PA Fellowship

Overview

This fellowship is an intensive 12-month program that will expose the PA to a wide variety of adult infectious diseases as well as the basics of academic life. Allocation of effort for clinical training will be approximately 80% and this will include work on the adult inpatient ID consult service, outpatient clinics (i.e. general ID, HIV and travel medicine), Outpatient Antimicrobial Therapy (OPAT), Antibiotic Stewardship, Microbiology and Infection Prevention. The fellow will also receive weekly didactic lectures, microbiology plate rounds and participate in ID case conferences and journal clubs. The remaining 20% allocation will be uniquely focused on academia, especially within a PA program. The fellow will participate in a myriad of activities such as evaluating physical exam or history-taking via rubric, case facilitation, providing anti-infective reviews, interviewing prospective students, participating in accreditation/assessment activities and other duties as appropriate.

The program at ECU Health Medical Center/Brody School of Medicine provides

Training in ID consultation in a 900+ bed academic referral center for Eastern North Carolina. ECU Health Medical Center serves as the teaching hospital for Brody School of Medicine, with referrals from a 29 county-wide region, in addition to the 8 hospitals which are part of ECU Health system.

A broad clinical experience, both in- and out-patient, which includes robust training and participation in

• Clinical Microbiology
• Antibiotic Stewardship
• HIV clinic
• Outpatient Infectious Disease clinic
  • General ID and chronic viral hepatitis clinic
  • International Travel Clinic & Global Health
• Hospital Epidemiology & Infection Control

The fellowship schedule includes

• Weekly lectures and Case Conference
• Weekly Board Review
• Weekly Microbiology Plate Rounds
• Monthly journal club

PA School Academic Duties

Participation in didactic as well as clinical activities within an ARC-accredited PA program

Fellowship Conference Schedule

Curriculum

Inpatient General ID Consultative Services

• One of the most important aspects of the educational experience is rotation through the inpatient consultative services comprised of two ID fellows, internal medicine residents, PharmD’s, occasionally 3rd and 4th year medical students or PA students as well as an APP.
• The fellows spend approximately 40-50 percent of their time on the ECU Health ID consult service.
• Consultations include patients with a wide variety of infectious disease pathology including a large number of patients with AIDS and opportunistic complications, as well as solid organ transplant recipients (kidney and pancreas) and those with leukemia, lymphoma, and solid malignancies.
• There are also weekly “plate rounds” with our in-house director of microbiology. The presence of multiple surgical services including a separate cardiac center offer unique consult opportunities. Read more about ECU Health Medical Center.

Outpatient experiences

HIV Continuity Clinic

The fellow will participate in an HIV continuity clinic over the course of their training. The clinic is one of the largest Ryan White funded comprehensive HIV clinics in the southeastern US with a >1500 patient base, social workers, case managers, two on-site pharmacists and adherence counselors.

General ID and HCV clinic

• The fellow’s general ID clinics typically occur two half-days per week when not on inpatient consults. In this clinic fellows will see infectious diseases referrals from within ECU/ECU Health and the outside community.
• The spectrum of patients includes tuberculosis, FUO, osteomyelitis, infective endocarditis, Lyme disease, complicated pneumonias, UTI, STDs, prosthetic joint infections, workup of the solid organ transplant patient, and many more.
• Additionally, this clinic serves as the fellow hospital follow-up clinic. Fellows will also have an opportunity to interact with social workers and home health agencies regarding follow-up and care of patients who are on home intravenous antibiotics.
• Our ID clinic is a major referral center for patients living with Hepatitis C in the region. We uniquely have our fellows participate in Hepatitis C management on their General ID Clinic. We have an on-site Hepatitis C pharmacist who processes drug applications, prior authorizations and helps manage potential drug interactions.

Microbiology

Antimicrobial Stewardship

• Antibiotic stewardship is an integral part of our Infectious Diseases training given our robust stewardship team. Fellows will participate in a two-week rotation with the stewardship pharmacists where an individualized curriculum is created based on individual fellow goals.
• There will be dedicated time for the Fellow to focus on specific areas including adherence to infectious disease guidelines, de-escalation, IV to PO conversion, pharmacokinetic and pharmacodynamic drug properties, drug dosing, dose adjusting based on renal function and weight, monitoring parameters of antimicrobials, drug cost, and drug-drug interactions.
• There is also a lecture devoted to the development, implementation, and management of an antimicrobial stewardship program. In addition, the stewardship team provides didactic lectures, case-based discussions, and services on the inpatient hospital consult service. Fellows are members of the antimicrobial utilization stewardship subcommittee and are encouraged to attend the monthly meeting the first Tuesday of every month.

Allison Field, PharmD

David Laurent, PharmD

Melissa George, PharmD

Nicole Nicolsen, PharmD

Outpatient Parenteral Antibiotic Therapy

Our fellows have the opportunity to do a 1-week rotation with the OPAT team at the end of the Antimicrobial Stewardship rotation during their fellowship. This rotation includes interaction with Infectious Disease attendings and Infectious Disease clinical pharmacists.  During this period, the trainees learn about selection of patients that qualify for intravenous antibiotic therapy outside of the hospital, selection of different antimicrobial agents and combinations amenable for infusions at home, they learn to determine duration of antimicrobial therapy, monitoring of important parameters to assess response to medical therapy and subsequent medical evaluations.

Ryan Gallaher, MD, FIDSA

David Herman, MD

Infection Prevention

Travel Medicine

• East Carolina University International Travel Clinic offers pre-travel counseling, immunizations, and health advice for adults and children who are planning to travel out of the U.S. The clinic is a North Carolina State Department of Health-designated center for yellow fever vaccine.
• The fellows are expected to provide service in the travel clinic during the second half of their training.

Research

The fellows are required to at least participate on a QI project. In addition, there are periodic research conferences in which the fellows will learn about and train on CITI courses, IRB process, research design, REDCap, and statistical analysis, etc.

NCIDS

NC Infectious Disease Society

Current Fellow

Megan Joyner, PA-C

Apply for Fellowship

The following information should be sent to the program directors listed below

• CV
• Official Transcripts
• Graduate of Accredited Physician Assistant Program
• NCAPA board certification
• Unrestricted PA license from NC Medical Board (may be obtained within 30 days of start of program
• Submission of required credentials package to ECU Health
• Completion of all required employment paperwork/background checks, etc.

**Failure to obtain/complete above items may result in dismissal from program

Contact Information

Dora A. Lebron, MD
Program Director
lebronfiguerod15@ecu.edu

Mike Schwartz, PharmD
Program Director
schwartzm18@ecu.edu