General training
Infectious Disease Fellowship Introduction (PDF)
- The clinical course and manifestations of major infectious diseases
- Comprehensive training in the use of infectious disease therapeutics including access to world-class Infectious Disease Pharmacists
- Basic concepts of immunology
- Comprehensive practical training in microbiology – our Clinical Microbiology Lab Director, Isabella "Ella" Martin, MD, provides exceptional support from our on-site state-of-the-art laboratory
- Training in the appropriate use of diagnostic testing for various infectious diseases and symptoms
- The theory and application of epidemiology
- Principles and practice of antibiotic stewardship and infection control
- Comprehensive care in our outpatient intravenous antibiotic therapy program (OPAT)
- Training in the prevention of infectious diseases
- Experience in public health and outbreak investigation
We provide opportunities for infectious disease consultations in the areas of General Medicine, General Surgery, Obstetrics and Gynecology, Critical Care Medicine, Emergency Medicine, Geriatrics, Hematology/Oncology, Neurology, Orthopedics, Neurosurgery, and Transplant and Cardiothoracic Surgery.
Trainees are exposed to the full spectrum of infectious diseases affecting normal and immunocompromised hosts. Experience in treating opportunistic infections is gained by seeing patients of the Solid Organ Transplant Service, Bone Marrow Transplant Service, the Dartmouth Cancer Center, and the Dartmouth HIV Program (HOPE).
Consultation rounds and clinics
The principal teaching component of the training program is daily consultation rounds on one of two main services, which are conducted by a member of the full-time Infectious Disease faculty. Trainees perform 15 to 20 new consultations per week, resulting in an active consultative service of roughly 10 to 20 patients at any given time. Trainees work closely with members of the house staff in the coordination of patient care, including management of social and economic issues and discharge planning.
Trainees see ambulatory patients in 4 settings: Dartmouth Hitchcock Medical Center, the Dartmouth Hitchcock ID Clinic, HIV outreach clinic in Bedford, New Hampshire, and the Traveler's Clinic. The ID Clinic is used for the longitudinal care of HIV-infected individuals and other patients with chronic infectious diseases, for non-emergent outpatient consultations, and for follow-up of patients seen as inpatient consultations.
Other activities
Trainees play an integral role in a variety of other clinical activities during the course of the fellowship, including:
- Traveler's Clinic and the Trip & Tropical Topics Conference
- Antibiotic Subcommittee of the Pharmacy and Therapeutics Committee
- Collaborative Healthcare Associated Infection Prevention (CHIP)
- Comprehensive Antibiotic Stewardship Program
- Dartmouth HIV Program (HOPE)
- AIDS Education and Training Center (State of New Hampshire)
The following educational experiences at Dartmouth Hitchcock Medical Center also augment those of direct patient care:
- Rotation in Clinical Microbiology and Virology Laboratories (3 to 4 weeks)
- Immunology Seminar Series
- New Hampshire State Public Health investigations and initiatives
- Experience and training in medical education, including Geisel School of Medicine and Dartmouth Hitchcock Medical Center residents
- Focused activities in Antimicrobial Stewardship
- Experience in Infection Control
Fellows have the opportunity to join several career focus tracks during fellowship, whether they choose to pursue a traditional 2-year fellowship or choose to pursue the Leadership Preventive Medicine Residency (LPMR) program. Currently, these include the focus areas outlined below:
- Infection Prevention/Hospital Epidemiology: led by Dr. Gabriela Andujar Vazquez
- Antimicrobial Stewardship: led by Dr. Rebecca Wang
- HIV: led by Dr. Antonia Altomare
We can support fellows in almost any area of interest, and also have plans for development of future tracks in Transplant ID, Mycobacterial Diseases, Public Health, and Rural Health Equity.
Trainees also attend and participate in regularly scheduled conferences of the ID Section: a weekly review of new inpatient consultations, an Infectious Disease House staff Teaching Conference, the AIDS Seminar Group meeting, and the Infectious Disease Journal Club; as well as conferences of the Department of Medicine, such as Morbidity and Mortality Conference, Medical Grand Rounds, ICU Critical Care Conference, Solid Organ Transplant Group meeting, and the Bone Marrow Transplant Group meeting.
