Department of Medicine - Knoxville

IM Residency Program

Curricula Areas- Infectious Diseases

1. Curricular Area:    Infectious Diseases

2. Location:  

• Outpatient: Knox County Health Department, HIV Center of  Excellence, Tuberculosis Clinic, and STD Clinic
• Inpatient: UTMCK, various floors and intensive care units

3. Faculty:

• John P. Narro, MD, Director, Division of Infectious Diseases
• Russell J. Smith, MD, Division of Infectious Diseases
• Mark S. Rasnake, MD, Division of Infectious Diseases
• Mark Cole, MT, SM, Clinical Director Microbiology Lab UTMCK

4. Schedule:

• Days   Monday through Friday, 8 AM until 5 PM
• Nights None

The resident should attend Morning Report then meet with their assigned attending for work rounds at 9 AM . The resident will be expected to perform a full consult on assigned patients and to make daily rounds with progress notes on those patients. Orders will be written by the resident in consultation with the attending physician. Residents will participate in outpatient care of HIV patients at the HIV Center of Excellence at the Knox County Health Department one half day per week. Residents will attend the Knox County TB Clinic on Thursday AM once per month. Residents will attend the Knox County Communicable Disease Clinic one half day per month for STD experience. Residents will attend a half day session one Monday per month under the supervision of Mark Cole, MT in the UTMCK microbiology lab to complete the Gram stain tutorial. Dr. Narro will provide small group discussion sessions on Fridays from 9 AM to 10:00 AM . Residents are expected to attend all Noon Conferences and Grand Rounds.

5. Related Conferences/Venues:

Infectious Diseases Noon Conference is the fourth Monday of each month**;Morning Report, Department of Medicine Conference Room; Grand Rounds, Morrison’s Conference Room; Various Specialty Noon Conferences, Department of Medicine

6. Primary Goals:   

The resident will be provided a broad overview of the spectrum of disease and related microbiologic principles, as well as practical knowledge and experience in managing common infectious illnesses.

7. Primary Objectives:

The general internist should be able to provide appropriate preventive (including optimal use of immunization and chemoprophylaxis), diagnostic, and therapeutic care for most infections. He or she should also be able to evaluate symptoms that may be caused by a wide range of infectious disorders.

General internists should also learn about the diagnostic and management approaches to patients with HIV infection. Experience should include patients with early HIV infection who have few or no symptoms and also patients with advanced HIV infection who manifest the acquired immunodeficiency syndrome (AIDS).

See Core Competency Table***.

8. Supplemental References, Suggested Readings :

Betts, RF, Chapman, SW, Penn, RL (Editors ) Reese and Betts’ A Practical Approach to Infectious Diseases. 5 th Edition. 2003 . Philadelphia : Lippincott Williams & Wilkins. ISBN 0-7817-3281-6.

AAHIVM. HIV Medicine Self-Directed Study Guide- 2005 Update. Washington , DC : The American Academy of HIV Medicine; 2005. ISBN 0-9726758-4-1.

Lipman, MCI, Baker, RW, Johnson , MA . An Atlas of Differential Diagnosis in HIV Disease. 2 nd Edition. 2004. New York . The Parthenon Publishing Group. ISBN 1-84214-026-4.

The Sanford Guide to HIV/AIDS Therapy, 14 th Edition, 2005.

Mayo Clinics Proceedings Symposium on Antimicrobial Agents. 2000 Mayo Foundation for Medical Education and Research.

Core Curriculum on Tuberculosis CD ROM. 2004, Centers for Disease Control, Atlanta , GA.

Mandell, GL, Bennett, JE, Dolin, R. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. 6 th Edition. 2005. Philadelphia . Elsevier Publishing. ISBN 0-443-06643-4.

9. Procedures:

The Resident will be instructed in the proper collection of culture specimens from various sites, basic Gram Stain interpretation, and Tuberculin and Anergy Panel skin testing and interpretation.

10. Other Resources:

The Resident will review various Infectious Disease Society of America Practice Guidelines with Dr. Narro as time permits. These guidelines are included in Up-To-Date, Preston Medical Library. In addition, the Resident will interact on a regular basis with other members of the healthcare team and both Attending and Resident physicians from other specialty areas.

11. Research Opportunities:

Residents will encounter patients who are appropriate for case presentation and/or poster presentation. They will also have access to ongoing Infectious Disease clinical trials which may be in progress per faculty. The faculty is available to assist with these efforts.

12. Method of Resident Evaluation:

Residents will be evaluated by direct clinical observation, adequacy of consultative writings and case discussions. In addition, quizzes will be given on material covered in the Gram Stain tutorial; TB and HIV core curriculum, and small group sessions. A summative evaluation using New Innovations will be completed by the Division Director or the assigned attending and discussed with the Resident.

13. Method of Specialty Evaluation:

Residents are asked to provide direct feedback to the attending in an informal manner during the course of the rotation. Cumulative feedback to the attending faculty member will be given during the annual faculty evaluation by the Departmental Chair in a non-identifying manner. The residents will participate in a once yearly program evaluation.

*Attendance required once per month, See Dr. Narro to schedule.

‡ Attendance required one afternoon per week, see Dr. Narro for scheduling

§Attendance required one afternoon per month, see Dr. Narro for scheduling

** See Appendix A - noon conference

***See Appendix B- Competency Table