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Faculty Spotlight: Welcome Dr. Carlos Gomez to UNMC ID!

A few weeks ago, we introduced three great new additions to the UNMC ID team. Among them, was Dr. Carlos Gomez, who recently joined UNMC ID as an associate professor on the Solid Organ Transplant service line. Read on to get to know more about Dr. Gomez’s background, interests, and love of soccer!

Dr. Carlos Gomez, infectious disease physician and new addition to UNMC ID faculty

Tell us a little about your background.

I was born and raised in Colombia, where I attended Medical School. Following a short tenure as a general practitioner in my own country, I came to the US for training in Internal Medicine and then a fellowship in Infectious Diseases (ID) and Medical Microbiology. I was always curious about the intersection of host, environment, and pathogens, which triggered my interest in ID. Lately, I have specialized in infectious complications that pertain to the immunocompromised population, that is, solid organ transplants and patients with cancer and hematological malignancy. I have always wanted to pursue a sustainable career in academic medicine. I like every aspect of the academic clinician world: teaching in the classroom or at the patient bedside, engaging in clinical research, and of course, the clinical practice where I interact with patients and their caregivers. 

Why did you choose UNMC?

I chose UNMC because of its commitment to faculty development, compassionate patient care, and support for clinical research. As a clinician-investigator, I cherish all the dedication from UNMC to advancing science while educating the next generation of healthcare leaders. As a leader in Transplant and Cancer care in the country, UNMC is a reference center for a vast population in the Midwest. Besides its excellent faculty and house staff, the above makes it a thriving place to foster a career in academic medicine.

What about ID makes you excited?

At this point, it’s evident that ID is intrinsically an exciting field with many challenges and opportunities (think about a particular pandemic!). We are in the dawn of breakthroughs and innovations that will bring us closer to more advanced diagnostics and sophisticated antimicrobial interventions. I like to be at the epicenter of that disruption, the patient bedside and the clinical trials bringing those breakthroughs to the field.

Tell us something interesting about yourself unrelated to medicine.

I enjoy playing soccer and watching Premier League, and UEFA Champions League matches. I like to read books about soccer tactics and biographies of Managers (the word for soccer coaches in the UK).

Research Digest: UNMC Investigates Blood Stream Infections

Blood stream infections are one of the most feared type of infections in the infectious disease world. And for good reason- if left untreated they can quickly develop into serious complications such as septic shock. Luckily, researchers are constantly exploring the risk factors and treatments for this infection, including many UNMC ID faculty. Read on for a digest of 3 recent articles authored by UNMC faculty exploring the diagnosis and treatment of sepsis.

Dr. Zimmer
Dr. Stohs
Authors of a recent article on blood stream infection in cancer patients.

Sepsis is of particularly high concern for cancer patients, as various cancers as well as their treatments can interfere with the immune system’s ability to fight off infection. Unfortunately, there is a shortage of up-to-date data about the epidemiology of sepsis and antibiotic resistance in this population, making adjusting best practice guidelines difficult. In a new article, our own Dr. Andrea Zimmer and Dr. Erica Stohs led a cross-sectional study assessing these very variables in hundreds of high-risk febrile neutropenic patients with blood stream infections. They found that the current standard of care, cefepime or piperacillin-tazobactam, remains effective in this population and has excellent results. Read on for the details, including resistance rates to many common antibiotics. Study here.

Dr. Cortés-Penfield, co-author of a recent article exploring the use of imaging in sepsis diagnosis.

Treatment of sepsis first relies on an accurate diagnosis. Bettering our ability to do that is the focus of this next article. Staphylococcus aureus bacteremia is a serious type of blood stream infection which requires heightened clinical attention, as this pathogen is capable of infecting visually any tissue in the body. The use of newer imaging modalities to better detect infection is a promising idea, but the implementation remains controversial. This paper presents a metanalysis examining the efficacy of using 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to identify this infection. Combining the analysis of 7 studies, Dr. Nicolás Cortés-Penfield co-authored the analysis showing there is promising evidence that this imaging technique could help detect infection and prevent mortality at evidence levels comparable to those currently used as standard practice. Read the study here for the full analysis and conclusions.

Dr. Cawcutt, co-author of an article exploring sepsis in the VV-ECMO population.

Sepsis is also a big concern for the patient population utilizing venous-venous extracorporeal membrane oxygenation (VV-ECMO), including right ventricular assist devices. But, just as in cancer patients, current data surrounding this problem is sparse. This study also aimed to investigate the rate of infection in these patients to better understand the risks involved. The article, co-authored by Dr. Kelly Cawcutt, confirmed that infection rate in this population is moderately low, sitting at 2.7%. The authors suggest that this low rate of infection may be owed to the use of preoperative antimicrobial medication as most cannulations occur in the OR. Read the full details here.

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Thinking about training with UNMC ID? Fellows past and present share why they chose UNMC.

Fellowship application season is well underway and our fellowship directors can’t wait to review applications. We have recently posted about the benefits of a UNMC ID fellowship (see here) and on how to thrive in interviews (link here). But today, we wanted to highlight the words of current and past fellows as they explain why they wanted to train at UNMC.

Dr. Zelus…with a bagel she baked herself…that is as big as her face!

Interestingly, I ended up coming to UNMC because they have a phenomenal Emergency Medicine Residency! My significant other enjoyed his away rotation in UNMC’s ED so much we ended up couples matching into their IM and ED residencies. Initially I thought I would pursue Rheumatology, but abruptly changed my mind after a phenomenal ID rotation my intern year. I subsequently rotated on ID two more times during residency and enjoyed working with the UNMC ID family so much I wanted to stay for fellowship.

