First Year – The first year of training is concentrated on core clinical rotations and an introduction to the laboratory and infection prevention. Approximately eight months are spent on the consultation service, one month in the microbiology laboratory, one month in infection prevention, and a half a month dedicated in planning and exploring opportunities for research project suited to each fellow’s career path, with the guidance of senior research faculty and each Fellow’s chosen research mentor(s). Fellows also complete several on-line training relevant to the conduct of clinical research. Fellows spend one half-day per week in the continuity HIV clinic. While rotating at Mount Sinai Beth Israel, Fellows participate in the General Infectious Disease clinic. During the first year, each fellow is given both ongoing mentoring and career development guidance, and will have formal meetings with senior faculty regarding career development and planning their Quality Improvement and research/scholarly activities.
Second Year – During the second year, the emphasis is on building each Fellow’s clinical growth and focus and on conducting their respective research and quality improvement projects, in conjunction with each Fellow’s chosen mentors. Approximately five months are spent on the inpatient consult service, five months conducting research and quality improvement projects and one or two months on the transplant service. Fellows continue to spend one half-day per week in their continuity clinics. Other responsibilities of the second year fellows include didactic teaching for the medicine residents at core conferences. During the second year, each fellow is given ongoing mentoring and career development guidance, and will have formal meetings with senior faculty regarding career development and implementation, conduction and completion of their quality Improvement and research/scholarly activities.
Inpatient ID Consultation Service: The fellows spend approximately equal amounts of time at Mount Sinai West (MSW), Mount Sinai St. Luke’s (MSSL) and Mount Sinai Beth Israel Hospitals (MSBI). There is a diverse patient population at each site, including patients who are immunocompromised, critically ill, and/or have wide range of postoperative complications, including device related infections. During these rotations, fellows work with Infectious Diseases faculty and clinical pharmacy to provide recommendations on antibiotic use via the antibiotic stewardship program.
Transplant Rotation: The 2nd year fellows spend one to two months at the Mount Sinai Hospital in order to gain a more in-depth experience in transplant infectious diseases. The aim of the rotation is to develop skills in the diagnosis and management of infectious diseases specific to patients who have undergone organ transplantation, both solid organ and bone marrow transplantation. The fellows learn the differential infectious diseases diagnoses associated with various types of transplants and learn methods for prevention and treatment of such infections. In addition, the fellows develop sophisticated skills in the use of the diagnostic microbiology laboratory in the setting of transplantation and infection control procedures specific to the transplant setting.
Microbiology Rotation: The 1st year fellows spend 4-6 weeks at Mount Sinai Hospital Microbiology lab. The fellows receive training in diagnostic clinical microbiology and virology, with an emphasis on susceptibility testing and its interpretation, and the detection of antimicrobial resistance. Particular attention is given to the various methods of identification of the bacteria, fungi and viruses, serological tests for infectious agents and identification of parasites from clinical material. Emphasis is placed on methods for the rapid pathogen identification of pathogens, and advanced molecular diagnostic techniques.
Infection Prevention Rotation: The first year fellows spend one month on the Infection Prevention Rotation. The fellows participate in the routine activities of the infection control practitioners including infection surveillance, patient isolation, and outbreak investigation. They also actively engage in participate in special projects carried out by the Infection Prevention team. An online training from the Society for Healthcare Epidemiology of America and endorsed by the Infectious Diseases Society of America is completed as well.
Research and Quality Improvement Activities and Rotations: During the first year, fellows are exposed to the breadth and range of active projects in the Division and potential research, quality improvement and other scholarly activities. Fellows are given basic formal research education and will complete several on-line research trainings. During the first year, fellows (in conjunction with senior faculty) will crystalize individual goals for their own scholarly activity and will formulate plans for conducting there during their second year. During the second year, fellows will work with their chosen mentors in pursuit of their individual scholarly goals, and will review progress with their chosen mentors and senior faculty. The program encourages all fellows to complete one or more scholarly endeavors which can be presented at internal, local or national meetings and yield one or more abstract presentations or papers. Importantly, the program is highly skilled in helping trainees choose and complete projects whose focus, type, and scope fit with each individual fellow’s career goals.
HIV/AIDS Clinic: Each fellow spends one half-day session per week in the continuity HIV clinic. Continuity fellow clinics are based at Morningside clinic at MSSL and Peter Krueger clinic at MSBI. Under the direction of several dedicated HIV ID-trained faculty, each fellow has primary responsibility for the care of a panel of HIV-infected patients. The principles of managing antiretroviral therapy and the prophylaxis and treatment of opportunistic infections are stressed, along with the diagnosis and management of key HIV related comorbidities, including the treatment of viral hepatitis.
General Infectious Disease Clinic: For the fellows assigned to Morningside clinic the ID clinic is combined with the HIV continuity clinic.Fellows assigned to MSBI clinic rotate through a separate ID clinic located on the campus. Patients in ID clinic are mostly seen as follow-up to inpatient care, in addition to community referrals. Patients on home IV antibiotic therapy are followed in this clinic. This clinic provides the opportunity for fellows to participate in the management of infectious diseases from diagnosis through to completion of treatment.
Sexually Transmitted Infections (STI) Clinic with the New York Department of Health (two days of clinic per week) rotation is designed for second year fellows to be exposed to the diagnosis and management of sexually transmitted diseases
Clinical Infectious Disease Conference: All fellows are expected to attend the weekly Clinical Infectious Disease Conferences which are held separately on weekly basis at MSW/MSSL and MSBI. The fellows attend the case conference at their respective rotation site. The fellows present most interesting and challenging cases seen on consult service followed by a discussion on management and existing literature.
Journal Club: Journal Club is a monthly combined conference telecast across the ID training sites at Mount Sinai Health System at the Icahn School of Medicine at Mount Sinai. Each month, the conference is led by a fellow and faculty member from one of the ID fellowships of the Icahn School of Medicine at Mount Sinai. All fellows attend and all faculty are invited to attend this conference. On a rotating basis, one fellow from each program is responsible for picking 1-2 appropriate articles which are critically analyzed. The fellow discusses the content of the article, including the study design, and then analyzes the strengths and weaknesses of the study. Research concepts (study design, significant values, clinical and public health significance, etc.) are stressed in this forum.
Core Lecture Series: The faculty across each site presents an ongoing series of didactic lectures on core topics in Infectious Diseases. These lectures encompass the wide range of topics and held in two blocks and offered through most of the year
HIV Lecture Series: Fellows are encouraged to attend the twice monthly lectures sponsored by the Institute for Advanced Medicine geared toward the development of state of the art skills in HIV care and prevention.
Mandell Club: There is a once weekly series held as formal preparation for the ID Boards. One of fellowship program directors leads weekly sessions in which fellows rotate each week in leading a group review of a chapter or section in a standard ID text, as formalized substantial preparation for the Board examination. The session is telecast across sites so all fellows can attend and participate.