Infectious Disease Fellowship Scholar Track

The Immunocompromised Host/Transplant Infectious Diseases Service at Beth Israel Deaconess Medical Center provides world-class care to hospitalized and non-hospitalized patients with a broad range of infectious diseases issues related to immunosuppression. The program conducts active basic science investigations, clinical research, and clinical trials:

• Carolyn Alonso's research focuses on the epidemiology and outcomes of C. difficile infection among transplanted patients with the ultimate goal of developing novel preventative and curative therapies for C.difficile.
• Sabrina Tan's laboratory investigates the immune response to BK virus in renal transplant patients and novel therapies for treatment of BK virus.
• Barbra McDonagh Blair is a master clinician-educator and leader in medical education at BIDMC, serving as Firm Chief of the Kurland Firm for the Department of Medicine Residency Program; her work focuses on curricular innovation and improvement in Transplant ID and Microbiology.

About Our Immunocompromised Host/Transplant ID Training Track

During year two of fellowship, fellows interested in pursuing this focused ID Transplant training will:

1. Engage in continued intensive inpatient and ambulatory Transplant ID consultation to expand experience:

• Inpatient Transplant ID consults (12 week minimum)
  • 4 additional weeks BIDMC ICH ID consult team
  • 4 weeks additional off-site* HSCT ID consult rotation to expand experience and practice
  • 4 weeks off-site* SOT ID consult rotation with a focus on heart, lung transplant experience (BIDMC performs kidney, liver, pancreas SOT on-site)
  • *Off-site opportunities are arranged based on fellow interest and rotation/faculty availability at collaborating sites, either within the Harvard affiliated hospitals and/or at appropriate academic centers outside of Boston with active Transplant ID Fellowships or structured rotations
• Transplant Clinic (1 half day per week in addition to 1 half day per week ID continuity clinic)
  • Every other week SOT clinic, Lowry Building - 7th Floor, mentored by Dr. Blair
  • Every other week BMT clinic on Wednesday afternoons, Shapiro 7, mentored by Dr. Alonso
  • Multidisciplinary Team rounds – weekly Friday afternoon patient care rounds involving BMT, Hematology faculty, Advanced Practitioners, Transplant ID Faculty and Transplant ID Track Fellow

2. Research (scholarly project will be required with plan to produce at least one abstract for presentation at national meeting/manuscript for publication) – options for scholarly work dependent on fellow interest:

• Clinical research project – in association with BIDMC ID Transplant or external faculty mentor
• Medical education project – curriculum development within Transplant ID
• Assistance with review and updates to Transplant ID BIDMC Standard Operating Procedures (SOPs)
• Review articles and case reports

During the second year, fellows interested in developing an expertise in microbiology can complete a one-year Committee on Postgraduate Educational Programs (CPEP)-approved fellowship by working in the microbiology lab under the supervision of Drs. James Kirby, Stefan Riedel and Ramy Arnaout.

• The goal of the program is to train fellows to assume leadership roles in academic, tertiary care, and public health microbiology laboratories through hands-on instruction in:
  • Microbiological methods
  • The consultative and administrative activities of the microbiology laboratory
  • The activities of the infectious diseases, pharmacy, and infection control/hospital epidemiology departments.
• Fellows will also rotate at Children's Hospital Boston and the Massachusetts State Laboratory to gain a comprehensive education experience that includes adult, pediatric and public health microbiology.
• For fellows who desire additional training beyond this, and want to qualify to sit for board certification in medical and public health microbiology, they can continue their medical microbiology training for a second year, after which may take the American Board of Medical Microbiology (ABMM) credentialing exam. Additional sources of funding would be needed for fellows wishing to pursue a second year of microbiology training.
• During training fellows will participate in scholarly projects related to infectious disease diagnostics.

