Didactic Component
There are five major venues in which the structured curriculum is presented to the subspecialty residents in pediatric infectious diseases. In most instances, each program element may be represented in more than one venue.
The first venue is formal lectures provided by pediatric infectious diseases faculty, adult infectious diseases faculty, other Stanford University faculty, and visiting faculty. Specifically, the Wednesday clinical conferences are structured so that one conference every other month is scheduled as a faculty didactic session. Mandatory Tuesday morning subspecialty teaching conferences are geared specifically to faculty lectures directed at both adult and infectious diseases clinical, epidemiologic and diagnostic topics. In addition, the program director posts ongoing lectures given by the pediatric infectious diseases faculty so that subspecialty residents may attend. Pediatric/adult infectious diseases grand rounds will also included faculty lectures. Monthly, there is an Ethical Morning Report for general pediatric and subspecialty residents. The Head of the Ethics Committee leads this case-based discussion, which frequently include children with infectious diseases. Attendance is monitored with a sign-in sheet. There is one Grand Rounds per year addressing Medical Ethics. There is also a Monthly Mortality Case Review for general and subspecialty residents and faculty in which quality of care issues are discussed and reviewed. Finally, subspecialty residents attend the PRECEPT course, which is a medical school year-round course for postdoctoral fellows and which addresses topics such as introduction to biostatistics, clinical trials, ethical issues in clinical research, manuscript preparation and grant writing. Through this venue, subspecialty residents will be exposed to (a) the appropriate use of antimicrobial agents in a variety of clinical settings, their mechanisms of action and their potential adverse reactions, (b) diagnosing and managing microbiological and immunologic factors that determine the outcome of the interaction between host and microbe, (c) the effects of underlying disease states and immunosuppressive therapies on host response to infectious agents, (d) mechanisms of enhancement of resistance by active or passive immunization and immunomodulating agents, (e) pharmacologic mechanisms that affect absorption, metabolism, excretion, and interaction of antimicrobial agents, (f) methods of determining activity of antimicrobial agents and techniques to determine their concentrations in blood and other body fluids, (g) indications for procedures for specimen collection relevant to infectious diseases, (h) culture techniques for and/or methods of identification in tissues and fluids of bacteria, mycobacteria, fungi, viruses, rickettsiae, chlamydiae, and parasites, (i) the sensitivity, specificity, efficacy, benefits, and risks of contemporary technologies, (j) the principles and practice of hospital epidemiology and infection control, (k) quality improvement, clinical outcomes analysis and cost containment in the clinical practice of infectious diseases, (l) understanding of adverse events attributed to specific immunizations and immunomodulators, (m) ethical and medicolegal issues pertinent to pediatric infectious disease, (n) recognition of social and emotional issues pertinent to pediatric infectious diseases.
The second venue for program elements is clinical rounds which cover all of the topics a-n outlined above. During clinical rounds, all aspects of the patients followed by the clinical service are reviewed, and in the course of the subspecialty resident’s training, each will have had informal discussions and literature review of all of these areas.
The third venue for program elements is laboratory rounds which occur several times weekly at the Stanford University Hospital laboratories, and which include teaching by Pathology, Microbiology and Virology faculty. This venue includes topics a,d,f,g,h, and k.
The fourth venue for program elements is the one month microbiology rotation offered at the Stanford University Hospital laboratories. This is similar to the clinical laboratory rounds but is an intensive, daily course for subspecialty residents. This venue also includes topics a,d,f,g,h, and k.
The fifth and final venue for program elements includes formal courses at the medical school which are available to all subspecialty residents. These courses will address all topics a-o.
Inpatient Experiences
- The Pediatric Infectious Disease residents are supervised directly by the attending physician.
- The Pediatric Infectious Disease residents participate in daily rounds with the faculty from three to five hours during weekdays and generally 1 to 2 hours on weekends.
Outpatient Experiences
- The Pediatric Infectious Disease residents provide all initial patient care for outpatients, followed by review and examination by the attending physician.
- The Pediatric Infectious Disease residents provide all followup of outpatient and inpatient laboratory results and pending consultations from other services with supervision by the attending physician. In most cases, the resident provides immediate telephone feedback to the referring physician. The subspecialty residents are also assigned continuity HIV patients for whom they are responsible, with supervision by the infectious diseases attending, throughout any outpatient interactions. If their patient is hospitalized, however, the subspecialty resident and attending on call are the primary care providers.
- The Pediatric Infectious Disease residents are directly supervised by the attending physician. They also receive staff support from three pediatric infectious disease clinical research nurses and a social worker.
- If the Pediatric Infectious Disease resident is on service when the inpatient returns to clinic, the resident will provide the clinical followup. Otherwise, all residents participate in the weekly Pediatric Infectious Disease clinical conference during which all current and pending activity on outpatients and inpatients is discussed.
The Pediatric Infectious Disease residents participate in presentations and meetings within the Department and at national and international infectious diseases meetings.
