The Clinical Microbiology Laboratory at Duke University Medical Center has a fellowship training program in medical microbiology that is approved by the American Council on Graduate Medical Education (ACGME).
The program is directed by L. Barth Reller, MD, DTM&H. Four additional full-time faculty members head the following sections of the laboratory:
- Bacteriology, molecular microbiology, and mycobacteriology
- Parasitology, serology, and virology
The backgrounds of the faculty include internal medicine, infectious diseases, and tropical medicine; anatomic and clinical pathology; and the basic sciences of microbiology.
Since its inception in 1990, the Medical Microbiology Program has stressed diversity of background and shared goals in its recruitment. As of June 2009, there have been 32 graduates. There are seven pathologists and 18 infectious diseases specialists trained in internal medicine, pediatrics, or both, now practicing and teaching in the U.S.
Additionally, eight medical microbiology and infectious diseases specialists have returned to direct diagnostic microbiology laboratories in Australia, New Zealand, Oman, Pakistan, Switzerland, or Turkey. Currently, the Duke program is the largest of 13 approved by the ACGME.
After the most recent ACGME site visit on January 18, 2006, the program’s full accreditation for three positions was renewed for five years, through March 2011.
Medical Microbiology Program Mission
Fellows in the two-year joint infectious disease and Medical Microbiology Program participate in all of the required activities (clinic and conferences) of the Division of Infectious Diseases. Additionally, the medical microbiology fellows are fully engaged in carrying out the Clinical Microbiology Laboratory’s three-fold mission of service, teaching, and research. The mission statement undergirds and guides all training efforts:
Service: To provide quality diagnostic laboratory support, testing, and consultation in a cost-effective and timely manner for patients and practitioners that enable outstanding patient care
Teaching: To teach appropriate use of diagnostic laboratory tests and resource utilization in the care of patients and to train the next generation of those who perform, interpret, and develop diagnostic tests
Research: To develop and evaluate procedures and protocols that support, enhance, and extend the ability of the clinical laboratories to effectively carry out their primary service and teaching responsibilities
Fellows are selected for their potential as future directors of academic diagnostic microbiology laboratories and leaders in public and international health. Prerequisites for the program for physicians trained in the United States include completion of four to five years of anatomic and clinical pathology or one year of clinical infectious diseases after board certification in internal medicine, pediatrics, or both.
Fellows completing the program are expected to apply for subspecialty certification in medical microbiology by examination of the American Board of Pathology, the Royal Colleges, or other relevant national certification bodies.
The medical microbiology fellows undertake bench training to attain proficiency in all areas of the laboratory, including bacteriology, histopathology, molecular microbiology, mycobacteriology, mycology, parasitology, serology, and virology.
Additionally, the fellows provide consultations with attending faculty 24 hours per day about appropriate specimens, interpretation of results, and special requests. Recommendations for clinical or epidemiological consultations by one of the adult or pediatric infectious diseases services or the infection control and hospital epidemiology service are made as appropriate.
Fellows are expected to attend the following conferences, rounds, and meetings:
- Attending work rounds for review of results and diagnostic strategies are done Monday through Friday from 11:00 a.m. to 12:00 noon.
- Plate (teaching) rounds are held Wednesday and Friday from 1:15 to 1:45 p.m. in the Clinical Microbiology Laboratory.
- A joint faculty and MM fellow meeting is held the second and fourth Wednesday of each month from 7:30 to 9:00 a.m to review the medical microbiology fellow educational program, fellow projects, and laboratory management.
- An infectious disease and MM journal club is held every Tuesday from 12:00 to 1:00 p.m.
- The fellows also attend a research conference every Monday from 4:00 to 5:00 p.m. and a clinical conference every Tuesday from 4:00 to 5:00 p.m.
- Additionally, the histopathology of infectious diseases is incorporated whenever possible into the daily teaching rounds. Fellows and faculty participate in numerous other conferences and lectures, both scheduled and on special request.
In summary, the published research activity and graduates of the Medical Microbiology Program have gained national and international recognition. The total integration of the program with the adult and pediatric infectious diseases units as well as the CDC and international collaborators is unique.
The joint training program in medical microbiology and infectious diseases (adult and pediatrics) at Duke University Medical Center has been in the vanguard of international innovations in clinical training to meet the increasing complexity of evolving infectious diseases.