Fellows interested in developing expertise in HPV and high resolution anoscopy (HRA) for diagnosis and management of anal dysplasia during year two of fellowship will work under the mentorship of Dr. Ami Multani at Fenway Community Health Center to develop the clinical skills needed to evaluate patients at risk for significant disease due to anogenital HPV infection, and obtain training to perform HRA in the clinical setting. Fellows will engage in hands on clinical/procedural training an average of 1-2 sessions/week (5-6 sessions per month for 10 months).

During year 2, fellows will:

• Attend the American Society for Colposcopy and Cervical Pathology (ASCCP) Course
  • 4-day course with colposcopy and HRA training, typically in late July
• Engage in HRA hands on clinical/procedural training (September–June)
  • 1-2 clinic sessions/week with Dr. Multani and possibly other certified HRA providers as schedules allow
• Goal is for trainee to graduate with competence in HRA diagnostic and treatment interventions so they can become an independent HRA provider and explore this as a potential clinical ID career avenue, with the objective to become certified with the AIDS Malignancy Consortium (AMC)
• Develop and conduct a research or QI project focused on HPV or anal dysplasia and present findings at a national conference or publish findings in a peer-reviewed journal
• Present at fellow/faculty teaching conferences both BIDMC and Fenway Community Health

Fellows interested in developing careers in medical education leadership will work under the mentorship of Dr. Wendy Stead. This track is designed for those interested in clinician-educator academic career paths, so fellows will also identify an area of clinical focus in ID to be further developed by specialty clinic experiences during year two of fellowship. Fellows in this track will apply to the Department of Medicine's BIDMC Clinician Educator Track and, if accepted, will take part in the longitudinal medical education curriculum, in addition to completing a mentored medical education research project, during year two. Outline of track structure below:

Clinical Activities

• 2-3 clinics per week
  • ID continuity clinic
  • Specialty clinics to be determined based on fellow's clinical interest (examples include HIV, hepatitis, HPV/HRA, TB, Transplant, Refugee Health, Travel)
  • At least 2 of these weeks as "supervising" fellow (junior fellows present cases to supervising fellow for teaching/guidance under the supervision of service attending)
• 5-6 weeks of ID inpatient consult service time
• Medical education fellow will be expected to provide advanced level teaching to junior fellows and will receive formal feedback by supervising attending.

Medical Education Scholarly Activities

• Apply to BIDMC Department of Medicine Clinician Educator Track (CET) for Fellows
• Develop and conduct a focused medical education project in a designated area of interest with plans to disseminate findings at a national meeting and/or in a peer-reviewed journal
• Examples of recent projects completed by ID medical education track fellows:
  • A curriculum to reduce unnecessary use of antibiotics for asymptomatic bacteriuria in ICU patients (Matthew Lee MD, 2019 graduate)
  • Putting Out Fires: Assessing Burnout and Teaching Resilience in ID Fellowship (Leslie Alexander MD, 2019 graduate)
  • A Meeting of the Minds Over Matters of the Heart: Using Interdisciplinary Education to Build Consensus in Managing Cardiac Implantable Electronic Device (CIED) Infections (Ahmed Abdul Azim, 2019 graduate)
  • A workshop to improve communication and reduce stigma and implicit bias in the care of patients with opioid use disorder (Colleen Kershaw MD, 2018 graduate)
  • An opioid overdose curriculum for medical residents: Impact on naloxone prescribing, knowledge, and attitudes – Taylor JL, Rapoport AB, Rowley CF, Mukamal KJ, Stead W. Subst Abus. 2018;39(3):371-376. doi:10.1080/08897077.2018.1439800. Epub 2018 May. (Alison Rapoport, MD, 2017 graduate)
  • Survey and needs assessment of resident expectations for elective subspecialty rotations at BIDMC followed by development of web-based core curriculum for medical students and residents rotating on the ID consult service – Int J Med Educ. 2016 Apr 10;7:115-8. doi: 10.5116/ijme.56f5.c7ec.; IDModules.com (Andy Hale MD, 2017 graduate)
• Develop and lead lectures for ID clinical conferences with post-lecture formal feedback on teaching skills
• Participate in medical student teaching opportunities (patient-doctor courses, participation in preclinical ID curriculum at Harvard Medical School)
• Become a member of the BIDMC Academy of Medical Educators and participate regularly in medical education symposia and lectures

