Curriculum The multi-institutional collaborative Adolescent Medicine

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Curriculum
The multi-institutional collaborative Adolescent Medicine (AM) Fellowship Program with the
University of Illinois at Chicago (UIC), John H. Stroger, Jr. Hospital of Cook County (Stroger), and
Rush University Medical Center (Rush) is a three year program consisting of up to 2 fellows per year.
Program Director, Christiane Stahl, MD, board-certified in AM and pediatrics, together with Drs.
Florence Desrosiers and Irene Eftekhar will direct the fellows’ clinical training at UIC. These core
faculty will provide training in the outpatient care center adolescent clinic, where the fellow will have a
half-day continuity clinic for all 3 years of the program as well as additional assignments in general
adolescent clinic, adolescent gynecology clinic, and adolescent weight management clinic. Dr.
Desrosiers will also partner with the fellow who will act as a ward co-attending and consultant for
adolescents hospitalized at the University of Illinois Hospital. Other pediatric faculty will assist in
clinical training with respect to adolescents with chronic illness. The fellows will also do a 2 month
rotation on the Adolescent Psychiatry Unit under the supervision of the Adolescent Psychiatry Faculty
(Dr. Elizabeth Charney) and, for medical aspects, Drs. Stahl or Desrosiers. Dr .Allison Cowett of the
Department of Obstetrics and Gynecology will precept the fellows during a 2 month outpatient rotation
in Family Planning where they will have the opportunity to interact with the Family Planning Fellows.
Drs. Mark Hutchison and Terry Nicola will provide training in Sports Medicine.
Key clinical experiences will be obtained through partnerships with the Stroger and Rush Divisions of
Adolescent Medicine. Three months of required rotations will take place through the Stroger program
under the direction of Dr. Lisa Henry-Reid, Associate Fellowship Program Director. These include
outpatient rotations in the Adolescent and Young Adult HIV clinic at the Core Center under the
direction of Drs. Jaime Martinez and Lisa Henry-Reid (both AM board-certified) and Margo Bell , as
well as the joint medicine-psychology Adolescent and Young Adult Clinic under the supervision of both
the physicians listed above and adolescent psychologists, Drs. Karla Anderson and Hal Fuentes, a
consultative inpatient experience with adolescent and young adult trauma patients (same supervision)
with community linkage through the Stroger Trauma Unit – UIC School of Public Health Program
Ceasefire connection, and the Morton East School-Based Health Clinic under the supervision of Drs.
Stahl and Dr .Nora Smith. Experience with adolescent care in the Juvenile Detention Center is also
provided through Stroger. 1 month of required rotations will take place through the Rush program in the
Job Corps clinics attended by Dr. Cathy Joyce (AM board-certified). Beginning in the second year of
training, the fellow will have the opportunity to choose 6.6 months of clinical elective rotations.
Research Training
Eighteen months of Research training and experience will be obtained through mentoring by faculty
with ongoing federally funded research in the field. These include Dr. Benjamin Van Voorhees in the
UIC Department of Pediatrics regarding adolescent depression; and Drs. Martinez and Henry-Reid at
Stroger on adolescent HIV.
The fellows are expected to complete additional training, most likely an MPH in Maternal and Child
Health at the UIC School of Public Health. Options for completion of the MHPE program in the
Department of Medical Education or the Clinical Translational Research Certificate Program in CCTS
are alternate training pathways. Fellows are expected to apply for funding, design and conduct research,
and to present and publish their research as part of their training and in order to be board-eligible.
Advocacy training and experience is also a required part of the fellowship.
Please see below for a schematic of block rotations, institutional allocations, and clinical training sites.
