Pediatric Infectious Disease Fellowship Training
in The National Capital Consortium

Introduction
Pediatric Infectious Diseases is a three-year fellowship in that includes the following educational activities:

Goals
We want to develop Pediatric Infectious Disease specialists who are adept at:

  1. Clinical Pediatric Infectious Diseases - consult services and clinic (Patients with fever and neutropenia, complex community acquired infections, post-surgical infections, unexplained inflammatory conditions, immune deficiency, etc.)
  2. Both basic science and clinical research (Cases, case series, prospective clinical projects; as well as work in immunology, vaccinology, tropical and global medicine, models of pathogenesis, enteric toxins, shock, novel therapeutics, etc)
  3. Teaching - both informal clinical teaching, and teaching in formal settings such as lectures, conferences, workshops, etc.
  4. Military medicine skills - in tropical and global medicine, travel, immunizations, humanitarian relief, biodefense agents.
  5. All of our graduates are board certified, and most hold senior leadership positions in and out of the military.

Prerequisites
Active duty in a uniformed service of the United States is required.

The Pediatric Infectious Diseases Fellowship program provides an intensive experience in pediatric infectious diseases for the physician who has completed at least one year of pediatric internship and two years of pediatric residency.

Applicants must be US citizens and either board certified or eligible to sit for the certifying examination in general pediatrics.
 
The program is designed to prepare physicians for careers in either clinical or academic pediatric infectious diseases and consists of three years of post-graduate medical education, which includes both clinical and research experience.

The program is flexible, and can be modified to meet the needs of the individual.
The program is sponsored by the National Capital Consortium, with clinical practice located at two of the affiliated hospitals (Walter Reed Army Medical Center, Washington DC and the National Naval Medical Center, Bethesda MD). The National Capital Consortium receives patient referrals from military bases around the world.
Research opportunities are available at the Uniformed Services University, the National Institutes of Health, the FDA and various private laboratories in the Washington area.
Application forms are available from local GME offices (major military hospitals) and are made through the individual services.
A copy of all application materials should be sent to:
Michael Rajnik, MD
Major, USAF, MC
Acting Program Director for Pediatric Infectious Diseases
Department of Pediatrics
Uniformed Services University of the Health Sciences
4301 Jones Bridge Rd., Bethesda MD 20814.
Telephone inquiries are welcomed (301)295-3391, and a visit to the unit is encouraged.

Program Description
The pediatric infectious diseases fellowship is made up of both clinical and research experience. The fellowship consists of 36 months, of which 12 months are inpatient clinical months and 24 months are primarily devoted to research.

The inpatient clinical experience is augmented by pediatric outpatient clinics for general infectious disease referrals and HIV specific referrals.  The inpatient service covers two hospitals which are within 10 minutes drive of each other. All non-newborn pediatric inpatient consults are based at Walter Reed Army Medical Center (WRAMC) in Washington, D.C., while all neonatal consults are based at the National Naval Medical Center (NNMC) in Bethesda, MD.  The pediatric referral base for WRAMC includes not only the 5 military bases in the immediate Washington, D.C. area, but also multiple military hospitals in the eastern region of the United States, as well as from various countries outside the continental United States. Nursery referrals are from a level III nursery located at NNMC that also services not only the local Washington, D.C. area, but many nurseries throughout the world.

Weekly case presentations are presented at dual pediatric and adult infectious disease conferences. In addition, both services meet on a weekly basis for an hour of didactic teaching. Participation in the Greater Washington Infectious Diseases conferences where the most interesting infectious diseases in the Washington area (both civilian and military) are presented monthly is an added bonus of our location. These conferences are attended by some of the leading experts in the various sub-specialties within infectious diseases.
Rotations in Tropical Medicine are also encouraged and are taught at USUHS. There are also field rotations in Peru, Belize, Brazil, Egypt (Cairo), and the Dominican Republic that are offered after the didactic portion of the rotation.
Research opportunities are also very plentiful. See "Research Opportunities" below to view some of the possibilities.

Research Opportunities
The opportunity for bench research within the fellowship is excellent. Research can be performed within various settings which include ongoing projects at the Uniformed Services University, the National Institutes of Health, the Food and Drug Administration, and various independent research labs in the local area.

Clinical investigations can also be arranged at either WRAMC or NNMC. Fellows also have the opportunity to be involved in NIH protocols if they so desire.
All fellows graduating from the program will be able to meet the national requirements for scholarly activity by the end of their matriculation.
Further information about specific research opportunities can be obtained from the program director by using the e-mail link, mrajnik@usuhs.mil or by calling (301) 295-3391.

