Graduating Fellows’ Last Words – Dr. Laura Selby

The following content was provided by graduating UNMC ID fellow, Dr. Laura Selby (pictured left).

Dr. Selby will be transitioning to an infectious diseases faculty position in Bend, Oregon. Congratulations Laura!

If one word could sum up my clinical experience of the last two years of Infectious Diseases fellowship it would be “pandemic”. When I moved to Nebraska and started training at UNMC in July of 2020, the United States was only a few months into the COVID-19 pandemic. There was limited evidence for what treatments worked best, vaccines were not yet available, and PPE shortages continued to make news nationwide.

So much of my learning as an ID fellow happened through the lens of COVID. I learned how to treat multi-drug resistant secondary bacterial pneumonia from COVID patients. Differentiating viral vs bacterial infections was nearly every COVID consult. Hospital epidemiology and infection prevention lessons were learned through COVID outbreak investigations. I worked on my patient communication skills by explaining the importance of COVID vaccination to my HIV Clinic patients. My research projects pivoted to, you guessed it, COVID.

This is not to say that I wasn’t well trained in all areas of Infectious Diseases during my fellowship. With the notable exceptions of low influenza rates, and travel medicine consults, throughout the pandemic people still had bacteremias, prosthetic joint infections, neutropenic fevers, and newly diagnosed HIV requiring ID consultation and management. Patients still got cancer treatment and organ transplants, so my experience with immunocompromised hosts wasn’t compromised (no pun intended). Yet, for nearly every diagnostic mystery consult, COVID was added to my differential right next to syphilis, TB, and histoplasmosis.

Amid the stress, overwork, and death that the COVID-19 pandemic has brought, watching the faculty of the UNMC ID Division practice and model compassion for patients, evidence-based medicine, and conduct research, all while still finding time to give lectures and teach on rounds, has shaped me as a physician and a person. I could fill pages with all the lessons I have learned from each of the standout faculty at UNMC such as learning the intricacies of randomized controlled trials from Dr. Andre Kalil during journal club and rounds, training in high consequence pathogen preparedness and PPE with Drs. Elizabeth Schnaubelt, David Kline, and Angela Hewlett, lessons on travel medicine with Drs. James Lawler and David Brett-Major while rounding on patients who haven’t traveled (thanks COVID), diagnostic stewardship skills from Drs. Trevor Van Schooneveld and Kelly Cawcutt, how to conduct a hospital outbreak investigation from Dr. Mark Rupp, employee health management in a pandemic with Dr. Rick Starlin who was also a wonderful research mentor, how to practice evidence-based medicine when the evidence is questionable at best from Dr. Nicolas Cortes-Penfield, management of patients with HIV from Drs. Sara Bares, Nada Fadul, Sue Swindells, and Jasmine Marcelin, and all the other amazing faculty I have neglected to name.

As I prepare to leave fellowship and move onto the next stage of my career, I am grateful that I had the opportunity to train at such an amazing program. It has been a privilege to work with the UNMC Infectious Diseases Division.

– Dr. Laura Selby, Graduating UNMC ID Fellow, June 2022

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