The Pediatric Infectious Diseases Fellowship Program at The University of Manitoba is a two year training program which is accredited by the Royal College of Physicians and Surgeons of Canada. The program includes 12 blocks of clinical consult service, including 2 blocks of adult ID service and the remaining time in pediatrics, 4 ½ months of clinical microbiology, the equivalent of 3 blocks of infection prevention and control and antimicrobial stewardship (ASP), 1 block of Public Health, and up to 5 ½ months of research and elective time which is tailored to meet the needs of the individual trainee. Successful applicants have funding ensured for the required two years of subspecialty residency training.
The program is fully integrated with the Adult ID, Medical Microbiology, and Clinical Microbiology training programs, including combined academic rounds and teaching sessions. The University of Manitoba and the Section of Pediatric Infectious Diseases have had a long-standing involvement in Global Health, and trainees in this program may participate in a number of clinical and research opportunities in existing overseas projects. Residents in Pediatric Infectious Diseases also have the option of enrolling in a combined Pediatric ID and Medical Microbiology fellowship or a combined Pediatric ID fellowship/PhD program via the University of Manitoba Clinical Investigator Program. There is significant potential for participation in teaching at both the undergraduate and postgraduate levels for those trainees who are interested in medical education, and training in teaching skills is available and required through the University of Manitoba PGME Core Curriculum series. Completion of a research project or other scholarly project is mandatory during the training period and opportunities exist in a number of areas including clinical epidemiology and basic science research under the supervision of staff within the Sections of Pediatric and Adult Infectious Diseases and the Department of Medical Microbiology.
Clinical rotations: The Pediatric Infectious Diseases Service provides consultation to all in-patient pediatric medical, surgical, neonatal (Level III) and intensive care services at Winnipeg Children’s Hospital (WCH), Health Sciences Centre (HSC). It also provides consultation to the Neonatal Units at Women’s Hospital, Health Sciences Centre (Level II) and St. Boniface General Hospital (Levels II and III). A continuity outpatient morning clinic is held twice weekly (Tuesday and Thursday) at WCH for patients seen in consultation and follow-up from the wards. The clinic uses an EMR system (Accuro). New, outpatient referrals are also seen in this clinic. Residents would be expected to attend a minimum of one clinic per week during training. The pediatric ID service also follows children chronically infected with Hepatitis B or C. Many, new outpatient clinical opportunities are currently being developed including shared clinic time with Pediatric Respirology for pediatric TB, outpatient skin and soft tissue infection follow-up, and a pediatric antimicrobial stewardship program. All HIV-positive and HIV-exposed children from the WCH catchment area are followed in this clinic. All children enrolled in the Community IV Program (CIVP) are reassessed by Pediatric ID within the clinic, although administration of antimicrobials is done offsite. WCH serves patients from the province of Manitoba, Northwestern Ontario and Nunavut. The 2 blocks of Adult Infectious Diseases Service will consist of time spent on two Adult ID Services among Adult Medical ID at HSC, and Adult ID at St. Boniface General Hospital. One block will be in early in first year, the other early in the second year. There is the expectation of increasing leadership and responsibility across the 2 blocks. Pediatric ID residents do not attend Adult ID clinics while on their Adult ID blocks. In addition, the last 2 blocks of clinical Pediatric ID will be as a Junior Attending role, with the expectation of the resident taking over the majority of management decisions of the Pediatric ID service while still having backup from the attending physician.
Medical Microbiology Rotations: Four and a half months of laboratory rotations are undertaken in the Medical Microbiology Laboratories at the Health Sciences Centre and St. Boniface General Hospital (1 block each plus 1 block of subspecialty benches), the National Microbiology Laboratory (NML; minimum 2 weeks), and the Cadham Provincial Laboratory (CPL; minimum 4 weeks). While the Royal College Subspecialty Training Requirements only specify 3 blocks of medical microbiology, the 3 Program Directors (Peds ID, Adult ID, Med Micro) as well as all the Pediatric ID faculty feel 4 blocks would be the absolute minimum to allow trainees to learn the basics and become sufficiently competent for clinical practice. One and a half blocks of elective time will be used toward this extra block of microbiology lab.
Elective/Research Rotations: Five and half months of elective and research rotations will be planned to meet the specific needs of the individual trainee, and can include any rotation as described in the Royal College training requirements. A maximum of 5 elective blocks can be taken for research. Elective rotations have previously included: clinical and research electives at the University of Nairobi in Kenya, clinical electives in India, and support to attend the Gorgas Course in Clinical Tropical Medicine in Peru (applicant must still apply individually via the normal, competitive application process), allergy and immunology, pediatric tuberculosis, and additional research/lab time at the National Microbiology Lab. Please refer to the Royal College website for the specific listing of other acceptable elective rotations outlined in the Pediatric ID Subspecialty Training Requirements (see item 1.6). Outside electives will be supported provided they will allow the trainee to meet the required educational objectives.
The block of public health is coordinated through colleagues working within Manitoba Health Communicable Diseases program, and is generally held offsite. Trainees will more than likely have the opportunity to participate in outbreak investigations, contract tracing, some committee work, policy development, as well as working one-on-one with Medical Officers of Health on various public health related issues.
The training blocks of IPC and ASP will be divided up into 2 separate rotations, each consisting of 6 weeks of full-time experience in each area. This will allow for maximum educational benefit and the best experience for the trainee.
Teaching Curriculum: A protected academic half-day occurs throughout the academic year on Wednesday mornings and is organized and taught in conjunction with the subspecialty training programs in Adult Infectious Diseases, Medical Microbiology, and Clinical Microbiology. Over the 2 year curriculum, the AHD also includes graduate courses in clinical bacteriology, virology, and parasitology. Infectious Diseases Case Rounds and Medical Microbiology Plate Rounds are held weekly on Fridays. Trainees are required to complete a Resident Teaching Course through PGME unless they have previously completed this course. Trainees will also receive epidemiology training during their program in the form of financial support to attend short courses off site. Many trainees have attended the Ohio State Summer Epidemiology course in Columbus, Ohio (~1 week) with course work geared toward leaners of a clinical and ID background.
Funding is also available to attend conferences such as IDWeek, the AMMI Canada Annual Meeting, PAS, or other meetings tailored to the career plans of the trainee. Residents will be strongly encouraged and supported to present poster abstracts at conferences (extra funding is available).
Additional components of the curriculum include:
1. ID Journal Club, last Friday of the month
2. Peds ID Journal Watch, first Friday of the month
3. Combined Radiology-Peds ID Rounds, last Tuesday of the month
4. Medical Microbiology Seminar Series Wednesday mornings as part of AHD, September to June
5. Trans-Canada Tropical Medicine Rounds, first Wednesday of the month
6. Pediatric Grand Rounds
|Clinical Pediatric ID||10|
|Infection Prevention & Control||1.5|
RC Specialty Training Requirements
http://www.uab.edu/medicine/gorgas/ (2 current PID faculty are Gorgas alumni; since 2009 we have had 4 Peds ID residents and several Adult ID residents accepted into the Gorgas Course)