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Educational Standards

Mayo's Infectious Diseases Fellowship program provides a comprehensive educational experience through a careful balance of didactic instruction and direct patient care.

The training program is three years in duration. Fellows must donate a minimum of 12 months to clinical experiences, both inpatient and outpatient, through a continuity clinic and HIV clinic.

The program provides fellows with a comprehensive knowledge base that prepares them to independently care for patients suffering from infectious diseases caused by various pathogens. The well-organized, effective curriculum also provides direct clinical experience and progressive responsibility for patient management.

Specialized rotations include experience with patients suffering from infections of diverse organ systems. Fellows develop skills in diagnosing and caring for patients suffering from common as well as unusual infectious diseases. Fellows rotate through five hospital services that provide a wealth of clinical material and ensure a thorough understanding of:

  • Biological variables inherent in patients
  • Immunological problems as they relate to the diagnosis and treatment of infection
  • Patient care within the context of the larger system
  • Pharmacokinetic and toxic properties of antimicrobial agents

Rotation Schedule

A typical rotation schedule includes:

Term Rotation
2 months Clinical microbiology
4 months General infectious diseases service
3 months Hematology/oncology infectious diseases
12-17 months* Research
5 months Electives
3 months Transplant infectious diseases
4 months Intensive care unit infectious diseases
2 months Orthopedic infectious diseases
1 month Outpatient/infection control rotation

* Fellows may extend research time to 17 months by using their electives for research.

Rotation Descriptions

Clinical Microbiology
Midway through their first year, fellows spend two months studying basic clinical microbiology, gaining hands-on experience in:

  • Antimicrobial assay techniques
  • Antimicrobial susceptibility testing
  • Diagnostic serologic tests
  • General and anaerobic bacteriology, including blood culturing, antibiotic susceptibility testing, antibiotic assay methods and immunofluorescent diagnostic studies
  • Molecular biology techniques, including polymerase chain reaction and DNA probing
  • Performance of gram stains and other stain techniques on selected specimens
  • Setup of biological specimens for cultures
  • Techniques used in the virology, mycology, mycobacteriology and parasitology laboratories

Explore the services that the laboratory medicine and pathology staff (including microbiology) provides for both Mayo Clinic patients and MSGME-referred samples.

General Infectious Diseases Service

The general infectious diseases service provides consultation to all Mayo Clinic inpatient medical and surgical services.

Infectious diseases fellows gain experience in the diagnosis and management of:

  • Community acquired and nosocomial infection
  • Endocarditis
  • Surgical infections and other communicable infections
  • More unusual conditions or infections such as fever of unknown origin, parasitic infections and endemic mycoses

Electives

Infectious diseases fellows may spend elective time gaining additional research and clinical experiences in:

  • Infection control
  • International clinical rotations, such as Mayo's exchange program with Republic of the Philippines via the Mayo International Health program
  • Microbiology
  • Off-campus clinical rotations
  • Pediatric infectious diseases
  • Molecular biology

The six-week molecular biology techniques class is a didactic and hands-on laboratory training course structured to allow each student to perform a set of experiments in an up-to-date modern molecular techniques setting. The class is designed for individuals with little or no previous molecular biology experience. It provides an opportunity to learn techniques in a low pressure environment.

Transplant Infectious Diseases

Mayo Clinic specialists perform more than 1,100 transplants per year. Mayo's transplant program is the largest in the U.S. It ranks 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. Mayo's transplant infectious diseases service is an integral member of a multidisciplinary team caring for all solid organ and bone marrow transplant patients.

Infectious diseases fellows develop skills in evaluating the febrile transplant patient, treating and preventing opportunistic infections, and using various means for preventing infection in this patient population.

Intensive Care Unit Infectious Diseases
The intensive care unit service performs consultations for medical, surgical, neurological and other intensive care unit patients. Fellows gain experience diagnosing and managing nosocomial pneumonia, systemic inflammatory response syndrome, meningitis and other life-threatening infections.

A critical care fellow rotates with an infectious diseases fellow on the ICU infectious diseases service each month.

Hematology-Oncology Infectious Diseases
Fellows 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 and some medical services. Fellows learn to diagnose, treat and manage:

  • Diabetic foot infections
  • Osteomyelitis
  • Outpatient antimicrobial therapy
  • Prosthetic or other bone or joint infections
  • Skin and soft tissue infections

Outpatient/Infection Control Rotation

Fellows rotate for four weeks in the travel & tropical medicine clinic to learn about pre-travel management and post-travel evaluation in a traveler who returns ill. The tropical medicine experience may be supplemented with a rotation in Republic of the Philippines.

Fellows also receive infection control didactic and hands-on experience during these four weeks and are expected to complete the Infectious Diseases Society of America's online Infection Control Course during this time.

Continuity Clinic

During the three-year fellowship, trainees participate in regular continuity clinics in the ambulatory setting, including:

  • Regular outpatient infectious diseases consultations
  • Ongoing care of patients so that you can learn the natural history of infection
  • Infectious diseases consultations at the Federal Medical Center in Rochester, Minn.

HIV Clinic

Fellowship training includes extensive experience in the medical, psychological and social aspects of infection with HIV and AIDS. Fellows learn to work with a multidisciplinary team to manage the longitudinal changes of AIDS.