Research studies
Fellows engage in 1 or 2 years of clinical or laboratory research under the supervision of a member of the Infectious Disease Section, the Immunology Program, or the Departments of Medicine and Microbiology.
Dartmouth Hitchcock Medical Center is well-known for its focus on quality improvement and healthcare delivery science, in close collaboration with The Dartmouth Institute of Dartmouth College. To that end, fellows at Dartmouth Hitchcock Medical Center have access to world-class training in quality improvement through the Value Institute Learning Center (VILC) as well as more formalized opportunities for those interested in completion of the Leadership Preventive Medicine program. Many Dartmouth Hitchcock Medical Center Infectious Disease faculty focus on work in the areas of process improvement and healthcare delivery, and can provide ample mentorship opportunities in this area.
Fellows will also have ready access to mentorship in research through faculty engaged in investigations that cross a wide spectrum of interests. Clinical research at Dartmouth Hitchcock Medical Center and throughout the DHH system is supported through access to data through the use of Epic and the system’s analytics institute.
Trainees have access to the modern facilities of the Geisel School of Medicine at Dartmouth. There are many opportunities for collaborative clinical and translational research.
Collaborations are possible with the many Departments at Dartmouth, including the Norris Cotton Cancer Center and The Center for Digestive Health, among others. Fellows may also be supervised and supported by members of the Immunology Program at the Geisel School of Medicine, a diverse group of scientists interested in cellular and molecular approaches to basic immunologic issues and their application to cancer and autoimmune diseases.
We have close ties to the New Hampshire State Public Health Department, so fellows have the opportunity to be involved in outbreak investigation and management.
Additionally, fellows have the opportunity to conduct research in an international setting with one of Dartmouth's many international collaborations.
Fellows are exposed to the breadth of research opportunities prior to selecting their research focus during fellowship.
The Fellowship
Academics
Fellows have the opportunity to engage in many academic and educational activities throughout their fellowship years.
Each year, a fellow (or possibly multiple, depending on the year) are selected to be the Chief Academic Fellow. The Chief Academic Fellow works with the Program Director to help establish educational and academic activities for the fellowship program. This includes integration of activities into other Residency Programs and the Geisel School of Medicine at Dartmouth. This role is tailored to the fellow’s interest and professional development needs.
Fellows are actively involved in the education of medical students both on the wards and also in teaching first and second-year medical student classes. Fellows also work with residents on the wards and are involved in resident teaching conferences. Fellows are assigned ID faculty mentors to assist in Medical Education skill development.
All fellows also are given an appointment as a Clinical Instructor at the Geisel School of Medicine.
Mentorship
Fellows have multiple mentors during ID fellowship at Dartmouth. In addition to guidance from the program director and associate program director, fellows have both personal and research mentors. In the first month of fellowship, we assign each fellow a faculty mentor that they will have for the duration of their fellowship. This is a faculty member that is not their research mentor, whose goal is to assist in navigating the system and as a resource for career and personal guidance. Fellows meet regularly for coffee or a meal with their faculty mentor for regular check-ins. We do this to ensure fellows have someone who is looking out for their well-being in addition to their program director and research mentor. We have found that fellows appreciate this relationship. When fellows begin to choose their research projects or career paths, we assist in the selection of research mentors. We have found that waiting to define a mentor until fellows have a clearer idea of their career pathway provides a more fruitful relationship.
Fellow well-being
The ID Section at Dartmouth takes fellow well-being very seriously. We strive to ensure that fellows are able to strike a balance between excellent training in clinical Infectious Diseases, maintaining life outside of work, and engaging in their academic/educational pursuits.
Examples of processes geared to fellow well-being:
- Attendings take all curbsides from both inside and outside the Dartmouth Health system during regular working hours
- Attendings hold fellow pagers during clinics and didactics
- Hard caps on new (4) and follow-up (12) consult patients seen on the inpatient service
- Antibiotic approval pager ends at 10 pm each night, restarts at 8 am
- Favorable call schedule to ensure adequate time off
- Annual fellows’ day out