Training requirements for the ABIM subspecialty board in Infectious Diseases include 2 years in an approved program with one year devoted to clinical care and 24 months of a continuity outpatient clinic. The Hopkins Fellowship Program is designed to satisfy current requirements with training in clinical or bench research.
Year I - Clinical
The first clinical year of the JHU School of Medicine ID Fellowship Program includes a 3-day Infection Control Course and a microbiology course. The rest of the first year is spent with 1-3 months on each of 8 rotations:
- The ID Consult team at Johns Hopkins Hospital: There are ~120 consults/month and a team consisting of 2 fellows, 1-2 medical residents, 1-3 students and an attending. This service includes additional microbiology training and didactic lectures.
- The Johns Hopkins Bayview Medical Center (JHBMC) ID Consult Service: Consultations on this service are comparable to many ID training programs at primary care centers. The consult team includes the fellow, an attending and an occasional student or resident who sees 60 consults/month. During their rotation, fellows get experience managing ID issues related to burn injuries and skin wounds. This rotation is the only training activity outside Johns Hopkins Hospital and has been retained in the program because fellows continue to give it high praise.
- The AIDS Service: Our division runs the Johns Hopkins AIDS Care Program which includes a large outpatient HIV/AIDS clinic (approximately 3100 patients) and a 20 bed HIV/AIDS ward. The fellow assigned to this rotation serves as a senior medical resource for four medical residents and 2 sub-interns (some months) assigned to the service. This service has been identified as one of the most popular rotations in the Department of Medicine by residents and the most popular rotation by ID fellows.
- The Transplant Infectious Diseases Consult Service: This Service sees solid organ transplant patients and leukemia and bone marrow transplant patients with ID issues. There are 40-50 consults/month and a team consisting of a fellow and an attending with an expertise in transplant ID.
- Microbiology Rotation: Each fellow spends 2-4 weeks in the microbiology lab. The fellow rounds with the director of the lab who is also ID trained and participates in the workup of specimens.
- Sexually Transmitted Diseases Clinic/Tuberculosis Clinic, Hepatitis C Clinic, Infection Control Service, Other Electives: Fellows are able to participate in the teaching and clinical experiences of the STD, and TB Clinics of the City of Baltimore, the Hepatitis C Clinic of The Johns Hopkins Hospital and/or the Infection Control Service of the Johns Hopkins Hospital under the supervision of ID faculty. Formal instruction in STDs and management of TB are incorporated into these rotations. Other possible electives include pediatric infectious diseases, course work, travel medicine clinic, or bench laboratory work. Fellows often use this time to initiate a bench project, epidemiological study or clinical trial and/or to help determine their research project for years two and three of their ID Fellowship.
- ID Continuity Clinic: First year fellows participate in 12 months of ID clinic either at Greenspring Station with Dr. Paul Auwaerter or at Bayview Medical Center with Dr. Jonathan Zenilman.
- HIV Continuity Clinic: The 12-month continuity clinic is fulfilled in the HIV Clinic of the Division's AIDS Service during the second year of fellowship
Years II & III - Research
The second and third years are usually devoted to a project under the direct supervision of a faculty member that is selected by the fellow and approved by the Fellowship Program Committee. The purpose of this training is to develop clinical or bench research skills for an anticipated career in academic medicine.
Three facets of research training are somewhat unique in this program compared to others:
- We do not require that the fellows define their area of research prior to coming to Hopkins; indeed, most of our fellows make these decisions after they get here and learn the various options available. However, applicants who have clearly defined research goals should inform us of their interests at the time of their interview.
- We do not require that the fellows find funding for their salary support unless they stay beyond the 3-year contractual period. However, fellows are required to submit one training level grant guided by their mentor (e.g. National Research Award or NRSA) to begin to develop skills in grant writing and to facilitate their research project development.
- Fellows may consider doing research projects in other departments of the School of Medicine and in the School of Hygiene and Public Health, thus taking advantage of the full range of training experiences offered at Johns Hopkins Medical Institutions. Most often the fellow's primary mentor is a faculty member of the Infectious Diseases Division or the Department of Molecular Microbiology and Immunology in the School of Hygiene and Public Health. However, given the depth of the resources of the Johns Hopkins Medical Institutions, fellows are encouraged to seek "secondary mentors" as necessary to achieve their chosen research and academic goals. Course work either in the epidemiologic or basic sciences is encouraged for all Fellows. Multiple opportunities for formal course work are available to Fellows through the School of Medicine and/or the School of Public Health.
Our experience indicates that some highly qualified fellowship candidates have specialized interests that are best served in what might be called specialized programs. The major special programs are:
- Training for clinical practice: The vast majority of our fellows receive extensive training in basic or epidemiologic sciences in preparation for a career in academic medicine with skills in both clinical care and bench or epidemiologic investigation. An occasional fellow is selected to complete a "clinical track" of 2 years. A two year track includes clinical training combined with a clinically applied research project able to be completed within the two-year time frame. We also select occasional fellow candidates who have completed research projects at other institutions and require only the clinical year for eligibility for subspecialty boards.
- Graduate Training Program in Clinical Investigation (GTPCI): This is a program directed by Dr. Charles Flexner, which provides a highly structured course in clinical research training including a thesis. The institution now grants either a Masters or a Ph.D. to graduates of this program. Our Division has had at least one fellow in this program each year.
- Clinical-investigator pathway: Our Division supports this relatively new program that is tailored to trainees who have a clear commitment to academic careers by reducing the time of training in Internal Medicine to 2 years and adding usually a required year of research to the fellowship (fellowship duration: usually 4 years). A specific clinic requirement throughout fellowship training is mandatory in this pathway.
Fellowship candidates who are interested in any of these special programs should make this known at the time of application. We will attempt to accommodate any special needs or interests if possible.