During the first year of the program the majority of the fellows' time is spent in performing consultations, under the supervision of a faculty member, on hospitalized pediatric patients with infectious diseases.
In addition to the infectious problems of the normal host, infections in immunocompromised hosts and in surgical patients form a substantial part of this clinical experience.
The Infectious Diseases Consultative Service typically is actively involved in the management of 15-25 patients at any one time. The service is divided into the General ID and Immunocompromised Host teams, and fellows rotate on both teams over the course of the year. Although they receive most of their clinical training at Boston Children's Hospital, fellows rotate through the Adult Infectious Diseases service of Beth Israel Deaconess Medical Center and the Pediatric Infectious Diseases service at Boston Medical Center. During the first year fellows take night call from home and weekend call approximately every third or fourth week.
Fellows also receive clinical training in the outpatient setting. At the beginning of the fellowship, each fellow takes on the longitudinal care, under the supervision of an HIV specialist, of 8-10 HIV-infected children in the outpatient setting. This experience continues through the first two years of the fellowship.
In addition to the clinical training, first year fellows receive formal training in clinical microbiology and virology. During the first year, several blocks are set aside for research planning for the second and third years of the fellowship.
Conferences in which the fellows participate include:
- weekly divisional case management conference
- weekly Harvard-wide combined infectious disease conference
- weekly immunocompromised host infectious disease conference
- weekly Journal Club
Medical students and residents are regular participants in the Infectious Diseases Service so there is ample opportunity for teaching by the fellows.
Clinical responsibilities during the second year typically include occasional night (home) and weekend call, as well as ongoing participation in HIV clinic. Second and Third year fellows participate in the weekly General Infectious Diseases clinic, where children with difficult infectious disease problems are referred from the community for evaluation and management.
Third year fellows rotate for one block each (total one month) on both the General ID and Immunocompromised Hosts inpatient services. In addition, third year fellows participate in the weekly General Infectious Diseases clinic and take occasional night (home) and weekend call