Educational Rationale ::

In the ambulatory block, fellows are free from distractions of inpatient duties and can concentrate on an intensive learning experience. The block design allows for focused experiences in ID Ambulatory Clinics (ID Clinic, Travelers clinic, HIV clinic and TB clinic) outside their continuity clinics. It also allows exposure to the Infection Control issues within a hospital setting.

Goals and Objectives ::

1. Provide an intensive experience in outpatient medicine, without the distractions of inpatient responsibilities.
2. Assess undiagnosed patients with subacute or chronic illness.
3. Acquire experience in the diagnosis and management of infectious disease problems. These include infections in outpatient cardiology, endocrinology, rheumatology, dermatology, pre-operative evaluation, transplant, gynecology, neurology and orthopedics, among others.
4. Gain experience in ambulatory disciplines including travelers’ medicine, sexually transmitted diseases, and TB.
5. Experience a curriculum of important topics in outpatient infectious diseases.
6. Gain experience in Infection Control issues in a hospital setting.

Teaching Methods ::

1. A case-based format is used in which the attending provides role-modeling, stimulates questioning, and emphasizes methodology over acquisition of facts they pertain to individual patients.
2. Adequate hands-on experience is critical, in which the fellow is given optimal patient responsibility.
3. Patient-centered discussions that include differential diagnosis, physical examination techniques, and cost-effective methods of diagnosis and treatment.
4. Systematic review of the medical record with discussion and feedback.
5. Attendance and participation in weekly case conferences.
6. Attendance and participation in bi-monthly journal clubs that focus on careful analysis of current literature.
7. Attendance at weekly half-day ambulatory continuity clinics.

Educational Material ::

1. The recent medical literature, which will be applied to specific cases.
2. An article-based curriculum, provided to each fellow.

Evaluation ::

1. Each fellow evaluates the attending in writing, that goes into their teaching file used for promotion when applicable.
2. Fellows are evaluated in writing at the end of the rotation by the Ambulatory Attending.