The program is designed to train fellows for careers in academic medicine. Therefore, there is a major emphasis on both clinical and scholarly activities.

Clinical Effort

Fellows spend a total of 12 months on the clinical service during a three year training period. The majority of the clinical time is spent at the main teaching hospital, The Lucile Packard Children’s Hospital at Stanford (LPCH), which currently has 302 beds and will add 150 additional beds in 2017. LPCH is at the core of the larger Stanford Children’s Health that together form the largest network of care for children and pregnant woman in Northern California. This extensive clinical program includes 94 specialties, 6 centers of excellence, a busy obstetrics program for high risk pregnancies, and is home to the #1 ranked Pediatric transplant program for volume with top patient outcomes. The large intensive care units along with high volume surgical programs add to the robust patient exposure that the fellow will encounter during their clinical rotations.

Clinical experiences are enhanced through the expanding ambulatory experiences available to the fellow. While on service, the fellow will attend one clinic embedded in the service week, as well as following a panel of continuity patients. The continuity of care is an important part of the fellow’s clinical skills development and provides long term follow-up experiences, including children with chronic illnesses such as HIV, and short term follow-up including hospital discharges and other patient populations such as TB patients. In addition, there is a strong collaboration with the transplant programs, and fellows are exposed to pre-transplant screening for exposures and vaccines, as well as the full array of infectious complications in the large population of transplant recipients followed at LPCH. Fellows also will be involved with pre-travel recommendations and any post-travel illnesses. Further, to expand ambulatory experiences, the fellow will have 12 days over the three years to explore other clinics, such as Adult HIV, larger Pediatric HIV clinic, the county TB clinic, travel clinic, immunology clinic, and STD clinics. The fellow will choose which clinics to visit.

The fellow is expected to lead the clinical service with direct supervision from the faculty member on service. Therefore, the fellow takes an active role in the care of all patients, runs rounds, and coordinates all other learners and team members rotating on the clinical team. The clinical team often includes medical students, pediatric residents and pharmacists. The fellow is expected to be the main contact communicating to referring physicians within LPCH and the broader community, and to work with the clinical nurse specialist and dedicated medical assistant on any patient-related issues.

Other Clinical Areas: Fellows are fortunate to benefit from the broad range of clinical programs that reflect growth areas in Pediatric Infectious Diseases. Our Division has robust programs in Transplant Infectious Diseases, Antibiotic Stewardship, Infection Prevention and Control, Hospital Epidemiology and Quality Outcomes, and Global Health. The fellows are exposed to all these programs, and may become more involved if interested.

Teaching Opportunities

While on the clinical service, fellows participate in teaching activities aimed at the other learners on the team and the general pediatric residents who are consultants. More formal teaching opportunities include running fellow-driven board review sessions, participating in journal clubs, presenting at clinical conferences, and doing didactics for the pediatric residents and the Pediatric Infectious Diseases Division.

Scholarship

Each fellow is expected to plan and carry out a personalized scholarly project in a research area including clinical, translational, or basic science research. The vision for the fellows’ project is to prepare the fellow for the next phase in their career, including applying for mentored grant funding, such as NIH K series grants, or pursuing clinical trials, or other research opportunities.

The process begins in the first year with identifying a project that aligns with the fellow’s interests, followed by developing a proposal to be analyzed during a one-week intensive course in clinical research (ICCR) in the fall of the first year. The fellow, with support from the identified research mentor and a research committee, will apply for grants during the first year. Securing funding is not a requirement for fellowship training; however the process serves as an important educational experience and, if successful, would benefit the fellow and the division.

Once the fellow has identified a scholarly project, the majority of Years 2 and 3 of fellowship will be devoted to the project. The progress of the fellow is monitored by their research mentor, the program director and a scholarly oversight committee (SOC), a three member committee including the research mentor, an external research mentor and a career mentor. The SOC will meet biannually during the two scholarship years to review the fellow's project and make recommendations. The fellow is encouraged to submit their work to national meetings and will be required to submit a scholarly work product at the end of fellowship, with the ultimate goal of a first author manuscript. There is curriculum that is required as part of the scholarly training and this is taught during the ICCR course as well as through a departmental program for all pediatric fellows. In addition, fellows many audit any classes at the University or Medical Center.