The Daily Schedule Of An Infectious Disease Specialist

An infectious disease (ID) specialist focuses on the prevention, diagnosis and management of nosocomial (in-hospital) and community acquired infections. These specialists are usually consulted by other physicians and specialists when they are looking after patients with unknown infections and difficult to treat or resistant infections, such as drug resistant pneumonia and tuberculosis.

The ID specialist will manage patients with infections such a HIV over the long-term as these patients need to be monitored for a long period of time. This will ensure that these patients will have someone to care for them when they are experiencing issues with their medications such as adverse events or side effects, or if their viral load is increasing despite being compliant with their medication. The ID specialist will then have to review their medication and change it to something else.

Training

An ID specialist needs to complete the following training in order to specialise in infectious diseases:

• In order to become a qualified medical doctor, they will have to complete a 5-6 years undergraduate medical degree.
• Following this, they have to complete a 1-2 year internship training phase where they are exposed to the different surgical and medical disciplines.
• The doctor will then be allowed to specialise and they will then complete a 4 year residency programme in internal medicine to become a qualified physician.
• To become an ID specialist, the physician will then have to complete a 2 year fellowship training programme in infectious diseases.

Diagnostic measures used by Infectious Disease Specialists

The ID specialist will take a comprehensive history from the patient and important information will include a family history, information regarding acute and chronic medication use (especially previous antibiotics to determine whether microbial resistance is a possibility), history of any previous infections and a travel and occupational history to determine whether the patient could have been infected with any tropical diseases.

READ Preventing Infections, Sickness and Flu

The ID specialist will then examine the patient to look for any suspect lesions on the body or rashes that could indicate specific bacterial infections such as cellulitis with secondary septicaemia or meningitis.

Special investigations

The following are specialised investigations that the ID specialist will request in order to diagnose a patient's condition.

• Serological tests such as a full blood count (FBC), C-reactive protein (CPR), erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) are used as markers to monitor infection. Other tests such as liver and kidney function blood tests are done to check whether these organs are being affected by the infection.
• Lumbar puncture to analyze the cerebrospinal fluid.
• Blood cultures.
• Gram staining.
• Polymerase chain reaction (PCR).
• Genotyping.

Treatments being used by Infectious Disease Specialists

ID specialists will prescribe numerous different antimicrobial agents to help treat infections, and this will depend on the infection being treated and the patient's health status.

The medications that are used are antiviral agents to treat viral infections, antibiotics to treat bacterial infections and antifungal agents treat fungal infections. These medications are prescribed to be used either orally or intravenously, with the latter being used to manage more severe infections. 

The Daily Schedule Of An Infectious Disease Specialist

An infectious disease (ID) specialist will consult with their patients in the general ward, ICU and isolation rooms of the hospital 1-2 times a day. This is done until the patient has progressed well and is clinically stable enough to be discharged home or to a step-down facility to continue management, such as receiving intravenous antibiotics and wound care. The latter will be done if the patient is not showing any more signs of an infection, such as fevers, but still needs to complete their course of treatment.

An ID specialist's office will be based in the hospital so that they can get to their ward and ICU patients as soon as they can, as well as being able to get to casualty patients in time if there's an emergency. 

ID specialists are expected to provide on call services for the hospital during after hours and weekends. These specialists will consult with primary healthcare and casualty personnel to give an opinion on or to consult with emergency patients. Emergency cases will include meningococcal meningitis, persistent high grade fevers that don't break despite treatment being given and patients with suspect tropical diseases that need to be isolated.

Monday 

Usually an administrative day, the specialist will deal with issues such as confirming and attending meetings with staff, hospital management and medical reps. 

Once all these tasks have been dealt with, the specialist will then begin consulting with patients. It's seldom that an ID specialist will consult with acutely ill out-patients at their offices, and they are more likely to visit patients who are already admitted by other specialists. Therefore, any out-patients they consult with will be managed conservatively or be admitted for further investigations and management, and in-patients will be consulted and managed appropriately.

The special investigations that are requested will be followed with the affected patient. Further tests and management will then be discussed with the patient.

Tuesday

The ID specialist may use this day to visit local TB (tuberculosis) clinics and hospitals to assess patients and to review chest X-rays, blood works and prescriptions. These are usually also academic institutions and the ID specialist will offer training to nursing personnel and medical officers who work at these facilities.

Wednesday

This day may be used to initially consult with or follow up HIV/AIDS patients. The initial consultation will include reviewing the patient's medical history as detailed by the referring doctor. The specialist will then continue care for the patient by prescribing the correct medication and referring them to allied healthcare workers such as physiotherapists, occupational therapists and dieticians. 

The patients will then be followed up accordingly by the ID specialist.

READ The Daily Schedule Of A Haematologist

Thursday

The specialist will continue to consult with patients and review their special investigations and medications.

The afternoon will be used for further training of undergraduate and postgraduate medical students and doctor at the local medical school. The specialist would also perform duties such as filling in motivation letters to medical aid companies or doing research for their own academic purposes.

Friday

The specialist will continue to consult with hospital patients and will resolve any unfinished administrative duties before the end of the day.

The specialist who is on call for the weekend will then look after their patients and those of their colleagues.