The alarm rings, the birds chirp, and the germs quiver; the infectious diseases fellow is up for the day.
When you are on a service week, the day starts with a mix of new consults and old patients to follow up. The spread is familiar: fever in a returning traveler, cough with a positive tuberculin skin test, joint pain and swelling in a febrile 12-year-old. There is work to be done. The good news is you have a co-fellow there to divide and conquer.
Rounds start mid-morning with our full team of fellows, rotators, students, the attending, and a pharmacy resident. We head to Radiology and review any new or questionable images. MRI confirms what we suspected, tibial osteomyelitis. Chest XR shows a cavitary lesion concerning for activate pulmonary TB. We head around to see our patients. Plans are made, teams are called, and diseases are stamped out.
The afternoon comes and it’s time for Microbiology rounds. We sit down with Dr. Campos and walk through the workup, identification, and susceptibility testing of a new culture. If it is Tuesday, we have a board review session and case conference. To end the day, we see our afternoon consults, check up on our patient’s management, and crank out those notes.
If you are not on a clinical week your day can begin quite differently. Categorical fellows will make their way to the hospital or the NIH to plan and carry out their research goals. FDA track fellows on the other hand make their way to the sprawling FDA compound in White Oak, MD for a top secret day of medical review. You are placed in charge of overseeing large scale clinical trials, reviewing protocols, and coordinating a team of statisticians, toxicologists, and biochemists. You’ll take meetings in the morning then critique and edit proposed clinical trials in the afternoon. Some of you will work on vaccine development: maybe helping with Phase 3 pivotal trials in HIV, Ebola, or Influenza; others will work on new antivirals and antibiotics. Good news, when the work gets too heavy you can take a walk on the campus trails or stop for a yoga or powerlifting class at the gym.
After work you see if your co-fellows are free to meet for drinks, food, or even a night at the opera before you call it a day…well sort of, fellows always have reading to do.