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Fellows participate in a minimum of 12 months of clinical training during the 3-year period. This clinical schedule is flexible. Typically fellows spend three months each on the consulting service at Le Bonheur and St. Jude and one month on the HIV service at St. Jude in their first year, and an additional two months at each hospital over the subsequent two years. In the third year, an additional two weeks is spent on the HIV service to bring fellows up-to-date on recent therapeutics and clinical trials. Fellows take calls by pager at night and have one day off per week (averaged monthly) during their clinical rotations.
Clinical rotations at Le Bonheur and at St. Jude afford the fellow the opportunity to manage a tremendous variety of pediatric infectious diseases. Le Bonheur is a new 230-bed JCAHO-accredited freestanding children's hospital that serves as a tertiary referral center for children in the neighboring six states. Fellows also see neonates at the adjacent Regional Medical Center 70-bed neonatal intensive care unit. More than 400 consultations for infectious disease issues are performed yearly. Fellows on the clinical service at Le Bonheur also attend the outpatient pediatric infectious disease clinic and bimonthly clinic for HIV-exposed newborns. At Le Bonheur, the fellow supervises medical students and pediatric and medicine/pediatric residents on the infectious diseases team.
St. Jude is a 60-bed freestanding JCAHO and Commission on Cancer-accredited hospital whose main mission is to provide medical care to children with cancer, other hematologic disorders, and immunodeficiencies, including HIV. Approximately 300 consults for infectious diseases are performed each year. One of the country's largest Pediatric AIDS Clinical Trial Units is located at St. Jude with subsites at Le Bonheur, the Regional Medical Center, Methodist Hospital, Washington University, and Vanderbilt University. Fellows on the clinical service at St. Jude consult on immunocompromised inpatients and outpatients and care for patients with HIV who are hospitalized. Rotations in the HIV clinic provide opportunities to learn about the day-to-day care of these patients and conducting multicenter trials.
A combined clinical conference with presentations of patients from St. Jude and Le Bonheur is scheduled weekly.