Fellowship & Training

Table of Contents

• Clinical Training
• Current Fellows
• Research Training
• Areas of Research Interests of ID Faculty
• Other Faculty with ID-Related Research Interests
• Research Interests of Faculty in Department of Molecular Microbiology and Immmunology SHPH
• Resources
• Special Programs
• Application Process

The Infectious Diseases (ID) Fellowship Program of the Johns Hopkins University School of Medicine is designed to qualify trainees for subspecialty boards in Infectious Diseases and to prepare them for a career in academic medicine. The usual program is three years with the first devoted primarily to clinical training and subsequent two years devoted almost exclusively to research. Important goals of the program are to take maximum advantage of the full range of training opportunities of The Johns Hopkins Medical Institutions (School of Medicine, School of Public Health, and the Hospital) and to retain flexibility to accommodate individual needs. The fellowship program began in 1981 and, to date, 81% of our graduating fellows are active academic Infectious Diseases investigators.

Clinical Training:

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, in addition, training in clinical or bench research. 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:

1. 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.
2. 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 see 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.
3. 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.
4. 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 anexpertise in transplant ID.
5. 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.
6. 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.
7. 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.
8. 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.

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Research Training:

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: 1) 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; 2) 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; and 3) 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.

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Areas of Research Interests of ID Faculty, Johns Hopkins University School of Medicine

Division Chief

• David Thomas, M.D., M.P.H., Professor: Division of Infectious Diseases; Epidemiology and Pathogenesis of Viral Hepatitis.

Post Doctoral Fellowship Director

• Stuart Ray, M.D., Associate Professor of Medicine and Oncology (Program Director)
• Michael Melia, M.D., Assistant Professor of Medicine (Associate Program Director)

FULL TIME FACULTY:

• Paul Auwaerter, M.D., Associate Professor: General Infectious Diseases, Lyme disease, EBV, respiratory tract infections, point-of-care education
• Adriana Andrade, M.D., Assistant Professor: HIV Medicine and pharmacology.
• Ashwin Balagopal, M.D., Assistant Professor: HIV and Hepatitis C Pathogenesis.
• John G. Bartlett, M.D., Professor, Director, Osler 8 Service: AIDS; infectious diarrhea especially Clostridium difficile; anaerobic infections; use of the microbiology laboratory.
• Stephen Berry, M.D., Assistant Professor:  HIV quality of care and cost-effectiveness.
• William Bishai, M.D., Ph.D., Professor: Molecular biology of Mycobacterium tuberculosis.
• Joel Blankson, M.D., Associate Professor: HIV pathogenesis.
• Robert C. Bollinger, M.D., M.P.H., Professor: Epidemiology and natural history of HIV infection in India; cellular immune response to HIV with emphasis on cytolytic T lymphocyte (CD4 and CD8) responses. Pathogenesis of acute, primary HIV infection.
• Richard Chaisson, M.D., Professor: Natural history of HIV disease; Mycobacterial infections including M. avium and M. tuberculosis.
• Larry Chang, M.D., M.P.H., Instructor: Global HIV 
• Sara Cosgrove, M.D., Associate Professor: Antibiotic Management and Infection Control.
• Andrea Cox, M.D., Associate Professor: Pathogenesis of Hepatitis C.
• Susan Dorman, M.D., Associate Professor: Epidemiology and diagnostics for Mycobacterium tuberculosis.
• Steven Dumler, M.D., Professor: Rickettsial diseases especially Ehrlichia.
• Emily Erbelding, M.D., M.P.H., Associate Professor: Liaison to Baltimore STD Clinics. Research interests include HIV/STD interaction and HIV prevention.
• Joel Gallant, M.D. M.P.H., Professor and Associate Director of the Johns Hopkins AIDS Service: Clinical trials of prophylaxis and treatment of HIV-related opportunistic infections; HIV-related health care costs; clinical trials of antiretroviral agents.
• Charlotte Gaydos, M.S., M.P.H., DrPH, Professor: Chlamydia pneumoniae, diagnosis and pathogenesis; laboratory diagnostics for International AIDS studies.
• Kelly Gebo, M.D., M.P.H., Associate Professor: HCV and HIV databases.
• Celine Gounder, M.D., S.C.M., Research Associate: TB/HIV co-infection, TB in pregnancy, diagnostic tests for TB, TB/HIV drug-drug interactions, global health, health policy
• Amita Gupta, M.D., Assistant Professor: HIV and co-morbidities management research in low-income settings, especially India.
• Christopher Hoffmann, M.D., M.P.H., Instructor: Care of persons living with HIV in resource-limited settings (especially Africa). Antiretroviral therapy, TB management, and HIV-hepatitis B co-infection.
• Kristine Johnson, M.D., MSc, Assistant Professor: Infectious Diseases, Bayview Medical Center
• Petros Karakousis, M.D., Assistant Professor: Tuberculosis.
• Jeanne Keruly, CRNP, Assistant Professor: Epidemiology and Service Utilization in HIV Management, HIV Clinical Services.
• Gregory Lucas, M.D., Ph.D., Associate Professor: HIV epidemiology and IVDU.
• Yukari Manabe, M.D., Associate Professor: Molecular pathogenesis of TB infection.
• Lisa Maragakis, M.D., Assistant Professor: Infection Control.
• Kieren Marr, M.D., Professor, Chief of Transplant Infectious Diseases: Fungal infections.
• Michael Melia, M.D., Assistant Professor: Clinical ID.
• Dennis Neofytos, M.D., Assistant Professor: Transplant ID
• Eric Nuermberger, M.D., Associate Professor: Animal models of tuberculosis therapy and pneumococcal disease.
• William Osburn, Ph.D., Instructor: Neutralizing antibody responses in HCV infection; Role of CCR5 in clearance of HBV
• Kathleen Page, M.D., Assistant Professor: International health, immigrant health.
• Catherine Passaretti, M.D., Assistant Professor: Hospital epidemiology and infection control, antibiotic management, public reporting of healthcare associated infections and the contribution of the environment to healthcare associated infections.
• Trish Perl, M.D., Professor, Hospital Epidemiologist: Nosocomial Infections.
• Paul Pham, Pharm.D. Research Associate: Pharmacology.
• Thomas C. Quinn, M.D., Professor: International HIV epidemiology and pathogenesis; HIV diagnostic evaluations; Chlamydia infections; Molecular diagnostic assay development.
• Stuart Ray, M.D., Associate Professor: HCV and HIV immunopathogenesis, computer-based research.
• Anne Rompalo, M.D., Professor: Sexually transmitted diseases especially syphilis and the interaction of syphilis and HIV; prospective studies of STD incidence and behavioral aspects of STDs.
• Cynthia L. Sears, M.D., Professor: Pathogenesis of infectious diarrhea especially toxigenic Bacteroides fragilis disease and cryptosporidiosis; AIDS-associated diarrhea.
• Maunank Shah, M.D., Instructor: TB diagnostics.
• Shmuel Shoham, M.D.: Assistant Professor: Transplant/Oncology ID.
• Janet Siliciano, Ph.D: Assistant Professor: Pharmacodynamics of HIV-1 Drugs; mechanisms of viral persistance.
• Robert Siliciano, M.D., Ph.D., Professor: Pharmacodynamics of HIV-1 Drugs; mechanisms of viral persistance.
• Gita Sinha, M.D., MS, Assistant Professor: International HIV
• Lisa Spacek, M.D., Ph.D., Assistant Professor: International HIV clinical research - assessment of alternative, less expensive algorithms to initiate and monitor antiretroviral therapy in resource-limited settings.
• Mark Sulkowski, M.D., Associate Professor: Epidemiology and Therapy of Hepatitis C.
• Chloe Thio, M.D., Associate Professor: Host predisposition to hepatitis.
• Jonathan Zenilman, M.D., Professor: Chief of Infectious Diseases, Bayview Medical Center: Sexually transmitted diseases, AIDS, public health policy.

PART TIME FACULTY:

• Laura Cheever, M.D., Health Research Services Administrator.
• Noreen Hynes, M.D., M.P.H., Associate Professor: STDs, Public Health Policy, and Tropical Medicine.
• Robin McKenzie, M.D., Assistant Professor: Clinical infectious diseases and travel medicine.

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JHU School of Medicine or SHPH Other Faculty with ID-Related Research Interests:

• Karen Carroll, M.D., Chief of Microbiology, Professor of Pathology.
• Charles Flexner, M.D., Associate Professor and Associate Director of the Clinical Scholar's Program: Experimental therapeutics and drug interactions for infectious diseases, especially AIDS.
• Craig Hendrix, M.D., Associate Professor of Clinical Pharmacology: Therapeutic effectiveness of anti-infectives including antifungals. Director: Drug Development Unit.
• Richard Moore, M.D., Professor: General Medicine - Epidemiology and natural history of HIV infection, and other infectious diseases, cost effectiveness research.
• Kenrad Nelson, M.D., Professor and Chief of the Infectious Diseases Division of the Department of Epidemiology (SHPH): Epidemiology and prevention of HIV infection (USA and Thailand), and hepatitis.
• R. Bradley Sack, M.D., Professor, SHPH: Vaccine development, travel medicine, international infectious diseases research.

