Contact Information

Pediatrics


Uniformed Services University of the Health Sciences
4301 Jones Bridge Road
Bethesda, Maryland 20814
Phone: (301) 295-3130
Fax: (301) 295-3898

Department Chair

Ildy Katona, MD, CAPT, USN (Retired)
Professor of Pediatrics and Medicine

Secretary: Ms. Daphne Thomas
Email: daphne.thomas@usuhs.edu

The Pediatric Infectious Diseases Fellowship Training Program of the National Capital Consortium

Introduction

The Pediatric Infectious Diseases Fellowship program, which had its start in 1984, is fully accredited by the Accreditation Council for Graduate Medical Education (ACCME) and designed to prepare physicians for careers in either clinical or academic pediatric infectious diseases. It consists of three years of post-graduate medical education, which includes both clinical and research experience. Applicants must have completed, or anticipate successful completion of, a pediatric residency, and be either board-certified or eligible to sit for the certifying examination in general pediatrics. The Pediatric Infectious Diseases Fellowship comprises clinical and research experience. The pediatric referral base for the Walter Reed National Military Medical Center (WRNMMC), Bethesda, MD, includes not only the five military bases in the immediate Washington, DC, area, but also multiple military hospitals in the eastern region of the United States, and from various countries outside CONUS. The program exists in affiliation with the combined National Capital Consortium (NCC) pediatric residency program at Walter Reed National Military Medical Center (WRNNMC), Bethesda, MD. The fellowship, which comes under the umbrella of the NCC, is based within the Departments of Pediatrics at WRNMMC and the Uniformed Services University of the Health Sciences (USUHS).

Weekly case presentations are discussed at dual pediatric and adult infectious disease conferences. In addition, both services meet on a weekly basis for an hour of didactic teaching. Participation in the Greater Washington Infectious Diseases conferences (both civilian and military), where the most interesting infectious diseases in the Washington-area are presented monthly, is an added bonus of our location. These conferences are attended by some of the leading experts in the various sub-specialties within infectious diseases. Rotations in Tropical Medicine also are encouraged and are taught at USUHS. There also are field rotations in Peru, Thailand, Brazil, Cairo, and Dominican Republic, which are offered after the didactic portion of the rotation. Active duty in one of the Uniformed Services of the United States (Army, Navy, Air Force, or Public Health Service) is required.

Information on incurred obligations, pay, and allowances may be obtained from the Office of Graduate Medical Education. Applicants must apply through, and be sponsored by, the Graduate Medical Education office of their respective branch of service for postdoctoral training. Requests for training should list the Pediatric Infectious Diseases Fellowship Program of the NCC at USUHS as their site of choice. Application deadlines are usually in September and are determined by the individual services. Where feasible, applicants are encouraged to visit the USUHS and Walter Reed facilities and arrange personal interviews with faculty members. If a visit is not practical, applicants should contact the Program Director and submit an updated Curriculum Vitae and letter of intent.

Goals

Our goals are to develop Pediatric Infectious Disease specialists who are proficient in:

  1. Clinical pediatric infectious diseases: consult services and clinic Patients with fever and neutropenia, complex community-acquired infections, post-surgical infections, unexplained inflammatory conditions, immune deficiency, etc.
  2. Both basic science and clinical research: cases, case series, prospective clinical projects; as well as work in immunology, vaccinology, tropical and global medicine, models of pathogenesis, enteric toxins, shock, novel therapeutics, etc.
  3. Teaching: both informal clinical teaching, and teaching in formal settings such as lectures, conferences, workshops, etc.
  4. Military medicine: in tropical and global medicine, travel, immunizations, humanitarian relief, and biodefense.

Clinical Experience

The Pediatric Infectious Diseases Fellowship comprises both clinical and research experiences. The fellowship consists of 36 months, 12 of which are inpatient clinical months, and 24 months primarily devoted to research and independent learning. The inpatient clinical experience is augmented by pediatric outpatient clinics for general infectious disease referrals and HIV-specific referrals. The inpatient service is primarily at the WRNMMC. Two outside rotations augment their clinical experience. The first is a one-month rotation at the Children's National Medical Center in Washington, DC. This rotation gives our fellows exposure to transplant (solid organ and bone marrow) medicine as well as opportunities to care for children with HIV in the inpatient setting. The second is a rotation at Inova Fairfax Children's Hospital, Fairfax, VA. This is a robust community children's hospital, where the fellows are exposed to a diverse cultural experience with high census neonatal and pediatric intensive care units. The ACGME has lauded this diversity in clinical rotation sites. The curriculum is integrated with the Internal Medicine Infectious Diseases fellowship. A unique part of our curriculum includes the experience in Tropical Medicine. All fellows participate in either a one-month or three-month course. The longer course is encouraged and allows the fellows to sit for certification by the American Society of Tropical Medicine and Hygiene, one of very few opportunities that exist in the nation. Furthermore, overseas travel is encouraged and recent graduates have experienced medicine in Kenya, Thailand, Ethiopia, Peru, Honduras, and Sri Lanka. The fellowship program benefits from the clinical and academic synergy of four other Pediatric Subspecialty fellowships that are part of the NCC, as well as a full representation of faculty from Pediatric and Pediatric Surgical subspecialties.

