Pediatric infectious diseases fellowship program

The program provides 12 months of clinical training including both inpatient and outpatient consultations. The majority of clinical experiences occur in the first year of the fellowship to provide an exceptional foundation in the diagnosis and management of infectious diseases. The first year includes an average of five to six months on the inpatient consultation service, where fellows supervise medical students, interns, and residents. Fellows also complete four-week experiences in clinical microbiology/virology, hospital epidemiology and infection control, antimicrobial stewardship, immunology, and cystic fibrosis. The curriculum is flexible and can be tailored to suit individual interests. Potential electives include medical education, medical ethics, travel medicine and global health, hepatology, and transplant infectious diseases.

Rotations on the inpatient consultation service are typically two weeks in duration with supervision provided by an infectious disease faculty member. Fellows are provided graduated autonomy as they gain increased knowledge and experience. Fellows are the first point of contact for new consultation requests, follow-up questions, as well as calls from community-based pediatricians. This includes overnight pager call when on the consult service. Fellows are never required to take in-house night call. During inpatient consultation rotations, fellows have at least one day off per week and also have at least one other night free from home call.

For all three-years of training, fellows participate in a unique continuity clinic experience in the Women, Youth, and Children HIV clinic (Family HIV clinic). This half-day per week clinic is a multidisciplinary clinic supervised by two med-peds attending physicians trained in infectious diseases. Fellows are provided direct experience managing a variety of issues related to pediatric HIV (maternal management, perinatally exposed infants, and infected children or adolescents). In addition, fellows receive training in the transition of care of HIV infected adolescents from a pediatric to adult model of care.

The first-year fellow also is assigned to general pediatric infectious diseases outpatient clinic for one-half day per week for approximately thirty-two weeks. This clinic allows the fellow to provide follow-up for patients seen on the inpatient infectious diseases consult service. Additionally, this clinic provides an opportunity to see new patients with undifferentiated illnesses as referrals from general pediatricians or other subspecialists.

The second and third years of the fellowship are devoted primarily to the pursuit of scholarship, with fellows spending two to three months per year on the inpatient consultation service.

In accordance with ACGME requirements, the pediatric infectious diseases training program at CHoR provides up to 24 months of research experience. During the first year, each fellow is given time to explore research opportunities throughout the VCU Medical Center and to identify a research mentor in the basic or clinical sciences. Many research opportunities exist within the Division of Pediatric Infectious Diseases, but fellows are also encouraged to consider research mentors in a variety of other basic science and clinical departments within the university according to individual interests.

The second and third year give the fellows the opportunity to pursue a focused research project. During this protected research time, the fellow is expected to gain experience designing and conducting hypothesis-driven research and submitting a manuscript to a peer-reviewed journal. Trainees are encouraged to attend regional or national meetings for educational experiences and present their research.

Fellows also can pursue advanced education through VCU depending on their interests. This can include individual courses to assist with scholarly pursuits, coursework leading to a certificate in medical education, or coursework leading to a master’s degree in public health, hospital administration, or health sciences. VCU provides a generous tuition reimbursement/waiver program that enables the fellow to pursue these optional activities simultaneously with the fellowship but at minimal additional cost to the fellow.

The Division of Pediatric Infectious Diseases convenes a biweekly clinical conference to discuss recent inpatient and outpatient consultation. This conference also provides a forum for reviewing and evaluating medical literature on topics pertinent to these cases, for discussions regarding systems-based practice and to provide practice-based learning and improvement. The fellow directing the inpatient consultation service is responsible for preparing and presenting selected cases at this conference.

While on the consultation service, fellows in both pediatric and internal medicine infectious diseases attend laboratory and didactic rounds with the clinical microbiology director in the virology and microbiology laboratory. Here, fellows observe the laboratory workup and findings of current patient specimens from both their own consultation cases and other interesting patients at VCU Medical Center.

Several additional conferences are shared with the internal medicine division of infectious diseases, including weekly infectious diseases grand rounds, a didactic lecture series on topics in clinical infectious diseases (using the Mandell textbook as a guide), an HIV lecture series, an epidemiology didactic lecture series and a journal club. Fellows are required to attend these conferences and lecture series throughout their training. 

In addition to a categorical Pediatric Infectious Diseases fellowship, we have more than twenty-five years’ experience collaborating with the internal medicine infectious diseases fellowship to provide an integrated, four-year combined fellowship in infectious diseases for graduates of med-peds residency programs. The program welcomes and encourages applications seeking combined fellowship opportunities in both adult and pediatric infectious diseases. Interested applicants should send a joint communication to the adult ID Fellowship Program Director, Dr. Jillian Raybould and to the Pediatric ID Fellowship Program Director, Dr. Suzanne Lavoie.

Other Combined Training Programs

The American Board of Pediatrics allows combined fellowships with other ACGME accredited fellowships in Pediatrics. The Department of Pediatrics at CHoR and the subspecialty fellowship directors are open to these types of programs which would be individualized to the applicant and their career goals. Interested dual fellowship applicants should contact the program directors for both programs to explore options.