Infectious Disease Fellowship

Program Overview

The Infectious Disease Fellowship at Penn State Health Milton S. Hershey Medical Center is a two-year, ACGME-accredited program (with an optional third year offered on an individual basis) that admits two fellows per year.

Program Details

The Infectious Disease Fellowship is fully accredited by the American Board of Internal Medicine and offers broad experience in the care of inpatients and outpatients with infectious diseases, including the care of patients with HIV/AIDS.

Penn State Health Milton S. Hershey Medical Center is a busy tertiary care hospital with a trauma center and stem cell and solid organ transplantation programs, which provide a wide range of infectious disease clinical case scenarios. Additionally, our patient population allows for the management of immunocompromised and critically ill patients.

The Division of Infectious Diseases, part of the Department of Medicine at Hershey Medical Center, is able to provide fellows with excellent clinical training as well as provide clinical and laboratory research opportunities.

The Comprehensive Care program for patients living with HIV follows more than 700 patients and provides services on the main campus and five satellite sites in the region. Seventy to 80 new patients are seen annually. The Comprehensive Care Clinic is a recipient of a Ryan White Part C grant, allowing the program to extend care to rural areas. Patient management is facilitated by QuickData/HIV, a comprehensive HIV data management tool developed at Hershey Medical Center. This provides excellent training and management of patients living with HIV, including the provision of primary care services, antiretroviral and opportunistic infection management.

The Division of Infectious Diseases runs a busy, varied and interesting Infectious Diseases outpatient clinic with an wide diversity of clinical cases. We have formed a dedicated orthopaedic infection co-management service that includes a large population of both inpatients and outpatients. Outpatients are seen in direct collaboration with our orthopaedic surgeons. This provides experience in the management of a wide range of infectious disease problems, including the follow-up of inpatients and experience in the management of outpatient parenteral antibiotic therapy (OPAT). Our OPAT program includes an innovative database tool (QuickData/OPAT) for efficient information management.

Clinical or laboratory research opportunities are available in the laboratories of several of our faculty members, as well as training in infection control.

Penn State College of Medicine offers two programs, funded by NIH K30 grants, specifically designed to provide clinical research training for physicians. Second-year fellows may enroll in a one-year program leading to a Graduate Certificate in Clinical Research. At the discretion of the advisory committee this may be continued for an additional year to include a mentored clinical research project, leading to a Master of Science in Health Evaluation Sciences. A Master of Public Health program is available for fellows interested in infectious-disease epidemiology.

Penn State College of Medicine boasts a friendly and approachable faculty who are committed to teaching and ensuring that graduating fellows are comfortable and competent at providing world-class care for those with infectious diseases.

Flexibility exists in the curriculum to tailor clinical or research months to an individual fellow’s interests and career goals. For example, fellows are encouraged to organize elective periods overseas in developing country settings. Our fellows have traveled to Kenya and India to gain ID experience in unique settings. We are exploring the establishment of clinical electives in Panama City, Peru and Ghana.

Our Team

Curriculum

Each fellow meets with the program director at the start of the fellowship for arrangement of the first 12 months and preliminary discussion of the second 12 months.

The first 12 months are largely clinical, while the second can be focused in clinical or laboratory research. A third year of fellowship may be available for special projects and will be arranged individually with the program director.

Fellow Research

Below are the research expectations for fellows in infectious diseases:

  • Each fellow will be required to complete at least one CQI project during their fellowship.
  • Each fellow will be required to complete at least one research project during their fellowship.
  • Each fellow is strongly encouraged to have completed a project during their fellowship that will eventually lead to a publication. That publication can be their research project, their CQI project or a case report.

ABIM Board Pass Rate

Our fellows have fared extremely well in their certifying ABIM board exams for ID. Since 2009, our pass rate for first-time takers among 16 graduates from the program is 94 percent (1 did not pass on first try, passed on second try). We attribute this high pass rate to the comprehensive ID training built into the program.

