Infectious Diseases

Welcome to your rotation in Infectious Diseases! This rotation is the consult service responsible for Infectious Diseases consultations in the University of Alberta Hospital and the Royal Alexandra Hospital (in-patients, and ER).  Generally, you see follow-ups and new consults on your own in the mornings and round with the staff in the afternoon. Journal Club takes place Tuesdays at 0815h, and ID Divisional Case Rounds are Thursdays at 11:00 am. Tuesdays and Wednesdays at 12:15 there are didactic teaching sessions at the UAH with an ID subspecialist. This will take place in 1-124Q CSB. There is also a teaching session at the RAH on Wednesday at 12:15 with the staff (location TBA). on Friday at noon there will be a teaching session with the ID fellow on consult service (location TBA). On Monday at noon there is a teaching session with the ID pharmacists at the UAH site (1-124Q). 

During this rotation, residents should develop an approach to the following:

• Use and Misuse of Antibiotics

• Optimal Use of the Microbiology Laboratory

• Recognition and Management of Common Infectious Diseases Syndromes 

• “Bugs and Drugs” - an appreciation of the common pathogens, the diseases they produce and therapeutic alternatives

• Accessing the medical literature to answer questions (goal: 1 paper per patient reviewing a problem or addressing its diagnosis or management)

Dr. Goldsand’s 5 Questions of Infectious Diseases

1. Is an infectious disease likely in this patient?

2. What is the likely microbiology of this infection? (How can the laboratory help us make a diagnosis) 

3. What therapeutic options are available?

4. Where did this infection come from?

5. Why does this patient have this infection?

6. Is anybody else involved?

You should also consider: What does the literature teach us about this problem and its management?

Reference Material

• The Sanford Guides: Guide to Antimicrobial Therapy - this is available as an App or in paper but the App is more user friendly.

Reading Materials

• Mandel, et al. Principles and Practice of Infectious Diseases – Available in the ID Conference Room 

• Cohen & Powderly. Infectious Diseases– Available in the ID Conference Room 

• I.D. Clinics of North America (nice reviews of many topics)

• The medical literature – you should be adept at searching the medical literature; there is Internet access on the Wards and in the ID conference room. Ask the Staff or Subspecialty Resident for help if needed. 

Call

Call is from home. It is a maximum of 1 in 3 call including one full weekend per 4 week block. Enclosed is a call schedule and you will receive updated call schedules via email. Problems with the call schedule should be addressed to the ID Lead Resident 

All consult requests must come from a member of the medical team caring for the patient. This can include medical students and nurse practitioners where they are part of the care team. 

During your rotation, you will likely see patients with a variety of infectious diseases diagnoses and syndromes. The following topics are considered “core” and your learning around them will be reflected on the evaluation. We recognize that not every rotating resident will see less common conditions (e.g. TB, travel infections, vaccine usage in adults) and would encourage you to seek teaching/discussion around areas that are underrepresented in the patients you see. There are handouts for the Wednesday noon teaching sessions which cover many of the disease entities/topics that you may not get a chance to see on service.

The objective of this rotation is to develop an approach to:
Updated August 2025

• Staphylococcus aureus bacteremia

• Bacteremia (non-Staphylococcus aureus)

• Endocarditis

• CNS Infections

• Gynecologic and peripartum infections

• Cardiothoracic infections

• Skin & Soft Tissue Infections

• Bone & Joint Infections

• Complications of Injection Drug Use

• Infections of the Head & Neck

• Urinary Tract Infections

• Respiratory Tract Infections

• Appreciation of Issues In Marginalized Inner City Populations

• Assessment & Management of HIV & STDs

• Assessment for TB

• Appreciation for IV Access Options & Issues Related to Home IV Therapy

OTHER OBJECTIVES:

• Applies knowledge of the microbial characteristics of specific infectious agents to the clinical problem.

• Elicits a history that is relevant, concise, accurate and appropriate to the patient’s problem(s), including the relevant epidemiologic and travel history related to particular infectious diseases.

• Performs a physical examination that is relevant and appropriate.

• Is able to assess the various types of immune suppression on the impact of differential diagnosis and management.

• Selects the appropriate investigative tools, including microbiologic tests in a useful manner.

• Is able to balance the benefits and risks of antimicrobial therapy with each patient encounter.

• Uses all pertinent information to develop a differential diagnosis and arrive at an accurate clinical diagnosis and treatment plan.

• Demonstrates knowledge of non-infectious causes of syndromes that mimic infectious diseases.

• Applies knowledge of antimicrobial agents in the prevention and treatment of infectious diseases.

• Recognizes and manages emergency conditions (extremely ill patients) resulting in prompt and appropriate treatment. Remains calm, acts in a timely manner and prioritizes correctly.

• Identify situations where radiologic guided surgical intervention is necessary for optimal patient care.

• Develops a comprehensive management plan

During your ID rotation, your work will be evaluated based on CanMEDS competencies as they apply to ID patients and conditions:

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level,  PGY2 is Manager level, PGY3 is Educator level (See Program Information - Overall Goals and Objectives).

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centred manner.

• Documentation and Verbal Presentation: The resident appropriately documents and presents cases for new consults, progress notes, and handover of care (succinctly organized, prioritized, summarized) including answering the question asked by the referring service.

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with referring physician and other healthcare providers effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident addresses disease prevention, risk factor reduction, and health surveillance when indicated.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice: The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment 

We will use the following In-Training Evaluation Report (ITER):  

• Infectious Diseases

Entrustable Professional Activities (EPAs)

This rotation focuses on mainly Core of the Discipline EPAs. However, due to scheduling, a resident may do this rotation during Foundations. Residents are allowed to start Core of Discipline EPAs during the Foundations stage. This rotation is an ideal learning environment for the following EPAs:

• FD2: Managing patients admitted to acute care settings with common medical problems and advancing their care plans

• FD4: Formulating, communicating, and implementing discharge plans for patients with common medical conditions from acute care settings

• CD1: Assessing, diagnosing and managing patients with complex or atypical acute medical presentations

• CD2: Assessing, diagnosing, and managing patients with complex chronic diseases

• CD3: Providing internal medicine consultation to other clinical services

• CD5: Performing the procedures of Internal Medicine (Lumbar Puncture)

• CD10: Implementing health promotion strategies in patients with or at risk for disease  (e.g. Counselling regarding immunocompromised state)

Evaluations

You should expect to have an informal evaluation with each staff that you work with. Ask your attending staff to ensure this happens. Evaluations will consider your skills in history taking and physical examination, knowledge base, professional interactions and ability to communicate as well as your record keeping and organization. In addition, complete your evaluation of the Infectious Diseases rotation. This is your opportunity to improve the rotation and we would appreciate your honest and critical appraisal with suggestions for improvements. Included is an evaluation of the Med Micro plate rounds and the staff Med Micro people. 

In addition to the evaluations you receive from your preceptors, you will also be required to write an MCQ examination. Your mark on this exam will not be reflected in your evaluation. It is a purely formative exam. At the end of your rotation you should be scheduled to meet with Dr. Smith, the ID program director to review the results of your examination. 

We want this rotation in Infectious Diseases to be interesting and challenging but, most of all, we want it to be fulfilling and rewarding, while meeting your educational needs. As medical residents, you will likely have only one chance to rotate on each service and you must make the most of that opportunity. If you encounter difficulties, have questions or feel that we could be doing something different (or better) during the course of the rotation you should not hesitate to contact Dr. Stephanie Smith, the Program Director, at 780-492-6701.

Program Director

Dr. Isabelle Chiu

ichiu@ualberta.ca

Medical Education Program Coordinator

mednid@ualberta.ca