Inpatient Rotations

Inpatient rotations are performed at the four primary Emory University affiliated teaching hospitals, which include Emory University Hospital (EUH), Emory University Hospital Midtown (EUHM), Grady Memorial Hospital (GMH), and the Atlanta VA Medical Center (VAMC).

Emory University Hospital is a tertiary care facility with 583 total beds and a patient mix that spans the entire spectrum of adult patients including general medical and surgical inpatients, those in a variety of intensive care units (medical, surgical, cardiac, cardiothoracic, and neurological), and patients with a range of immunocompromising conditions (including patients living with HIV and those taking immunosuppressive medications). Unique aspects of this site for clinical training include exposure to patients with complex surgical, neurosurgical and cardiovascular procedures, and those receiving immunomodulatory therapies for a variety of benign and malignant conditions.

Fellows rotate on the General ID Consult service at EUH in one month blocks (average of two blocks in Year 1). The consult team includes the fellow, an attending, an advanced practice provider, as well as residents and medical students. Teaching takes place at daily attending rounds as well as clinical microbiology (“plate”) rounds that are held Monday-Friday in the microbiology laboratory that are led by a fellow in the separate training program in medical microbiology.

EUH is the only training site where hematopoietic stem cell and solid organ transplants are performed. The Winship Cancer Institute is Georgia's only National Cancer Institute-designated comprehensive cancer center and the Bone Marrow and Stem Cell Transplant Center is the oldest and largest program in Georgia. The Emory Transplant Center (ETC) is the largest transplant center by volume in Georgia and ranks among the top 12 transplant programs in the nation for overall adult volume (OPTN, 2018 data).

Fellows rotate on the Transplant ID consult service at EUH in two-week blocks (one block in Year 1, average of 3 blocks in Years 2 and beyond). The Transplant ID Consult team includes the fellow and attending, as well as residents and rotators from other subspecialties. During this rotation fellows can expect to see patients with hematologic malignancies, recipients of hematopoietic stem cell and solid organ (kidney, kidney-pancreas, liver, multi-visceral, heart, and lung) transplants as well as patients with mechanical circulatory support devices (i.e. ventricular assist devices).

Fellows rotate through the clinical microbiology laboratory at EUH for one-month in Year 1. During this time ID fellows spend time at the different benches in the laboratory (including, but not limited to, primary plating, subculturing, susceptibility testing, blood, respiratory, urine, wound/body fluid, and anaerobic cultures, mycology, mycobacteriology, parasitology, and molecular microbiology). Fellows will learn the basic principles and practices of clinical microbiology and the capabilities of our laboratory from medical technologists and laboratory faculty. Fellows may contribute to patient safety/quality improvement projects related to laboratory workflow, and are also expected to participate in and periodically lead daily microbiology rounds with the clinical teams at EUH as well as pathology residents and fellows. One unique aspect of the clinical microbiology rotation at Emory derives from the proximity of EUH to the Centers for Disease Control and Prevention, which allows expert faculty from CDC to join microbiology rounds on a regular basis and provide their insights on active issues in the clinical laboratory.

Emory University Hospital Midtown is located in Midtown Atlanta and is a university-owned community teaching hospital with 500 beds that is staffed by both private physicians and full-time faculty of Emory University School of Medicine. The patient mix includes the entire spectrum of adult patients including those with critical illness, post-travel patients, persons living with HIV and obstetrical patients. Unique aspects of this site for clinical training include exposure to patients with complex otorhinolaryngological and cardiovascular procedures, patients with orthopedic infections, obstetrical patients, and post-travel patients (EUHM is the site of the Emory TravelWell Clinic).

Fellows rotate on the General ID Consult service at EUHM in one month blocks (average of two blocks in Year 1). The consult team includes the fellow, an attending, an advanced practice provider, as well as residents and medical students. Teaching takes place at daily attending rounds.

Grady Memorial Hospital is a large public urban hospital (~1000 beds) located in downtown Atlanta that serves as the source of care for a population of more than half a million and receives 2,000 patient visits per day. Common infectious disease problems encountered include HIV/AIDS and associated complications, orthopedic and trauma/burn-related infections, diabetes-related infections, tuberculosis, sexually transmitted infections, and tropical diseases (because of an increasing number of patients from Latin America, Southeast Asia and sub-Saharan Africa). Specialized HIV care for select patients is provided on a separate ward (Special Immunology Service, see below), but the inpatient consult fellow will nevertheless gain significant experience evaluating opportunistic infections in patients with late stage HIV infection

Fellows rotate on the General ID Consult service at GMH in one month blocks (average of two blocks in Year 1). The consult team includes the fellow, an attending, as well as residents and medical students. Teaching takes place at daily attending rounds and clinical microbiology rounds several times per week.

The Special Immunology Service (SIS) is one of the few remaining inpatient services nationwide dedicated exclusively to the care of patients living with HIV who are admitted for complications related to HIV infection or HIV medications, opportunistic infections or any other acute medical issues. ID fellows play a significant and primarily teaching role on this service. In conjunction with the supervising ID attending, the ID fellow assists in supervising the education of PGY-2/3 residents and medical students and facilitates daily work rounds. In addition, formal teaching rounds occur daily, five days/week, and the ID fellow is expected to present teaching rounds twice/week.

First-year fellows rotate on the SIS service at GMH for one month in Year 1.

The Atlanta VA Medical Center is a 243-bed primary and tertiary care facility with an adjacent 100-bed nursing home unit. Given the burden of multiple medical and mental health comorbidities affecting our veteran population, including diabetes and substance use disorders, common infectious disease problems encountered include “bread-and-butter” issues such as diabetes-related and skin/soft tissue and bone and joint infections, as well as HIV/AIDS and associated complications.

Fellows rotate on the General ID Consult service at the VAMC in one month blocks (average of two blocks in Year 1). This tends to be a lower volume service than the other training sites, therefore the consult team is made up of the fellow and an attending.