Clinical Rotations

Our Infectious Disease Fellowship provides extremely strong clinical training in order to ensure that graduating fellows are comfortable and competent at managing complicated clinical problems.

Fellows are required to complete a minimum of 12 months on core clinical rotations. In addition, significant flexibility is present and every effort is made to provide individual fellows with the opportunity to explore their own clinical interests including at the discretion of the program director, arranging outside rotations.

Clinical Experience

Inpatient Consults at Hershey Medical Center

These are the core rotations for the fellowship program and are divided into two services: General ID and Transplant/Orthopaedics ID.

During the course of the fellowship, each fellow will generally complete six months of General ID and five months of Transplant/Orthopaedics ID.

The General ID team consists of an ID attending physician, ID fellow, and varying numbers of medical residents and students along with members of allied health services (e.g. pharmacy). The team is responsible to consult on and follow patients with infectious disease problems throughout all inpatient services at the Medical Center, including patients with complex medical and surgical infections located in standard and intensive care beds. This includes patients with malignancy, stem cell transplant and other forms of immunocompromise with the exception of patients with solid organ transplants and orthopaedic infections.

The Transplant/Orthopaedics ID team rounds with both the Transplant ID Attending and the Orthopaedics ID Attending and consults on patients with orthopaedic infections and those who have had or will soon have a solid organ transplant.

Inpatient Consults at Harrisburg Hospital

Harrisburg Hospital is a large community-based hospital located in downtown Harrisburg, PA, approximately 12 miles from Hershey Medical Center. Consult cases tend to be somewhat less complex but equally interesting. Fellows working on the Harrisburg Hospital Infectious Disease service perform in a similar way to the Hershey service.

Outpatient Infectious Disease Clinics

This rotation includes half-day clinic sessions at a variety of clinical sites that include exposure to the following groups of patients: HIV/AIDS, orthopaedic infections, travel medicine, sexually transmitted diseases. Clinic sessions take place at the East Campus (orthopaedic infections), Front Street (HIV/AIDS, travel medicine, STDs), and Lebanon/Altoona (HIV/AIDS). A hepatitis B and C clinic experience with the hepatology service may also be available depending upon availability and continuity clinic schedule conflicts.

Inpatient/Outpatient Pediatrics Infectious Disease Elective

This rotation exposes fellows to the full spectrum of pediatrics infectious diseases and includes inpatient consultations as well as selected outpatient clinics both in general pediatric infectious diseases and HIV/AIDS.

Fellows’ Continuity Clinic

Each Infectious Disease fellow is assigned to one half-day continuity clinic per week throughout their two years of clinical training. Patients are not pre-selected by disease type, but consist of a mix of HIV and general infectious diseases, including the follow-up of infectious disease inpatients and care of patients receiving outpatient parenteral antibiotics.   Fellows are assigned new patients and are expected to follow these patients during the entire training period. At least one new patient each week is scheduled in every clinic. Supervision of each fellow is provided by a designated faculty member who is constantly present in the clinic.

Antimicrobial Stewardship Rotation

We implemented an antimicrobial stewardship rotation for all fellows beginning in 2015, overseen and instructed by Dr. Michael Katzman, who directs the institution’s Antimicrobial Stewardship Program (ASP). Dr. Katzman has become widely recognized for the organization and discipline he has brought to the ASP. He has been elected to the ranks of Distinguished Educators by Penn State College of Medicine and the program has quickly become a favorite among our fellows. Our fellows learn as much ID during their time on this rotation as they do while on the inpatient rotation since, in order to make judgments about the appropriateness of antibiotic use, they need to continuously review treatment guidelines and primary literature. This rotation improves year after year.

