Curriculum
Our clinical curriculum, based on the American Board of Internal Medicine’s (ABIM) Infectious Diseases certification exam blueprint is designed to augment hands-on supervised patient experiences in the management of general adult infectious diseases, transplant infectious diseases, HIV, viral hepatitis, microbiology, virology, surgical infections, hospital epidemiology, infection prevention, antibiotic stewardship, outpatient parenteral antimicrobial therapy, tropical and emerging infections, drug resistant organisms, infectious diseases epidemiology and public health and travel medicine with lectures and case reviews by faculty Educational objectives and expectations for each rotation are reinforced with attendings and fellows each rotation.
First Year – The first year of training is concentrated on core clinical rotations and an introduction to the laboratory and infection prevention. Approximately seven months are spent on the consultation service, 2 weeks in bone marrow transplant, 2 weeks in solid organ transplant, 4 weeks in infection prevention, 4 weeks in the microbiology laboratory, 2 weeks in the outpatient parenteral antibiotic therapy (OPAT) clinic, and 6 weeks 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 on-line training relevant to the conduct of clinical research. Fellows spend one half-day per week in the continuity HIV 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, four months conducting research and quality improvement projects and two months on the transplant service. Fellows continue to spend one half-day per week in their continuity HIV clinics. Other responsibilities of the 2nd year fellows include didactic teaching for the Internal Medicine Residents at core conferences. During the second year, each fellow is given ongoing mentoring and career development guidance, formal meetings with senior faculty regarding career development and implementation, and will continue to implement with completion of their quality improvement and research/scholarly activities with overall goal of presentation at professional conference and/or publication.
Inpatient ID Consultation Service: The fellows spend time at Mount Sinai Beth Israel (MSBI), Mount Sinai Morningside (MSM), and Mount Sinai West (MSW) each with its own unique history and diverse patient population. Mount Sinai Morningside (523 beds), formerly Mount Sinai Morningside, serves as the principal health care provider for the West Harlem and Morningside Heights communities and operates one of Manhattan’s few Level 1 trauma centers. Mount Sinai West (505 beds), formerly Mount Sinai Roosevelt, is a full-service community and tertiary-care hospital with an emergency department serving Midtown and the West Side of Manhattan, while Mount Sinai Beth Israel’s acute care teaching hospital is the Milton and Carroll Petrie Campus serving the lower Manhattan.
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 1st year (4 weeks) and 2nd year (8 weeks) fellows rotate 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 Solid Organ Transplant (SOT) ID services consult on patients after liver, kidney, heart, and small bowel transplant, while the BMT/Oncology ID service sees patients with malignancies including hematologic malignancies (for example, leukemia, lymphoma, myeloma, myelodysplastic syndrome), patients undergoing autologous and allogenic stem cell transplants, and solid oncology patients. 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 prevention procedures specific to the transplant setting.
Microbiology Rotation: The 1st year fellows spend one month 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. Throughout the year, fellows can attend virtually “Plate Rounds” every Wednesday from 9-10am.
Infection Prevention Rotation: The 1st year fellows spend one month on the Infection Prevention Rotation. The fellows participate in the routine activities of the infection prevention 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 course with certification from the Society for Healthcare Epidemiology of America (SHEA) and endorsed by the Infectious Diseases Society of America covering healthcare epidemiology, infection prevention, and antimicrobial stewardship is completed as well.
Antimicrobial Stewardship: The 2nd year fellows are expected to attend Antimicrobial Stewardship Meetings under the direction of both Dr. Valida Bajrovic and Dr. George McKinley at Mount Sinai Morningside and Mount Sinai West and Dr. Sanjana Koshy at Mount Sinai Beth Israel. The IDSA Antimicrobial Stewardship Curriculum for ID Fellows is completed at this time.
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 the Institute for Advance Medicine’s Morningside Clinic at Mount Sinai Morningside, Peter Krueger Clinic at Mount Sinai Beth Israel, and Samuels Clinic at Mount Sinai West. Under the direction of several dedicated HIV ID-trained faculty, each fellow has primary responsibility for the care of a panel of patients with HIV. 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: ID clinic is combined with the Fellow’s HIV continuity clinic. Patients in ID clinic are seen as follow-up to inpatient care, in addition to community referrals. The 2nd year ID fellows also will attend General ID Clinic for 2 weeks at Mount Sinai Union Square.
HIV Lecture Series (Monday 12-1pm): Fellows are encouraged to attend the twice monthly lectures sponsored by the Institute for Advanced Medicine and the New York State Department of Health AIDS Institute’s Clinical Education Initiative (CEI) geared toward the development of state of the art skills in HIV care and prevention.
Weekly Scholarly Day/Academic Half-Day (Tuesday afternoon)
Core Lecture Series: The faculty across each site presents an ongoing series of didactic lectures on core topics in Infectious Diseases based on the ABIM Infectious Diseases certification exam blueprint. These lectures encompass the wide range of topics and held in two blocks and offered through most of the year.
Fellows Case Conference: This is a weekly combined conference telecast across the Mount Sinai Health System at the Icahn School of Medicine at Mount Sinai. On a rotating basis, adult and pediatric infectious disease fellows throughout the Mount Sinai Health System present interesting cases from the consult services or ambulatory settings. The case presentations are complemented by a review of the relevant medical literature. Monthly divisional Quality Improvement (QI) conference is incorporated into the weekly case conference schedule.
Mandell Club: There is a once weekly series held as formal preparation for the ID Boards that is led by Dr. Stanley Yancovitz, Fellowship Site Director at Mount Sinai Beth Israel and recipient of a multitude of teaching awards including most recently the Institute for Medical Education at the Icahn School of Medicine at Mount Sinai’s Master Clinician Award in 2019. Dr. Yancovitz leads each weekly session with 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.
Journal Club (monthly, Wednesday: 5-6pm): 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 critical appraisal includes each fellow discussing the content of the article, including the study design, and the strengths and weaknesses of the study. Research concepts (study design, significant values, clinical and public health significance, etc.) are stressed in this forum.
Clinical Infectious Disease Conference: All fellows are expected to attend the weekly Clinical Infectious Disease Conferences which are held separately on weekly basis at Mount Sinai Morningside/Mount Sinai West (combined conference, Thursday: 8-9am). The fellows present most interesting and challenging cases seen on consult service followed by a discussion on management and existing literature. This is a relatively informal discussion of active cases designed primarily to expose the division at large to clinical cases and for the current inpatient teams to garner advice on active cases from the rest of the Faculty.