Military-Unique Curriculum

An environment of military experience excellence is promoted by the program. All elements of the military-unique curriculum of the Department of Pediatrics are encouraged strongly to include participation in tropical and global medicine, biodefense agents training, travel medicine, Military Medical Ethics, and completion of the Military Medical Humanitarian Assistance Course sponsored by USUHS. The Tropical Medicine training is as robust as any such training in the nation. Following completion of a one- to three-month didactic portion of the course, fellows travel to overseas sites to apply the knowledge learned to practical situations. Due to our unique geography, our trainees are able to take advantage of the Medical Management of Chemical and Biological Casualties Course (MMBC) offered at Ft. Detrick, MD. This course provides state-of-the-art training in the management of biologic casualties. The fellows also learn by direct hands-on participation in aero-medical evacuation from within and without the United States. They provide telephone consultations to colleagues around the world, building a future pediatric community of international scope.

Research

Research is an integral component of the training received by a fellow. The combined NCC pediatric subspecialty fellowships are founded among a rich scientific research community. This facilitates flexibility in choosing a high impact fellowship research project and providing the experienced mentoring required for success. The USUHS Department of Pediatrics also has a corps of faculty mentors skilled in clinical research in the areas of observational, outcomes/comparative effectiveness, and health services research. Research Administration provides research review services, computerized data analysis, statistical support, and publication pre-review and approval.

The fellowship has a long history of excellent research productivity. Present research opportunities include working with investigators at USUHS, the National Institutes of Health (NIH), Walter Reed Army Institute of Research (WRAIR), and the Naval Medical Research Center (NMRC). Recent fellows have worked in various fields that have both pediatric and military relevance. HIV research on the prevention of mother-to-child transmission and vaccine development has been the focus of some recent efforts in conjunction with investigators with the U.S. Military HIV Research Program. Similarly, fellows have worked in both WRAIR and NMRC laboratories in the field of malaria treatment and prevention. This involvement has allowed fellows to experience the process of translational medicine, evolving from basic science research to clinical trials. Lastly, opportunities exist for collaboration with investigators in the Enteric Diseases Department at NMRC. These longstanding research connections train fellows in areas with great operational and pediatric relevance in both the United States and global health communities. These fields help trainees work on both clinical and basic science research in settings in the United States and overseas.

Opportunities with investigators at USUHS are vast. The basic science laboratories include 2000 square feet of space, and are well equipped for animal studies, general biochemistry, cell culture, and molecular biology. Extractions of RNA and DNA, Northern, Western and Southern blotting and polymerase chain reaction analysis are performed. Gene synthesizers, automated nucleic acid sequencers, and protein sequencing are available also. A very strong relationship with the Department of Microbiology has led to collaborations in many areas. Past fellows have worked with investigators studying the pathophysiology of E. coli and its many disease manifestations. Other fellows have worked in laboratories studying Neiserria gonorrheae and Neiserria meningitidis. These investigations have focused on the developing antibiotic resistance and immunologic aspects of the host response to these organisms. Finally, opportunities exist to work with scientists who have research focuses on many other bacterial, viral and parasitic diseases.

The last area of emphasis for research resides in the area of respiratory pathogens. The fellowship has a long track record of success in examining pathogens that cause childhood respiratory diseases. Previous investigators have focused on the pathophysiology, prevention, and treatment of disease due to pathogens such as respiratory syncytial virus (RSV), influenza, and parainfluenza. Additionally, studies have examined co-infection models with common bacterial pathogens such as Staphylococcal aureus and Streptococcus pneumoniae. Ongoing research investigates the early childhood immune responses in order to help understand why RSV remains such a difficult pathogen in pediatric patients.

The USUHS Department of Pediatrics also has a corps of faculty mentors skilled in clinical research in the areas of observational, outcomes/comparative effectiveness, and health services research. Recent efforts have looked at the pediatric manifestations of infection due to Clostridium difficile and vancomycin-resistant Enterococcus. Fellows performing clinical research also will have the opportunity to complete requirements for the MPH degree at USUHS.

Additional information for the specialty can be found on the Council of Pediatric Subspecialties website.

Program Leadership

Program Director: Michael Rajnik, Col, USAF, MC
Associate Program Director: Matthew Eberly, Maj, USAF, MC
Associate Program Director for Tropical Medicine: Patrick Hickey, LTC, MC, USA

Additional Program Faculty

Stephen Spencer, COL, MC, USA
David Stagliano, LTC, MC, USA
Martin Weisse, COL, MC, USA
Allison Malloy, MD
Martin Ottolini, MD, Col (Ret), USAF, MC

Additional information, application instructions and program requirements are available through:

Program Coordinator
franklin.abram@usuhs.edu
301-319-0708

or

Michael Rajnik, MD, Col, USAF, MC
Pediatric Infectious Diseases Fellowship Director
Associate Professor of Pediatrics
F. Edward Hébert School of Medicine - "America's Medical School"
Department of Pediatrics, USUHS
4301 Jones Bridge Road
Bethesda, MD 20814
e-mail:michael.rajnik@usuhs.edu
Fax: 301-295-3898