Microbiology

An orientation to the clinical microbiology laboratory takes place each August for first-year fellows. A multidisciplinary microbiology rounds takes place each week on Tuesday mornings, during which both faculty and fellows (those on and off clinical service) participate with the microbiology lab staff in reviewing specimens from patients on service and other interesting specimens seen in the lab each week. Rounds are conducted by the Director of Clinical Microbiology, Dr. David Craft. We believe these are some of the best teaching rounds in the country. We utilize a high-definition overhead monitor connected to a microscope (to review slides) and to a dissecting scope (to review plates). Our graduating fellows finish the program with a broad understanding of clinical microbiology. A separate Friday fellows-only teaching session is conducted by Dr. Craft.

Click here to a see a video from the American Society for Microbiology about a clinical microbiology lab.

Other Rotations

A variety of other rotations are also provided to the fellows.

Infection Control

Fellows are required to complete the IDSA-sponsored Infection Control Lecture series online; this will generally be accomplished during a non-clinical rotation during the first year.

Fellows are also invited to attend the weekly infection control meetings that take place on Tuesday mornings from 10 to 11 a.m. Specific ongoing infection control issues are discussed and analyzed during this weekly meeting. 

Fellows are also invited to attend the monthly Infection Control Committee meetings, during which general issues of infection control policy and procedures are discussed.

Outside Rotations

Fellows with a particular interest in a clinical area may arrange to spend an elective period at an outside institution. For example, several of our fellows have chosen to spend time overseas in a developing country setting, to increase their experience of tropical infections.

Conferences

Fellows have the opportunity to attend a wide variety of clinical and basic science research conferences in the Infectious Diseases and Microbiology and Immunology areas, and the Medical School and Medical Center as a whole, including:

Clinical Infectious Diseases Conference

Wednesdays, 4 to 5:30 p.m.

Every fellow is expected to attend these conferences each week. This is a clinical conference during which faculty, fellows, residents and students present and discuss clinical cases or guidelines.

Journal Club

Second Friday of each month, 12:30 to 1:30 p.m.

Every fellow is expected to attend these conferences each month and present on a rotating basis.

Core Curriculum Conference

Thursdays, 7:30 to 8:30 a.m.

Each fellow is expected to attend
these conferences each week. A two-year schedule of ID-related topics is covered during this conference.  These topics are meant to inclusively cover all ID-related topics during a two-year fellowship and to serve as a basis for board review.

HIV/AIDS Conferences

Third Friday of each month, 8:30 to 10 a.m.

This conference consists a schedule of HIV-related topics followed by a team meeting consisting of case presentations primarily involving genotypes/antiviral histories to determine appropriate changes to treatment, as well as interesting cases of AIDS-related complications, along with review of important HIV/AIDS literature. It is conducted by one of the HIV physicians, Drs. Crook, Zurlo and Whitener, on a rotating basis to review general topics in HIV medicine. A series of introductory lectures for first-year fellows will take place each August.

Research Conference

Third Friday of each month, 12:30 to 1:30 p.m.

This conference is designed for brainstorming of research and/or program improvement projects for the fellows, monitoring progress of such projects, and presenting data (whether preliminary or at the polishing stage before formal presentation or submission for publication).

ACGME Core Competencies Lecture Series

First Thursday of each month, 7 a.m.

The objective of the lecture series is to provide an institutionally sponsored didactic program, aimed at covering some of the core topics inherent in the ACGME competencies.  These conferences should be considered mandatory. Since they are available online, they can be viewed at a later time. Learn more about the ACGME Core Competencies Lecture Series.

To Apply

We welcome informal enquiries via email to Dr. John Zurlo, Program Director, Kelly Friedman, Program Coordinator, or by calling 717-531-8881

We accept applications only through the ERAS System.

Interview Process

Candidates selected for interview will be contacted by Feb. 1 to arrange an interview between mid-February and late April each year. Knowing the busy schedules of our candidates, we are flexible with our interview dates. However, we prefer to interview candidates on Wednesdays, when faculty and fellows are available to meet with candidates. Candidates are also invited to attend our weekly Infectious Diseases Case Conference.

Faculty

Current Fellows

Contact Us

Mailing Address

Penn State Health Milton S. Hershey Medical Center
500 University Dr.
Hershey, PA 17033