October 25th, 2014

What Makes An Ideal Applicant for a Fellowship in Infectious Diseases?

We’re at the tail end of the ID fellowship interview process, and am pleased to report we’ve seen some outstanding applicants.

They know that our field is the most interesting in medicine, and they view our recent “Epidemic of Epidemics” — to coin a phrase from John Bartlett to describe all this activity (Ebola, MERS, Enterovirus D68, etc.) — as not as a deterrent, but instead an important and fascinating challenge.

Face it: if it’s in the news these days, and it’s health related, there’s a good chance it’s an ID topic. Take a look at this, for example:

In that spirit, I thought I would share a recent email exchange with a former colleague:

Hi Paul,
I just started as program director for an internal medicine residency program in Illinois. I have been doing some career counseling with the residents, and have decided to email specialists I have known along the way with the following two questions about their field:
1. What are the characteristics of an excellent candidate for your fellowship?
2. How important is research experience? Bench vs. clinical?
Hope you’re well,
Craig

Here’s my response:

Hi Craig,
We look for the top clinical people, in particular those who relish the “great case” and love taking detailed patient histories (you know, does the patient have any pets, or has he/she been spelunking). They should definitely also enjoy bread-and-butter inpatient ID (which includes plenty of surgical/routine stuff as well as the fascinomas) and HIV and the complexities of transplant patients. It’s great when they express enthusiasm for the minutiae of microbiology (such as has Strep bovis changed its name?) as well as anti-infective agents (another cephalosporin — ceftolozane/tazobactam — is coming soon, am sure you’re thrilled). And they should want to be the local “expert”on all the newsworthy stuff that fills our days.
As for the research, it’s more important that they have a strong idea of what they would like to do. Yes if they have research experience, that’s a bonus, but it’s not required.
And they shouldn’t be going into ID for the $$$, or if they love to do procedures, because if they are, they are not very smart.
Nice hearing from you after all these years!
Paul

Sound about right? And what’s the story with Strep bovis anyway?

Speaking of pets and surgical infections, this one never gets old:

3 Responses to “What Makes An Ideal Applicant for a Fellowship in Infectious Diseases?”

  1. Holly batterman says:

    Thank you Paul, I LOL from the video. I needed that, taking my recent ID boards tomorrow . By the way, I agree that ID is the most interesting subspecialty. There is always something new! Including name changes.

  2. Husain says:

    Hi Dr Sax,

    Four months into fellowship I could not agree with you more. Wouldn’t want do anything else!

  3. Steven Norris says:

    I have enjoyed your comments for years. Enclosed is something we wrote dealing with our orthapedic buddies. It was initially a joke however it has helped our relationship with Ortho, they have embraced it.

    We also have similar Dealing with EP buddies with a Dying implantable

    Steven Norris MD

    STRESS IN THE ORTHOPEDIC SURGEON WITH
    “THE DYING PROSTHESIS”
    Stage I: DENIAL.
    It should be anticipated that the orthopedic surgeon will initially deny that his or
    her prosthesis is no longer salvageable. We as health care workers should be
    understanding at this difficult time for our orthopedic colleagues.
    Stage 2: ANGER.
    The next stage for our orthopods is anger. They typically will use us, their
    Infectious Disease colleagues, as the “fall guys”. We will be blamed for our
    inability to save their excellent piece of work. It is still important for us at this
    point in time to continue to understand and support our orthopedic friends.
    Stage 3 BARGAINING.
    Once the orthopedic surgeon has realized that his or her prosthesis is no longer
    salvageable, it is characteristic that he or she will try to “strike a deal” with his
    or her Infectious Disease colleagues to try alternatives to removing the
    prosthesis. Many options that are truly outrageous will be proposed. We
    should continue to support our orthopedic colleagues during this difficult time
    and understand that this is a natural process for ±2^. V/e should lisrsn
    carefully to their thoughts and recommendations despite the fact that many
    times, they are quite preposterous.
    Stage IV: DEPRESSION.
    Once all the denial, yelling, screaming, finger pointing, and ludicrous plans
    have ended, depression should be expected to be intense and deep. We must
    continue to offer strong support as our ortho buddies continue to process during
    this difficult time.
    Stage V: ACCEPTANCE.
    Finally, our orthopedic surgeons will come to the realization that what we have
    told them all along is indeed true: THE PROSTHESIS MUST BE REMOVED!
    We have achieved success in appropriately treating our patient.
    Should we be very sensitive and supportive during this time, our orthopedic
    colleagues will be able to make it through this difficult period in our lives
    without feeling shame, remorse or long-lasting psychological injury.

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

Biography | Disclosures | Summaries

Learn more about HIV and ID Observations.