Didactic Training

A core curriculum, infectious diseases research conference, clinical conferences, seminars, journal clubs, and one-on-one instruction are all integral to Mayo Clinic's subspecialty infectious diseases fellowship. Fellows participate in:

  • Bimonthly journal club alternately focusing on AIDS and general infectious diseases topics with an emphasis on critical evaluation of recent literature
  • Monthly Infection and Immunity Research Club featuring renowned, invited speakers
  • Weekly clinical case conferences involving current inpatient and outpatient cases
  • Year-round core curriculum lecture series on infectious diseases and other topics, including ethics, managed care and medical informatics

Research Training

Fellows are encouraged to participate in research projects with Mayo consulting staff. Research opportunities at Mayo Clinic are diverse and outstanding and include opportunities for clinical studies and laboratory-based projects.

Fellows may 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 within or outside the division also offer opportunities for fellows who want to pursue basic science bench research.

Learn more about research within the division of infectious diseases at Mayo Clinic.

The section of clinical microbiology is active in broad areas of applied clinical research. Interest in basic research can be satisfied by collaborative efforts with basic sciences departments:

  • Cell biology
  • Experimental pathology
  • Immunology
  • Microbiology
  • Pharmacology
  • Vaccinology

Fellowship protocols are reviewed and approved by the division of infectious diseases research committee and the Mayo Clinic institutional review board. Fellows are encouraged to present research results at national or international infectious diseases meetings and publish them in peer-reviewed journals.

Current research programs in infectious diseases at Mayo Clinic include:

  • Clinical trials involving new antimicrobial agents
  • Epidemiology of prosthetic joint infections
  • Identification of genetic markers of drug resistance in Mycobacterium tuberculosis and other mycobacteria
  • Immunologic and pathogenic factors in viral infection
  • Interactions of HIV proteins with host-cellular proteins
  • Investigation of new or novel antimicrobial agents in vivo and in vitro
  • Molecular determinants of HIV disease progress or rates
  • Molecular identification and mechanisms of emerging bacterial resistance
  • Novel applications of molecular diagnostic and epidemiological techniques
  • Pathogenesis of viral persistence in human immunodeficiency virus infection
  • Pathogenesis of cytomegalovirus infection following solid organ transplantation

Learn more about research resources at Mayo Clinic.

Additional Training

Masters or Certificate in Clinical Research
Mayo Clinic offers a Masters or a Certificate of Knowledge in Clinical Research through Mayo Graduate School (MGS) for fellows interested in clinical research.

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.

The Masters program is only allowed during the infectious diseases fellowship on a limited basis.

Learn more about Mayo Clinic's clinical research training program.

Courses

The infectious diseases division pays for fellows to complete the Infectious Diseases Society of America's online Infection Control Course during training. It will also pay for you to attend one of the following courses:

Mentors or program advisors will help fellows who wish to enroll in any of these supplemental courses.

Call Frequency & Duty Hours

Call schedule and duty hours vary by individual rotation. Mayo Clinic follows recommendations of the ACGME. Off-hours call during the week is shared among fellows on inpatient services.

Only fellows on non-clinical rotations (first-, second- or third-year fellows on research or other non inpatient assignments) take weekend calls, which occur Saturday noon until Monday at 8AM).

This plan provides four continuous 24-hours off-call periods in every 4 week period for rest and restitution. Experienced second- or third-year fellows are most likely to be on call. Fellows are limited to no more than two weekends per month during non-clinical rotations.

Fellows on weekend call while on an inpatient clinical service (only in special circumstance and if approved by the program director) receive a complete day off on the Saturday following the previous call weekend.

All fellows on inpatient services work half-Saturdays.

Committee Assignments

Fellows have opportunities to gain experience in a number of administrative capacities. An appointment to one of the hospital infection control committees will helps fellows understand the basic principles of infection control, surveillance methods, isolation procedures and the investigation of outbreaks.

Appointment to the pharmacy and therapeutics committee will provide experience in processing and evaluating new antimicrobial and other drug reagents. Fellows also may be appointed to the education or research committee at the divisional level.

Evaluation

To ensure that fellows acquire adequate knowledge and develop your technical skills, performance is monitored carefully during the entire course of the fellowship. Fellows are formally evaluated by their supervising faculty member after each clinical rotation, according to the ACGME stated six competencies.

Fellows also regularly evaluate the faculty to ensure educational needs are being met. The infectious diseases fellowship program also undergoes an annual internal evaluation.

Career Development

Fellows meet periodically with various faculty members and the program director to discuss long-term goals.

Mayo Clinic recruits many of its staff physicians from its own training programs. Upon completion of the subspecialty infectious diseases fellowship, job opportunities may be available in one of Mayo's group practices.

Graduate Outcomes

The success of any training program is reflected in how its graduates fare after they begin their careers. In the last 10 years:

  • All graduates have successfully passed their certification examinations.
  • Approximately 50 percent are in private practice and 50 percent hold academic positions.
  • Recent graduates practice in 12 states and five foreign countries

Moonlighting

Licensed fellows beyond the PGY-1 level may moonlight. Moonlighting activities may only be scheduled during times when fellows 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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