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Research Interests of Faculty in Department of Molecular Microbiology and Immunology SHPH

• Vern Carruthers, Ph.D., Assistant Professor - Toxoplasma gondii and its mode of entry into host cells to initiate infection.
• Diane Griffin, M.D., Ph.D., Professor and Chief, Department of Molecular Microbiology and Immunology (SHPH) - Pathogenesis of viral encephalitis, HIV-associated neurologic disease, measles and vaccine development.
• Gregory Glass, Ph.D., Associate Professor - Influence of mammalian population dynamics and behavioral interactions on the transmission and maintenance of zoonotic diseases. Specific studies are focused on hantavirus infections in small mammals and Borrelia burgdorferi transmission among vertebrates and vector populations.
• Thaddeus K. Graczyk, M.Sc., Ph.D., Associate Research Professor- Human opportunistic zoonotic protozoan pathogens with particular emphasis on Cryptosporidium, and immunodiagnosis of animal helminthiases and blood protozoan parasites.
• Marie Hardwick, Ph.D., Professor - Virus-cell interactions with an emphasis on herpes viruses and alphaviruses and molecular mechanisms of programmed cell death and its role in viral pathogenesis.
• David Irani, M.D., Assistant Professor- Regulation of lymphocyte homing into the brain during viral encephalitis at various stages of infection and regulation of brain-derived t cells during acute central nervous system inflammation.
• Gary Ketner, Ph.D., Professor - Regulation of gene expression in eukaryotes using adenovirus as a model system. Research is focused on defining the functions of proteins encoded in early region 4 and use of adenovirus as a vector for vaccines and gene therapy.
• Nirbhay Kumar, Ph.D., Professor - Development of a transmission-blocking vaccine for Falciparum malaria. Specific studies are directed at inducting an immune response to the sexual stage that will interfere with parasite development in the mosquito midgut.
• Douglas Norris, Ph.D., Assistant Professor  Role of insect vectors in the transmission of infectious diseases particularly Lyme, West Nile Fever and Malaria. Population genetics of vector species, particularly ticks and mosquitoes.
• Richard Markham, M.D., Professor - Pathogenesis of HIV infection and approaches to vaccine development. Specific studies examine the immune responses of HIV-infected individuals and analyze HIV infection in scid immunodeficient mice transplanted with human peripheral blood leukocytes.
• Joseph Margolick, M.D., Ph.D. Associate Professor- Regulation of T Cell turnover and homeostatis in HIV infection, effects of illicit drugs on immune function and effects of cytokines and intercurrent infections on progression of HIV infection.
• Noel Rose, M.D., Ph.D., Professor - Mechanisms responsible for the maintenance of immunological tolerance. Autoimmune responses to thyroglobulin, Coxsackie B virus-induced autoimmune myocarditis in mice and glomerulonephritis induced by mercuric cloride in inbred mice.
• David Schwartz, M.D., Ph.D., Associate Professor - Interaction of HIV with the immune system and determinants of maternal-fetal transmission of HIV. Specific studies examine the immune response in HIV-infected individuals and recipients of candidate vaccines and examination of cord blood in infants born to HIV-infected mothers.
• Alan Scott, Ph.D., Professor - Immunobiology of filarial nematode infections in humans and the molecular biology of larval development. Surface antigens and secretary products of the early infective stages of Onchocerca and Brugia are studied as targets for a protective immune response.
• Keerti Shah, M.D., DrPH, Professor - Pathogenesis of human papilloma virus infections in the genital tract. Studies are designed to determine whether papilloma viruses cause cancer at sites other than the cervix, the role of the immune response in pathogenesis and the natural history of HPV infections.
• Clive Shiff, Ph.D., Associate Professor- Population genetics of Schistosomiasis virulence and host response. Malaria entomologic control (e.g. bednets).
• David Sullivan, M.D., Assistant Professor - Molecular biology of Plasmodium falciparum with a focus on metal metabolism and heme polymerization related to antimalarial drug action and resistance.
• Xiao-Fang, Yu, M.D., DSc, Associate Professor - Molecular mechanisms of HIV pathogenesis. Studies focus on the role of the gp 120 envelope protein in cytopathogenicity of strains of HIV, mechanisms of effective cytotoxic T lymphocytes response to internal HIV proteins and the mechanism of HIV assembly and entry.
• Ying Zhang, M.D., Ph.D., Assistant Professor - Molecular basis of drug resistance (e.g. pyrazinamide and isoniazid), mycobacterial dormancy and virulence of Mycobacterium tuberculosis.
  