FIRST YEAR BLOCK DIAGRAM
Month/4wk
1
2
OP with
OP with
HIV focus HIV focus
90%C
Experience or
Rotation
10%R
3
4
5
6
7
8
9
OP with
SBHC
focus
OP with
SBHC
focus
OP with
JD focus
OP with
JD focus
Inpt
consults +
Inpt psych
Inpt
consults +
Inpt psych
70%C
70%C
OP V
with A
FP C
focus
70%C
70%C
90%C
70%C
90%C
OP with FP
focus
70%C
Sites 1&2 Sites 1&2
50-50
60/12
12
Site 1&2
50-50
50-50
50-50
60/12
60/12
60/12
Site 1&2
80/20
80/20
90/10
50-50
60/12
Site 1&2
85-15
80/16
60/12
60/12
60/12
60/12
60/12 H
Duty Hours
H
H
H
H
H
H
H
H
VA
C
Site
1&2
Site 1&2
90-10
13
OP with Researc
Chronic
h
Illness
20% C
focus
70%C
Sites 1&2 Sites 1&2
60/12
11
10%R
Sites 1&2 Sites 1&2
50-50
10
H
H
60/12
H
Clinic sites:
General Adolescent Clinic in Site 1 – 10% time all year, additional 10% blocks 1- 6 (Revised to 10% all
year, additional 2.5% blocks 1-10)
AYAC in Site 2 – 10% time blocks 1-6 (Revised to 10% of time blocks 1&2, 5% of time remaineder of
year)
Core AYAC (CoAYAC) joint med-psych clinic for acquired HIV infection in adolescents and young
adults –Site 2 -10% time blocks 1-2, 5% of time blocks 3-13
School-based Health Center in site 2- 35% time blocks 3-4
Sports Medicine Clinic in site 1- 10% of time blocks 3-4 (revised to 5% of time blocks 3-6)
Adolescent Weight Management Clinic in site 1 – 10% of time, blocks 3-6, 11-12 (revised to 10%
blocks 3-4, 5% block 11.5-12.5)
Juvenile Detention Center in Site 2 – 10% time blocks 1-4, 35% time blocks 5-6
Inpt Psychiatry in site 1 – 70% time, block 7, 50% time block 8
Inpt Consults in site 1 – 10% time blocks 7&8
Adolescent Gynecology Clinic in site 1 – 10% of time, blocks 9-12 (revised to 5%)
Family Planning Clinic in site 1- 20% of time, blocks 11-12
Adolescent Chronic Illness Clinics in site 1 (Sickle Cell, Endocrinology, Neurology, Oncology,
Nephrology, Rheumatology, HIV) in site 1 -20% of time, blocks 11-12 (Revised 5% of time 9-10.5, 60%
in block 11.5-12.5)
Research/Didactic experience:
Research mentoring – 10% time throughout the year (Revised to 2.5% throughout the year, 10% during
block 12.5-13.5)
Masters’ degree coursework – 20% time blocks 3-6,9-12 (Revised to 0% due to prior MPH and 2 year
fellowship program adaptation due to Family Medicine residency)
Clinical Didactics
General adolescent lecture series with journal club and case discussion – 10% of time block 1, 5% of
time blocks 2-6 (revised to 5% of time blocks 1-13)
Other clinical didactics (EBM, online training, substance abuse, case discussion, QI) – 5% time blocks
1-13 (Revised to EBM, online training, PD question sets, case discussions & clinical conferences, QI)
Psychiatry orientation series – 10% of time blocks 1&2
Family Planning & Reproductive Health Didactics – 5% time blocks 11&12
SECOND YEAR BLOCK DIAGRAM
Month/ 4wk
1
2
3
4
5
Research
Inpt
Clinical
Inpt
OP with
Trauma Elective Adol.+ Job Corps
consults+
consults
focus
community
injury
70%C
prevention
Experience or
10%C 90%R
90%C
70%C
Rotations
Sites
90%C
Sites
Site 1
Sites
1&3
Sites 1&2 1&tbd
1&tbd 30/70
30/70
100
50-50
20/80
60/12
60/12
60/12
60/12
60/12
H
H
H
IH
H
6
7
ED Inpt Clinical
Elective
&
Outpt
8
9
10
11
12
13
Clinical
Elective
Research
Clinical
Elective
Clinical
Elective
Clinical
Elective
Research
70%C
70%C
70%C
Sites
Sites
Sites
1&tbd
30/70
1&tbd
30/70
1&tbd
30/70
70%C
70%C
Sites
1&TBD
40-60
70%C
Sites
Sites
1&tbd
30/70
1&tbd
30/70
10%C
90%R
Sites
1&tbd
30/70
60/12*
60/12
60/12
H
H
60/12*
10%C
90%R
Sites
1&tbd
30/70
60/12
60/12
60/12
60/12
H
H
H
H
Duty Hours
Clinic sites:
General Adolescent Clinic in Site 1 – 10% time all year, additional 5% in block 3, additional 10% blocks
4-9
Adolescent Chronic Illness Clinics in site 1 (Sickle Cell, Endocrinology, Neurology, Oncology,
Nephrology, Rheumatology, HIV) in site 1 -20% of time, block 3 -20%
Clinical Electives are chosen from prior sites and are arranged in conjunction with the Program Director
and the Site Faculty at the beginning of the 2nd year.
