Trainee Responsibility

With the advice and support of faculty, the fellow should:

• Define individual goals, make these goals known to the program director in regular meetings, and assure that the program helps the fellow meet these goals successfully.

Licensing and Certification

Minnesota Medical Licensure

The fellow must hold a current License to Practice Medicine and Surgery by the Minnesota Board of Medical Practice the program at the start of the program and maintain it throughout the program. 

DEA Registration: DEA is not required

Life Support Certification

Life support certification requirements are hospital-specific. M Health Fairview does not require CPR certification for this program. If CPR certification is required through the Instructor appointment process (for the General ID physician role), it is specified through a separate credentialing process that is not part of this fellowship program requirements. 

Parking

The program does not pay for the fellow's parking. Information on parking is available through Parking and Transportation Services.

Clinical Responsibilities

Inpatient 

• The fellow's clinical time will be focused on transplant patients (solid organ transplant [SOT], HSCT) including pre-transplant assessment and peri-operative and post-transplantation care. The fellow may also provide ID care for patients immunocompromised on the basis of cancer chemotherapy. Care of other immunocompromised hosts, such as patients with human immunodeficiency virus, will not be a significant focus of training unless transplant-related. 

• Clinical encounters will occur on inpatient wards, intensive care units, and the emergency department. 

• Each transplant case should be reviewed by the attending physicians, and important learning points highlighted and discussed on a case-by-case basis. The fellow is expected to provide longitudinal follow-up of patients along with the attending physicians. 

• Independent decision making and problem solving will be encouraged. Medical decision making should take into account relevant findings (Gram stain, preliminary culture results, molecular diagnostic assays, pathology and imaging results, etc.) from the Clinical Microbiology Laboratory, and the Pathology and Radiology Departments. 

Outpatient

• The fellow will have an longitudinal outpatient clinic once a week that is staffed by a transplant ID faculty 

Non-Clinical Responsibilities

• Present three times during the year at the ID Citywide Clinical Case Conference (weekly conference)

• Present a journal club article 3-4 times during the year (monthly conferences)

• At the end of the year present research at the IDIM Infections and Immunity Conference

• Submit a research project to either the AST Conference (Spring/summer) or ID Week conference (Fall)

• Seek and respond effectively to feedback and advice, including review of coding while on General ID rotation

• Provide feedback regarding the fellowship program and its faculty members. 

Attendance Requirements

The fellow is expected to attend the weekly ID Clinical Case Conference and participate in the regularly monthly scheduled Transplant ID Journal Club.

Teaching Responsibilities

Fellows are an essential part of the teaching of learners. For the Transplant Infectious Diseases Fellowship, only residents and fellows are assigned to clinical transplant rotations. It is critical that any fellow who supervises or teaches learners be familiar with the educational objectives of such rotations and be prepared for their roles in teaching and providing feedback.

LCME Requirements 

The TID fellow may encounter medical students while assigned to the General ID rotation. The syllabus for MED 7521 Infectious Diseases Clerkship, which is offered at the University site is available here. 

Resident ID Rotations

Residents are scheduled for Infectious Disease rotations and may rotate on the SOC and HSCT assignments at the University. A description of this rotation can be found here. 

Religious Holidays / Scheduling 

Fellows are asked to communicate any religious holidays or needs they may have to the program coordinator. Likewise, fellows are asked to share any significant personal events that are happening and the program will do everything that can be done to accommodate such occasions. 

Call schedules are prepared by the site’s administrator and the fellowship coordinator; fellows will not be scheduled for more than two weekends of call during a monthly clinical rotation. Please communicate any concerns or needed changes to the site coordinator as soon as possible.

Please see Vacation, Leave, and Other Time Away section of the PPM.

Fitness for Duty

The fellow is required to report to work physically and mentally capable of safely performing the functions of their job. The fellow must not report to work if they are impaired for any reason. The fellow must not consume alcohol or any controlled substance while on call, including “at home call.” The fellow must self-regulate their use of prescribed or over the counter medications to ensure these medications do not cause impairment. The fellow must manage their sleep to avoid excessive fatigue. The program has a responsibility to remove any fellow from patient care activities if the fellow's impairment poses a threat to patient safety.  

Fatigue

Faculty and the fellow are educated to recognize the signs of fatigue and will adopt and apply policies to prevent and counteract its potential negative effects. The fellow is encouraged to use fatigue mitigation processes to manage the potential negative effects of fatigue on patient care and learning. The fellow is reassured that there will be no negative consequences and/or stigma for using any fatigue mitigation strategies, including reaching out to others to transition care as needed. Likewise, the fellow is responsible to act if they recognize fatigue in others that can pose negative health and care of others.

Well-being

The Medical School and fellowship program are committed to promoting and supporting the health and wellbeing of each fellow. Faculty members and program directors need to make sure each fellow functions in an environment that has safe patient care and a sense of well-being. If, at any time a fellow feels this is not the case, they are asked to bring this to the attention of the Program Director or other faculty leadership they are comfortable with.  

The Medical School has a number of support resources available on its website for fellows, and fellows have access to appropriate tools for self-screening of well-being. The Program Director is available at any time to provide support and information for any reason. The fellow is granted time away from training for vacation, illness, parental or family leave, or pregnancy-related disabilities. Vacation leave is essential and should not be forfeited or postponed. Any emergent issue is to be communicated to the site or program leadership to ensure the health and safety of fellows and patients.

Monitoring of Wellbeing links to UMN GME Health Task Force Resources.

Trainee Supervision

Supervision will fall on a continuum of need (direct/indirect/oversight), based on the trainee's competency level and clinical scenario. While on inpatient transplant rotations, each case should be reviewed by the attending physician, and important learning points highlighted and discussed on a case-by-case basis. The fellow is expected to provide longitudinal follow-up of patients along with the attending physicians. Independent decision making and problem solving is encouraged. Medical decision making should take into account relevant findings (Gram stain, preliminary culture results, molecular diagnostic assays, pathology and imaging results, etc.) from the Clinical Microbiology Laboratory, and the Pathology and Radiology Departments. 

In outpatient setting, all transplant cases are to be reviewed with attending physician through direct and indirect supervision.

All transplant rotations and on-call responsibilities are supported by readily available transplant teaching faculty. The fellow is provided with reliable systems for communication and interaction with supervisory physicians and is responsible for contacting supervisory physicians for all areas of transplant patient care. The fellow has the opportunity and is expected to assume increasing responsibility for patient care commensurate with their level of training, under faculty supervision, as they progress through the program. The level of responsibility accorded to each fellow is determined by the teaching staff.  

Since the TID fellowship program has NST recognition for J1 visa sponsorship there are supervision requirements outlined by the ACGME for those with a J1 visa.