Peds ID Staff and Interests
Senior Advisor: Martin G. Ottolini, MD
Area of interest:  Respiratory viruses; viral pathogenesis; HIV

Acting Director: Michael Rajnik, MD 
Area of interest:  Respiratory viruses, MRSA, clinical epidemiology
Associates:
Margaret C. Bash, MD
Area of interest:  Neisseria meningitidis; diagnostics and vaccine development
Jorge Blanco, PhD
Area of interest:  Respiratory viruses, animal modeling
Phil Brunell, MD
Area of interest:  Varicella, virology, vaccine development
Judy Epstein, MD
Area of interest:  Malaria vaccine development

Gerald W. Fischer, MD
Area of interest:  Immuoglobulin therapy of infections; neonatal infections; group B streptococci; conjugate vaccines

Val G. Hemming, MD
Area of interest:  Respiratory viruses; immunoglobulin therapy of infections; group B streptococci
Julia A. Lynch, MD
Area of interest:  Viral research, medical education, Tropical medicine
Douglas Pratt, MD
Area of interest:  Antiviral agents; retroviral therapy
David Regis, MD
Area of interest:  Malaria vaccine development
Merlin Robb, MD.
Area of interest:  HIV transmission and vaccine development; mucosal immunity
Margan Zajdowicz, MD
Area of interest:  Hospital Epidemiology

Three-Year Overview of the Pediatric Infectious Diseases Fellowship
Clinical Experience
A. Inpatient - total of 12 months full-time service coverage

  1. Year one = 7 months
  2. Year two = 3 months
  3. Year three = 2 months, 1 month as a "Junior Staff"

** Will include rotations at Children’s National Medical Center

B. Outpatient Clinic Involvement:

  1. HIV and General Pediatric Infectious Disease clinic – WRAMC
  2. Travel Medicine Clinic - NNMC

Research Requirements
A. 24 months allocated (minus tropical medicine course, etc.)

B. Goal:  At least one first-person publication in a world-class peer-reviewed journal, to be accepted within one year of completion of fellowship

C. Expectations:

  1. One to two oral or poster presentations at major meetings (Society for Pediatric Research, Infectious Disease Society of American, I), as well as similar presentations at "closed" meetings (Uniformed Services Pediatric Seminar, St. Jude Research Conference)
  2. Primary or co-authorship in one to two individual case write-ups or clinical series.
  3. Development of laboratory (Basic Science) expertise in at least one area that can be applied to future post-fellowship research at the common military training facilities
  4. Development of a "Research Protocol" submission outlining a workscope for 1 to 2 years; aimed at either fellow-obtained funding, or work to be done under senior researchers' support
  5. As a result of the above planning, completion of one to two "prospective clinical" or "bench research" projects that eventually result in publication

Development of Teaching Skills

A. Year One:

  1. Informal Student/Resident Lectures weekly during on-service months
  2. Weekly case presentation at the combined conference on Thursday afternoons during on-service months
  3. Leading infectious disease staff rounds weekly
  4. One to two didactic "state of the art" reviews per year each 30-60 minutes for Friday Morning combined I.D. service lectures
  5. Supervision of Residents/Students assigned to infectious disease elective elective
  6. One formal case presentation to the Greater Washington Infectious Diseases Society (GWIDS) Conference
  7. Presentations at combined USUHS/Children’s National Medical Center Conferences when on service.

B. Year Two:

  1. Informal conferences when on-service
  2. One formal case presentation at GWIDS
  3. Presentations at combined USUHS/Children’s National Medical Center Conferences when on service.
  4. Occasional "Staff/CME Lectures" at NNMC, WRAMC, and MGMC, etc.
  5. Involvement in MS-1 through MS-4 teaching activities

C. Year Three:

  1. Occasional "Staff/CME Lectures"
  2. Presentations at combined USUHS/Children’s National Medical Center Conferences when on service.
  3. Pediatric Grand Rounds as the presenter
  4. "Junior Attending" for one month supervising first year fellow

Computer Competency

A. Teaching-related skills

  1. Word Processing skills for handouts and outlines
  2. Proficiency in PowerPoint presentation preparation
  3. Use of search engines such as PubMed in order to complete Evidence-Based presentations
  4. Use of online database and journal access to present data at above conferences.

B. Research-related skills

  1. Database skills
  2. Statistical programs
  3. Graph/analytical programs
  4. Word Processing for publishing and use of EndNote
  5. Use of search engines such as PubMed in order to complete Evidence-Based presentations
  6. Use of online database and journal access to present data at above conferences.

Pediatric ID Weekly Schedule (Day: Time: Activity)
Monday
Tuesday
0900: HIV Meeting/Clinic at WRAMC
Wednesday
Thursday
0700:  USUHS Research Conference (monthly)
0745: Pediatric Grand Rounds (bimonthly).
0900: Naval Travel Clinic (bimonthly)
1600: ID Staff rounds and Combined case conference at NNMC or Combined rounds with Children’s National Medical Center (once monthly)
Friday
0730:  Combined Ped/Int.Med ID presentations.
0830:  ID Staff Rounds at WRAMC.
NOTES: **2 of the fellows will attend all I.D. clinics. At least one fellow attends travel clinic (If Staff Available). Everyone attends all other functions.

Contact Information
Michael Rajnik, MD, Major, USAF, MC
Phone: 301-295-3391 (Autovon 295-3391)
Fax: 301-295-3898 (Autovon 295-3898)
e-mail: mrajnik@usuhs.mil

Resources