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Resources for Training:

1. Johns Hopkins Hospital is a 900-bed hospital with over 40,300 discharges in FY 99, an average of 182,000 ambulatory visits per year, 70,000 emergency room visits annually, a regional Oncology Center, an 18 bed NIH-sponsored clinical research unit and organ transplant program for bone marrow, renal, liver, heart and heart-lung transplants. The hospital has a bed occupancy rate of about 82%, and operating budget of about $605 million/year and has been ranked #1 among US hospitals for each of the last 8 years in the physician survey by US News and World Report.
2. The Infectious Disease Division includes approximately 6,000 square feet for offices and laboratories. Most of the faculty and most of the divisional research and space designated for fellows are located within this unit. The division has 40 full-time faculty members, 99 employees, and an annual budget of $6.5 million including a research budget of $3.5 million/year. This is a division of the Department of Medicine (DOM), chaired by Dr. Michael Weisfeldt.
3. The Clinical Microbiology Laboratory is a separate 9,000 square foot facility with 78 full-time persons and an annual work volume for bacteriology: 185,000 specimens; mycobacteriology: 5,000; mycology: 24,000; parasitology: 6,000; virology: 26,000; microbiology-immunology: 97,000; special microbiology testing (therapeutic monitoring and special sensitivity testing): 55,000, molecular microbiology testing: 47,000. Dr. William Merz directs this laboratory.
4. The School of Hygiene and Public Health is located adjacent to the hospital and is the world's largest School of Hygiene and Public Health with a full-time faculty of over 600. The Departments of paramount interest are the Department of Molecular Microbiology and Immunology directed by Dr. Diane Griffin (recruited from our Division) with 50 faculty members, the Department of Epidemiology under Dr. Jonathan Samet with 46 faculty members, the Department of Biostatistics under Dr. Scott Zeger with 20 faculty members and the Department of International Health, directed by Dr. Robert Black with 280 faculty members.
5. The School of Medicine is located adjacent to the hospital. The school was founded in 1893 and now has 1,829 full-time faculty members and an annual NIH research awards of $225 million, making it one of the top U.S. medical school in total research dollars. The Welch Library, located adjacent to the Basic Science building, is the library for the School of Medicine, School of Nursing, School of Hygiene and Public Health, and the Johns Hopkins Hospital, with 400,000 bound volumes plus 2,300 biomedical periodicals.
6. Johns Hopkins-Bayview Medical Center, formerly known as Baltimore City Hospital, has been purchased by the Johns Hopkins Health System and is now an integral part of the Hopkins program. JHBMC is a 130-acre park-like campus with a 700-bed community teaching hospital and long-term care facility. Some of its neighbors include: The National Institute of Aging Gerontology Research Center, National Institute of Drug Abuser Addiction Research Center, and Johns Hopkins Asthma and Allergy Center. Dr. Jonathan Zenilman is Chief of the Infectious Diseases Division at this facility.
   

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Special Programs:

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:

1. 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.
2. 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.
3. 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.

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Application Process:

Five to six positions are available in the Infectious Disease fellowship each year on a competitive basis.

How to Apply

We are accepting applications through the Electronic Residency Application Service (ERAS). The application and all supporting documents must be submitted by August 1 of the year preceding the appointment date. The academic year begins in July. Applicants considered for an appointment will be invited to visit for a personal interview with the program director and selected faculty. Interviews are conducted between September 4 and November 27 and are held on Tuesdays from 7:30 AM and 4:00 PM.

A complete application should include:

•  Three letters of recommendation one of which should be from the director of your internal medicine  residency program
•  Medical Student Performance Evaluation (MSPE)
•  USLME Transcript
•  Official medical school transcripts
•  Valid ECFMG certificate (if you graduated from medical school outside of the United States)
•  Personal statement
•  Photograph

We appreciate the candidate's time and expense in this process so interviews are restricted to those most likely to be selected and we try to accommodate different scheduling demands. Please let us know of any specific requests concerning faculty or fellows you would like to see at the time of the interview, or if you have specific career goals you would like to discuss. We honor the match date in National Residency Match Program which takes place about 13 months prior to the start date of the Fellowship. Johns Hopkins University is an equal opportunity employer.

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