Inpatient Experience:

Fellows spend a total of 12 months on clinical service over the course of a three year training period, divided into both inpatient and outpatient experiences:

The inpatient experience is spent at the main teaching hospital, The Lucile Packard Children’s Hospital at Stanford (LPCH), which has 361 beds. LPCH is at the core of the larger Stanford Children’s Health that together form the largest network of care for children and pregnant woman in Northern California. This extensive clinical program includes 94 specialties, 6 centers of excellence, a busy obstetrics program for high risk pregnancies, and is home to the #1 ranked Pediatric transplant program for volume with top patient outcomes. The large intensive care units along with high volume surgical programs add to the robust patient exposure that the fellow will encounter during their clinical rotations.

In 2021, in response to increasing patient volume and complexity, we divided our inpatient service into two teams, General ID (Gen) and Immunocompromised Host ID (ICH). Both teams include a variety of patient complexity and illness states. The ICH team specifically includes patients who are immunocompromised, including patients with solid organ transplants, bone marrow or stem cell transplants, rheumatologic conditions on biologic agents, primary immunodiffusions- and more. We also include patients from the neonatal ICU on the ICH team.

The fellow is expected to lead the inpatient clinical service with direct supervision from the attending faculty member on service. The fellow thus takes an active role in the care of all patients, runs rounds, and coordinates all other learners and team members rotating on the clinical team. The clinical team often includes medical students, pediatric residents and pharmacists. We also often have an advanced practice provider who works with the clinical team on inpatient rounds and consults during the week.  The fellow is expected to be the main contact communicating to referring physicians within LPCH and the broader community, and to work with the clinical nurse specialist and dedicated medical assistant on any patient-related issues.

Outpatient Experience

Clinical experiences are enhanced through the expanding ambulatory experiences available to the fellow. Fellows follow a panel of continuity patients throughout training. First year fellows follow a select population of patients discharged from the hospital to build experience in the full trajectory of an infectious disease experience. Second and third year fellows have a regular clinic where they see hospital discharges as well as new patients referred from the LPCH network and broader community of general pediatricians.  The continuity of care is an important part of the fellow’s clinical skills development and provides long term follow-up experiences. There is a strong collaboration with the transplant programs, and fellows are exposed to pre-transplant screening for exposures and vaccines, as well as the full array of infectious complications in the large population of transplant recipients followed at LPCH. Fellows also will be involved with pre-travel recommendations and any post-travel illnesses.

Other Clinical Experiences:

Fellows are fortunate to benefit from the broad range of clinical programs that reflect growth areas in Pediatric Infectious Diseases. Our Division has robust programs in Antibiotic Stewardship (ASP), Infection Prevention and Control (IPC), Hospital Epidemiology and Quality Outcomes, Global Health, and Transplant Infectious Diseases. Antimicrobial Stewardship and IPC are both particularly relevant skills both for regular clinical service as well as career exploration and development. Our fellows thus have two week dedicated experiences with each team in the first year. Fellows also complete a two week rotation in our state-of-the-art Microbiology lab in the first year. There are also options for additional electives, clinical or otherwise, built into the first and second year, which are individualized for each fellow’s interests.