Infectious Diseases
Educational Goals & Overview
The overall purpose of this rotation is to train residents to competently care for hospitalized and clinic patients with a broad range of infectious diseases, and know when and how to appropriately consult or refer to specialty care.
Important Information
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The General ID consult team is expected to arrive by 7:30am on weekdays. The residents & students on the team will be overseen and lead by the General ID Consult Fellow listed on Amion (amion.com → login: usc id).
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The General ID Consult Service is a daily service with attending and resident coverage and inpatient rounds everyday, including on weekends and holidays. To facilitate timely consults and recommendations to primary teams, ID attending rounds with the ID fellow, residents, and any students will generally be conducted twice a day: once in the morning and again in the afternoon.
Specific times will be coordinated with the ID attending on service, but morning rounds will typically focus on old patients and new consults from overnight, with afternoon rounds focusing on additional new consults from the late morning and pertinent updates. ID faculty are expected to perform bedside teaching, discussion of pathophysiology and use current literature to aid in diagnostic and therapeutic decisions. The attending can always be found listed on Amion (amion.com → login: usc id).
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The ID consult team must check the consult line regularly throughout the day. We recommend checking at least 5 times per day: once when you get in the morning, ~30 minutes before morning rounds, after morning rounds, ~30 minutes before afternoon rounds, and one more time before heading out for the day.
- Dial 323-409-3851 (or x93851 from a hospital landline)
- Once the automated message begins, push *
- Prompts for an ID: Enter 93851#
- Prompts for a PIN: Enter 12345#
- Press 3 to delete a message
- Share all consult requests in the “ID Consult Team” Teams with patient’s name, MRN, reason for consult, and brief story.
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- Lectures take place every Tuesday and Friday 8:00-9:00am in the Clinic Tower A6E Conference Room. Please plan your pre-rounding accordingly as morning rounds often start 9:15-9:45am and you are expected to have seen all of your patients by then.
- ID Clinic at Rand Schrader 3rd Floor are on Wednesdays 8:00am-12:00pm and Fridays 1:00pm-4:30pm. One resident representative from the ID consult team may attend.
- Microbiology Plate Rounds take place weekly on Fridays from 11:30-12:00pm. Micro rounds are held in the microbiology lab (Clinic Tower, 7th floor) and conducted by Dr. Susan Butler-Wu, Director of Clinical Microbiology.
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An important first step for a consultant is to identify and document the specific reason for consultation. “Fever” or “Antibiotics” are generally not adequate reasons for ID consultation, whereas “assistance with diagnostics and empiric therapy for suspected CNS infection” is more appropriate.
Data Gathering:
In most circumstances, the following are critical data elements to obtain and include when evaluating and presenting new Infectious Disease consult patients:
• A thorough history of symptoms – including onset & duration
• A complete social history, including birth, travel, tuberculosis exposure, vaccine history, animal contact, sexual history, & drug use history all as appropriate.
• A complete physical exam including review of vital signs (particularly fever curve) with special care given to organ systems relevant to the clinical symptoms.
• A review of current and previous antimicrobials, including dates of administration*
• Relevant Microbiology cultures with antimicrobial susceptibility testing results
• Relevant current or previous serologic testing and/or histopathology
Communication of Recommendations:
After rounds, ID consult team members are expected to communicate all recommendations to the primary teams. Please ensure that at least one member of the primary team has been reached before the end of the day.
Documentation:
All notes need to end with “Discussed with Attending Dr. [Name]” and should be forwarded to the ID fellow to addend and co-sign. The ID fellow will then forward the note to the attending to sign.
• Remember that notes are legal documents! You must take ownership of every sentence in your notes. Please do not copy & paste other teams’ histories or exam findings.
• Do not forget to add a “subjective” section that is separate from the “Hospital Course” in your progress notes.
• Make sure that there are “microbiology” and “antimicrobials” sections on your notes and that they are updated daily.
• Please read and update your entire A&P daily! If a differential is no longer being considered, then state so. If a diagnosis is made, update it.
• Unless you will be gone in the afternoon, do not sign your notes until afternoon rounds are done as there might be updates to the plan.
Infectious Disease Clinic
The Los Angeles General Rand Schrader Clinic provides comprehensive HIV primary and specialty care to over 2,000 patients, primarily from underserved Latino and African American communities. Staffed by a multidisciplinary team of faculty, fellows, physician assistants, nurses, and case managers, the clinic offers over 50 weekly provider sessions to ensure accessible and continuous care. The clinic operates weekdays, including Tuesday evening hours, and emphasizes whole-person care through its Medical Care Coordination (MCC) model. Additional on-site services include psychiatric care, gynecology, a unique HIV dermatology clinic, and advanced procedures for HIV-associated lipodystrophy. A specialized HIV-Hepatitis C Coinfection Clinic is also held weekly to address co-infected patients’ needs. Read More Here
The Infectious Diseases clinic occurs on Wednesdays from 8:00am-12:00pm and Fridays 1:00pm-4:30pm at Rand Schrader 3rd Floor. If you are on consults and in ID clinic, please complete clinic and return to the hospital to evaluate consults in the morning or afternoon depending on your clinic schedule.