Fellows interested in building careers in Quality and Safety and Infectious Diseases will work under the mentorship of Dr. Mary LaSalvia during year two of fellowship. The goal of this track is to launch careers in QI leadership and/or QI research in Infectious Diseases. Fellow will:

• Attend QI Symposium for Fellows during first year of fellowship
• Represent ID fellowship on Housestaff QI Committee and ID Division Clinical Practice/QI Committee
• Consider applying to Harvard Medical School Master of Healthcare Quality and Safety based on funding availability
• Develop and conduct a QI research project with plans to disseminate at a national meeting and/or in a peer-reviewed journal

Fellows interested in building careers at the intersection of Infectious Diseases and Addiction Medicine will work under the mentorship of Dr. Christopher Rowley during year two of fellowship. The goal of this track is to launch careers in research and/or clinical care of patients with substance use disorders and infectious comorbidities and complications. Fellows will:

• Attend Fellow Immersion Training in Addiction Medicine course in Spring of first year
• Complete training for buprenorphine waiver through BIDMC program lead by Dr. Rowley
• Develop and conduct a clinical or medical education research project exploring the complex interactions between substance use disorders and infection with plans to disseminate at a national meeting and/or in a peer-reviewed journal

Fellows interested in building careers in Antimicrobial Stewardship can explore two or three-year training pathways. Learn more about training opportunities for Antimicrobial Stewardship here.

Fellows interested in building careers in Infection Control/Hospital Epidemiology can explore two or three-year training pathways. Learn more about training opportunities for Infection Control here.

The enormous impacts of climate change on human health are increasingly recognized in the medical community. Exploring and understanding the relationships between climate change and infectious diseases will be critical to preparing future ID clinicians, scientists, educators and epidemiologists to address the escalating impacts of climate change on the patients and populations we care for.

The goal of this track is to provide innovative, world-class training for fellows hoping to develop careers at the intersection of infectious diseases and climate change and to train future physician leaders to pursue careers in research, advocacy and policy making to address the impact of climate change on infectious diseases.

Fellows will work with a multidisciplinary mentorship team including mentors from the ID Division along with mentors from the BIDMC Climate and Human Health Fellowship, Drs. Caleb Dresser and Satchit Balsari, and throughout the greater Harvard community depending on the fellow’s particular area of interest. The Fellowship is designed to allow access to and mentorship from an interdisciplinary team of faculty from medicine, public health, law, government, business, engineering and the climate sciences. The Fellowship is co-hosted with C-Change (Harvard’s Center for Climate, Health and the Global Environment) and the Harvard FXB Center for Health and Human Rights.

Fellows in the Climate Change and ID Track will:

1. Attend a climate-related conference during year one and meet frequently with mentorship team for research and career planning. Relevant conferences may include regional, national, or international Infectious Disease conferences, as well as: the Medical Society Consortium on Climate & Health Annual Meeting, CleanMed healthcare sustainability conference, annual Clinical Climate Change Conference hosted at Mount Sinai, UN COP,  APHA annual meeting, as well as the AMS (American Meteorological Society) and AGU (American Geophysical Union) conferences, which have had sub-focus areas on human impacts of climate change in recent years.

2. Develop and conduct a climate related research project within an ID specific content area during year two with support and guidance from the mentorship team.

3. Attend climate change didactics, journal clubs, media trainings, communications workshops, and advocacy workshops offered by the BIDMC Climate Change & Human Health Fellowship.

4. Participate in the academic life of the collaborating Centers hosting the Fellowship.

5. Consider applying for the HSPH Program in Clinical Effectiveness (PCE) to learn rigorous clinical research methods, depending on previous training and research plans.

Fellows may continue training in this track for a third year of fellowship depending on fellow research and career interests and funding availability. This additional year may include additional research opportunities, medical education opportunities, and/or externships with outside agencies or organizations.