My Infectious Disease Elective

One of the most important parts of acting like an adult learner - rather than just another med student requiring to be spoon fed - is going into clinical experiences with your own list of personal objectives you would like to meet.

While these may not always be met, it gives you an opportunity to guide your own learning. My personal objectives before starting infectious disease were very simple. I wanted to know how to treat the types of diseases I would see in a family docs office. This wasn't at all accomplished in my 2 week rotation, but I did end up with a completely different learning experience than I expected.

Our days went from 8:30 to 5:00, starting with going through our patient list and ensuring that lab work was within limits from an ID perspective (liver enzymes, drug levels, neutropenia, etc.) and that our patients were still on the level of anti-infectious agents the team had suggested. As a consult team, we make suggestions about the care of a patient, but it's up to the patient's primary team to agree or disagree with our recommendations.

We would also be paged from other services asking for our opinion on treatment options for their patients. These were for patients who were allergic to most meds, had a resistant type of infection, had no identifiable source of infection, were HIV positive or just generally were a bit too strange for the team to deal with.

Some half days were spent in the HIV patients in follow up or to start those recently diagnosed as being HIV positive with a drug regimen.

The list of things that I learned on this elective includes:

1. How to find the source of infection when it's not immediately obvious. This can include scraped skin on carpet after an elderly patient has fallen, a pneumonia 6 months before osteomyelitis and hepatitis secondary to needle sharing in the '90s.

2. How to use my Sanford Guide. This book is brilliant!

3. HIV care has changed dramatically since my friends were diagnosed in the 90s. One pill once a day. WTF? It's amazing. I'm still in awe.

4. Hospital staff are incredibly prejudiced about our patients with HIV and Hep C. I wish I could teach them all to behave like good boys and girls but feel this could take a very long time.

5. I can see myself adding an infectious disease element to my family practice, likely HIV and Hep C care.

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