.
Intensive Care Unit Infectious Diseases
The Intensive Care Unit Service performs consultations for medical, surgical, neurological and other intensive care unit patients. You will gain experience in diagnosing and managing nosocomial pneumonia, systemic inflammatory response syndrome, meningitis and other life-threatening infections.
A Critical Care fellow rotates on the ICU Infectious Diseases service along with an Infectious Diseases fellow each month.
Hematology-Oncology Infectious Diseases
In this service, you will learn to prevent, diagnose and treat infections that result from complications of hematologic/oncologic disorders and chemotherapy.
Orthopedic Infectious Diseases
The Orthopedic Infectious Diseases Service provides consultation for patients on various orthopedic services and some medical services. You will learn to diagnose and manage osteomyelitis, prosthetic or other bone or joint infections, treat diabetic foot infections and skin and soft tissue infections, and support optimal utilization of outpatient antimicrobial therapy.
Outpatient / Infection Control Rotation
You will rotate for 4 weeks to the Travel and Tropical Medicine Clinic to learn about pre-travel management and post-travel evaluation in a returning ill traveler. You can supplement the tropical medicine experience with a rotation in the Philippines. In addition, during these 4 weeks, the fellow also receives Infection Control didactic and hands on experience. You are also expected to complete an IDSA/SHEA approved online Infection Control Course during this time.
Continuity Clinic
During your three-year fellowship, you will have regular continuity clinic in the ambulatory setting. This will include regular outpatient infectious diseases consultations, as well as ongoing care of patients so that you can learn the natural history of infections and their response to therapy. You also will conduct infectious diseases consultations at the Federal Medical Center in Rochester, Minn.
HIV Clinic
Your training will include extensive experience in the medical, psychological and social aspects of infection with HIV and AIDS. You will learn to work with a multidisciplinary team in this setting and manage the longitudinal changes of AIDS.
Didactic Training
Clinical conferences, seminars, a core curriculum, journal clubs, ID research conference, and one-on-one instruction are all an integral part of Mayo Clinic's subspecialty Infectious Diseases Fellowship.
During your fellowship you will participate in:
- A weekly clinical case conference involving current inpatient and outpatient cases.
- A monthly Infection and Immunity Research Club that meets once a month and features renowned, invited speakers.
- A bimonthly journal club alternately focusing on AIDS and general infectious diseases topics with an emphasis on critical evaluation of recent literature.
- A
year round
core curriculum lecture series on infectious diseases and other topics, including ethics, managed care and medical informatics.
Research Training
Your research opportunities at Mayo Clinic are diverse and outstanding. You are encouraged to participate in research projects with the consulting staff. This includes opportunities for clinical studies and laboratory-based projects.
During your fellowship, you can participate in clinical research doing prospective or retrospective clinical studies. The Infectious Diseases Laboratory offers many research opportunities using both in vivo and in vitro techniques. Other laboratories with the Division or outside of the Division also offer opportunities for fellows wanting to pursue basic science bench research. You can visit some of the ID labs at this link: http://mayoresearch.mayo.edu/mayo/research/id/
The Section of Clinical Microbiology is active in broad areas of applied clinical research. Your interests in basic research can be satisfied by collaborative efforts with the basic sciences departments of cell biology, microbiology, experimental pathology, vaccinology, immunology or pharmacology.
Fellow protocols are reviewed and approved by the Division of Infectious Diseases Research Committee and the Mayo Institutional Review Board. You will be encouraged to present your research results at national or international infectious diseases meetings and publish them in peer-reviewed journals.
Examples of current research programs in infectious diseases at Mayo Clinic include:
- Pathogenesis of viral persistence in human immunodeficiency virus infection
- Interactions of HIV proteins with host-cellular proteins
- Molecular determinants of HIV disease progress or rates
- Immunologic and pathogenic factors in viral infection
- Novel applications of molecular diagnostic and epidemiological techniques
- Epidemiology of prosthetic joint infections
- Investigation of new or novel antimicrobial agents in vivo and in vitro
- Clinical trials involving new antimicrobial agents
- Pathogenesis of cytomegalovirus infection following solid organ transplantation
- Identification of genetic markers of drug resistance in Mycobacterium tuberculosis and other mycobacteria
- Molecular identification and mechanisms of emerging bacterial resistance
Find out more about research within the Division of Infectious Diseases and Mayo Clinic.
Additional Training
Masters or Certificate in Clinical Research
For fellows interested in clinical research, Mayo Clinic offers a Masters or a Certificate of Knowledge in Clinical Research through Mayo Graduate School (MGS). Fellows who plan to do clinical research during their second year are required to undertake the coursework to complete the Certificate of Knowledge in Clinical Research. Masters program is only allowed during fellowship on a limited basis. .
Courses
During your fellowship, the Division will pay for you to complete the online Infection Control Course and pay for you to attend one of the following courses:
Talk with your program advisor if you are interested in enrolling in any of these supplemental courses.
Call Frequency & Duty Hours
Your call schedule and duty hours will vary by individual rotation. Mayo Clinic follows recommendations of the Accreditation Council for Graduate Medical Education. Call during the week (off-hours) is shared among fellows on inpatient services.
Only fellows on non-clinical rotations such as 1st, 2nd or 3rd year fellows on research or other non inpatient assignments take weekend calls (start Saturday noon until Monday 8AM). This plan provides four continuous 24-hours off-call periods in every 4 week period for rest and restitution. The on call fellow is most likely to be a 2nd and 3rd year fellow and therefore more experienced and efficient. To correctly implement this, the fellows are limited to no more than 2 weekends per month during non-clinical rotations.
In the event you have to do a weekend call while on an inpatient clinical service (only special circumstance and if approved by the Program Director), then you will be given a complete day off on the Saturday following the previous call weekend. All fellows on inpatient services work half-Saturdays.
Committee Assignments
You will have opportunities to gain experience in a number of administrative capacities during your fellowship. An appointment to one of the hospital infection control committees will help you understand the basic principles of infection control, surveillance methods, isolation procedures and the investigation of outbreaks.
Appointment to the Pharmacy and Therapeutics Committee will give you experience in processing and evaluating new antimicrobial and other drug reagents. You also may be appointed to the education or research committee at the divisional level.
Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the entire course of your fellowship in infectious diseases. You will be evaluated formally by your supervising faculty member after each clinical rotation according to the ACGME stated six competencies (link to http://www.acgme.org/outcome/comp/compFull.asp ). In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met. The ID program undergoes an annual internal evaluation to help meet your needs better.
Career Development
You will meet periodically with various faculty members and the program director to discuss your goals. Mayo Clinic recruits many of its staff physicians from its own training programs. Thus, when you successfully complete the subspecialty Infectious Diseases Fellowship, job opportunities may be available at one of Mayo Clinic's group practices.
Graduate Outcomes
The most important sign of the success of any training program is how its graduates fare after they begin their careers. Over the last decade, all of our graduates have successfully passed their certification examinations. Fifty percent are in private practice and fifty percent are in academic positions. Our recent graduates practice in 12 states and five foreign countries.
Moonlighting
Moonlighting is permitted for licensed fellows beyond the PGY-1 level. Moonlighting activities may only be scheduled during those times when you are assigned to non-call rotations. Fellows working with a J-1 or H-1B Visa are not permitted to moonlight.
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