Clinical Didactics
General adolescent lecture series with journal club and case discussion – 5% time
Other clinical didactics (EBM, online training, substance abuse, case conf) – 5% time
Research/Didactic experience:
Research mentoring – 10% time 1-9, 30% time blocks 10-12
Masters’ degree coursework – 20% time blocks 1-9, 50% time blocks 10-12
THIRD YEAR BLOCK DIAGRAM
Month/4wk
1
Research
10%C 90%R
Experience or
Rotations
2
3
4
5
6
7
8
9
Research Research Research Research Research Research Research Research
10%C
90%R
10%C
90%R
10%C
90%R
10%C
90%R
10%C
90%R
20%C
80%R
20%C
80%R
20%C
80%R
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
1&tbd
10
11
12
Research
Research
Research
20%C 80%R 20%C 80%R 20%C 80%R
Sites
Sites
Sites
1&tbd
1&tbd
1&tbd
30/70
30/70
30/70
VAC
1&tbd
1&tbd
1&tbd
1&tbd
1&tbd
1&tbd
1&tbd
1&tbd
30/70
30/70
30/70
30/70
30/70
30/70
30/70
30/70
60/12
60/12
60/12
60/12
60/12
60/12
60/12
60/12
60/12
60/12
60/12
60/12
H
H
H
H
H
H
H
H
*
H
H
H
30/70
Duty Hours
Continuity Experience in the 3rd year
General Adolescent Clinic in Site 1 – 10% time all year
Adolescent Inpt Consults in Site 1 – 10% blocks 7-12
Clinical Didactics
General adolescent lecture series with journal club and case discussion – 1% time
Other clinical didactics (EBM, online training, substance abuse, case conf) – 1% time
Research/Didactic experience:
Research mentoring – 40% time 1-6, 30% time blocks 10-12
Masters’ degree coursework -48% time, blocks 1-10
13
Total number of clinical months _____18 4-week months________
Total number of research months ______18 4-week months, includes course work in SPH______
Legend
AYAC
Adolescent and Young Adult Clinic, a co-located clinic for adolescent medicine and psychology
C
Clinical
ED
Eating Disorders
FP
Family Planning
HIV
HIV clinics & community-based work
Inpt
Inpatient
JD
Juvenile Detention Center
OP, Outpt
Outpatient General Adolescent
Psych
Psychiatry inpatient unit
R
Research-includes coursework for master’s degree, online training in HIPPA & Human Subjects Protection, meetings with
research mentor, orientation to ongoing research programs in the Divisions and others of interest in the institutions,
development of a research proposal, grant writing, execution of project, write up and presentation of project, preferably in
national setting
SBHC
School-based Health Center
SMC
Sports Medicine Clinic
SPH
School of Public Health
Trauma
Stroger Trauma Unit – adolescent consults with follow-up in AYAC and community-based work with Ceasefire, a program
of the UIC SPH
Site 1
UIC: includes School of Public Health MPH course including capstone project or MHPE, outpatient clinics including
general adolescent clinic, adolescent HIV (predominately congenitally acquired) clinic, adolescent gynecology clinic, family
planning clinic including termination services, pregnant teens group, adolescent obesity clinic, sports medicine clinic,
inpatient adolescent consultation service, inpatient adolescent psychiatry ; broad spectrum of research potential including
obesity and reproductive health services, adolescent depression
Site 2
Cook County Bureau of Health Services: includes adolescent and young adult HIV clinic and outreach services, general
adolescent and young adult med-psych clinic, school-based health center, inpatient adolescent consultation service
including trauma unit ; research potential in HIV & STIs
Site 3
Rush: includes inpatient & outpatient eating disorders services, Job Corps clinics; research potential in ED & obesity
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