- The clinical course and manifestations of major infectious diseases, including sexually transmitted diseases and AIDS
- Comprehensive training in the use of infectious disease therapeutics
- 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 antibiotic therapy program
- Training in the prevention of infectious diseases
- Basic training in pediatric infectious diseases care
- Experience in public health and outbreak investigation
We provide opportunities for infectious disease consultations in the areas of General Medicine, General Surgery, Pediatrics (including Neonatology), 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, the Dartmouth HIV Program, and the Neonatal ICU.
Consultation rounds and clinics
The principal teaching component of the training program is daily consultation rounds, 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 housestaff in the coordination of patient care, including management of social and economic issues and discharge planning.
Trainees see ambulatory patients in four settings at DHDartmouth Hitchcock Medical CenterMC: the Dartmouth Hitchcock I.D. Clinic, HIV outreach clinic in Bedford, New Hampshire, and the Traveler's Clinic. The I.D. 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
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
- 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:
- Course in Decision Making and Clinical Epidemiology (Department of Medicine)
- Rotation in Clinical Microbiology and Virology Laboratories (3 to 4 weeks)
- Course in Clinical Pharmacology
- 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
Trainees also attend and participate in regularly-scheduled conferences of the I.D. Section; a weekly review of new inpatient consultations, an Infectious Disease Housestaff Teaching Conference, the AIDS Seminar Group meeting, and the Infectious Disease Journal Club; and 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.
Fellows engage in one or two 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.
Trainees have access to the modern facilities of the Geisel School of Medicine at Dartmouth. Members of the section occupy an infectious disease laboratory complex in the new medical center. This complex includes a clinical virology laboratory; a research virology laboratory; a laboratory for the study of bacterial pathogenesis, including facilities for bacterial cultivation and tissue culture; and a research laboratory for the study of mycobacteria.
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.
During their first year, trainees are asked to select a research laboratory or an area of clinical investigation in which to work for the ensuing year(s). Submission of grant proposals for salary support is encouraged.
Fellows have the opportunity to engage in many academic and educational activities throughout their fellowship years.
Each year, two fellows are selected to be the Chief Academic Fellow for 6 months of the year. 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.
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 the Medical Education skill development.
All fellows also are given an appointment as a Clinical Instructor at the Geisel School of Medicine.
The ID Section at Dartmouth takes fellow well-being very seriously. We strive to ensure fellows have a healthy work-life balance and are engaged and interested in their educational pursuits. We are continually seeking fellow feedback so that the day-to-day work continues to serve fellow educational and career goals.
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
- Short and long-call system for new inpatient consults
- Hard caps on new (4) and follow-up (12) consult patients seen on the inpatient service
- Antibiotic approval pager ends at 10:00 pm each night, restarts at 8:00 am
- Favorable call schedule to ensure adequate time off
Fellows have multiple mentors during ID fellowship at Dartmouth. In addition to guidance from the 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 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 more clear idea of their career pathway provides a more fruitful relationship.