Infectious Diseases Fellowship FAQs

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Frequently Asked Questions for Fellows, by Fellows:

Can you tell me about the fellowship generally?
Since 1976 the Medical University of South Carolina (MUSC) Infectious Diseases Fellowship has trained fellows to become experts in adult infectious diseases. This extensive training encompasses a broad range of areas within the discipline including general ID, transplant ID, HIV, clinical microbiology, OPAT, antibiotic stewardship, hospital epidemiology, and infection control. There are also specialized opportunities within the fellowship for travel medicine, STI training, and PICC line insertion.

What are the program strengths and weaknesses?
The MUSC ID Fellowship offers excellent clinical training. As a regional referral hospital and highly ranked transplant center (the only transplant center in SC), MUSC exposes fellows to both common and less common pathology, including transplant and immunosuppressed populations, with a wide array of disease processes. South Carolina has a large HIV population and the infectious diseases division serves ~2000 HIV patients. Currently, there is less exposure to travel medicine than in the past, but fellows still receive this training in the VA clinic.

How many fellows does the program match each year?
Two-to-three fellows match each year.

What type of schedule can I expect?
The fellows’ schedule is divided into 13 separate 4-week blocks. Fellows will be on inpatient or outpatient, with accordingly different responsibilities. Blocks change every fourth Tuesday. Each fellow will have their own weekly continuity clinic on either Monday or Thursday morning. In addition, while on outpatient service, fellows are in VA clinic Wednesday morning and general fellows’ clinic on Friday mornings. Second year has more research time.

Inpatient consult services:

  • Either A, B, or C service; rotate with attending and usually one resident, one medical student, +/- ID pharmacist
  • A and B service fellows alternate weekend coverage of all three services
  • A service (Main University Hospital) – more general ID, bone & joint infections, STICU
  • B service (Ashley River Tower and VA) – general ID, liver/GI patients, malignant hematology
  • C service (Main and Ashley River Tower) – transplant only (lung, liver, heart, kidney, bone marrow transplant)

Outpatient rotations:

  • Blocks of research, microbiology, antimicrobial stewardship/infection control, other clinics
  • Staffed with various attendings
  • Weekly personal continuity clinic (Monday or Thursday a.m.)
  • VA clinic (Wednesday a.m.), covered by both outpatient fellows
  • Fellows’ clinic (Friday a.m.), alternating coverage by one outpatient fellow

What is the call schedule?
Call for ID fellows consists of being available to answer pages after hours (5 p.m. to 8 a.m.). This is taken from home and only under extenuating circumstances do fellows need to physically return to the hospital. Coverage for the week (Tuesday – Tuesday) is provided by the inpatient fellow during the week encompassing their weekend coverage.

How many facilities do fellows cover?
Three. MUSC Main Hospital, MUSC Ashley River Tower (ART), and the Ralph H. Johnson VA Medical Center. There are rarely consults at the Institute of Psychiatry (an inpatient psychiatry ward) covered by the B service. All are located within a 0.5 mile radius or less.

What does a regular day look like?
Inpatient days vary based on patient load. Usual fellow hours are 7a.m. to  5 p.m., but this also depends on workload. Fellows will attend whatever clinic/conference is scheduled and then proceed with rounds. Fellows pre-round as able prior to bedside rounds with attendings. This is attending-dependent, but usually starts between 9 and 10 a.m. with a lunch break. Teams will see new consults as they are called and generally stop seeing new consults after 3 p.m. unless more urgent.

What is a usual patient load for inpatient/outpatient?
Average patient loads are 15 (A service), 12 (B service), and 10 (C service), but vary and can be significantly busier.

Do fellows have teaching opportunities?
Yes. Fellows will generally have medical students/residents and sometimes pharmacy residents on service to teach. This is usually in an informal setting.

What didactics, lectures, and conferences do fellows attend?
Incoming fellows have a crash course lecture series on HIV, drug resistance, and general common ID consults over orientation and the first month. Other monthly or bi-monthly conferences include monthly ID Grand Rounds, HIV Collaborative Conference, various didactic lectures by attendings, Journal Club, and Case of the Week (COW). Fellows generally present Journal Club once yearly and COW bi-monthly while on inpatient service.

What research opportunities are available for fellows? Time?
There are numerous research opportunities available and attendings with a wide array of ongoing interests and projects to serve as mentors. Prior to your interview, you will be provided with more information about research opportunities with individual faculty members. First year fellows have ~3 blocks of dedicated research time and second year fellows have ~5.

What type of support staff is available to fellows?
Aside from our fellowship coordinator who organizes much of the behind-the-scenes operations, fellows have scheduling staff for clinics, outreach/social work, RNs/CNAs/MAs in clinic, and a close relationship with ID and HIV pharmacists.

How do fellows give and receive feedback?
Fellows are regularly evaluated electronically following rotations and bi-annually in person with their program director. Fellows submit evaluations of their peers, rotations, and attendings regularly as well.

What board review materials are available to fellows?
Traditionally, fellows have attended the George Washington ID Board Review Course during the first half of their second year. The cost is covered by the fellowship program.

Where and in what capacity do most fellows end up practicing after training?
Fellows have sought employment in a number of practice types and locations. This includes private, academic, public health, and industrial roles, generally located in the southeast U.S.

Are there opportunities to moonlight?
Yes. Fellows with appropriate licensing are eligible to moonlight in so far as it does not violate duty hours or fellowship obligations.

How has the ID division responded during the COVID-19 pandemic?
The MUSC ID Division has been integral in the MUSC and state of South Carolina response to COVID-19. Numerous aspects of this response are still in motion and there are ongoing efforts to continue to learn from and combat this pandemic. Operationally, the ID division has expanded its telehealth capacity and is conducting regular less-complicated office visits virtually. For select patients there are still face-to-face visits, but there are continued efforts to maintain this virtual coverage to hopefully reach expanded populations in the state.