Image of ID fellow Dr. Bryan Walker wearing a red shirt and blue jacket and dark blue jeans and sunglasses leaning against a brick wall
Dr. Bryan Walker

After researching the program for infectious diseases fellowship, I was especially struck at how both comprehensive and well-organized the training program appeared to be. Having dedicated clinical experiences in orthopedics, oncology, and transplant, for example, caught my eye.  After my interview day, I learned that the program’s strongpoints were largely the result of a dedicated program leadership and faculty.  There is a sincere interest at UNMC in helping me become the clinician I hope to be.   

I chose UNMC for Internal Medicine residency in part because of the strong Infectious Diseases fellowship program. During residency, I was able to form strong mentorship bonds that truly made leaving the program incredibly hard. Working with the incredible faculty throughout my three years made staying at UNMC the right decision for my career. My interest in ID is antimicrobial stewardship. Our stewardship team is one of the best in the country (maybe I’m biased?), and I look forward to training under them throughout my fellowship. Furthermore, having access to the biocontainment unit and leaders in the field of emerging pathogens is an experience I don’t know I would be able to get anywhere else. Our training here is well balanced between general ID, immunocompromised services, and antimicrobial stewardship so I know that when I come out of fellowship I will be prepared for whatever position I decide to take. – Dr. Mackenzie Keintz

Dr. Nabil Al-Kourainy

UNMC has a rich tradition for being a center of clinical and scholarly excellence while promoting education through mentorship and fostering initiative and collaboration. The Medical Center is also committed to providing empathetic, evidenced-based, and patient-centered care while serving a diverse and often medically underrepresented population. I look forward to experiencing this collegial and supportive atmosphere during fellowship training. The HEAL track also represents an amazing opportunity to further advance my knowledge and skills in medical education and leadership!

Dr. Catherine Cichon and her dog Loki.

(1)  The infectious disease training here is highly regarded, and I wanted to train at a location where I could learn from all branches of ID – from emerging infectious diseases (check this out) to antimicrobial stewardship to transplant ID…even pediatrics ID!

(2)  I have family here in Omaha, and Omaha is much closer to my family in Colorado. It’s great to be close to your support system!

(3)  Omaha itself is a great city! There is so much to eat, do, and see here. The affordable cost-of-living adds to the attraction.

Dr. Timothy Jang

Before the COVID pandemic began, I had visited UNMC and Omaha for internal medicine residency interviews, and I was considerably impressed by the medical facilities, the strength of the educational program, and the tranquility of the city. One of the faculty that I had interviewed with for residency interviews was Dr. Mark Rupp, the chief of the ID division, and I had promised him that regardless of where I ended up for residency, I would apply to UNMC for ID fellowship. So when I matched to UNMC for ID fellowship, I knew I had matched to the right place!

UNMC ID Faculty on the Power of Social Media within Infectious Disease

In addition to world-class patient care, UNMC ID faculty are leading the charge in the use of social media in medicine and infectious disease. Recently, members of our department contributed heavily to a social media supplement published in the journal Clinical Infectious Diseases. This supplement is a fascinating and actionable exploration of social media’s role in medical education. Read on for a brief synopsis of these great articles! (Link to Full Supplement)

Digital Strategy and Social Media for Infectious Diseases – Dr. Jasmine Marcelin

Dr. Jasmine Marcelin, co-author and guest editor of this issue.

This introductory article covers the impact, both potential and realized, of social media on ID education and practice. As the authors explain, social media use has the promise of enabling “improved clinical care and advocacy, data analysis, broad reach to diverse patient populations, educational access, best practices in medical education, peer review, digital strategy for individuals and institutions, and combating misinformation.” For a self-contained explanation of the benefits of social media in ID, look no further than this article!

Social Media: Flattening Hierarchies for Women and Black, Indigenous, People Of Color (BIPOC) to Enter the Room Where It Happens – Dr. Jasmine Marcelin

A good mentor is one of the most impactful accelerators of success. In this article, the authors note that social media platforms can and have been used successfully to connect mentors and sponsors in medicine, especially in the case of marginalized and under-represented groups. Due to a lack of representation of women and, Black, Indigenous, and People Of Color (BIPOC) in senior leadership positions, finding a mentor can serve as a barrier to professional advancement for many healthcare professionals. Social media can then make it easier to connect with leadership outside of one’s institution.

Dr. Kelly Cawcutt, co-author and contributor to this supplement in Clinical Infectious Diseases.

#SoMe the Money! Value, Strategy, and Implementation of Social Media Engagement for Infectious Diseases Trainees, Clinicians, and Divisions – Drs. Kelly Cawcutt, Jasmine Marcelin, and Nico Cortés-Penfield 

Social media platforms are ubiquitous throughout society and have revolutionized how we consume information. The same can be said for academic fields, especially in ID. This article outlines the rationale for incorporating social media competency into ID training, equipping the next generation of ID doctors with the skills needed to take full advantage of the benefits of social media in education.

The Digital Classroom: How to Leverage Social Media for Infectious Diseases Education  – Dr.Nico Cortés-Penfield

Sold on the benefits of social media in ID but don’t know how to start implementing this tool in education? This article describes how to best use social media in medical education while underscoring the educational theories that support its use. For an operational user-manual for social media in education, read the full article at the link above!

Dr. Nico Cortés-Penfield, co-author of multiple articles in this supplement.

Educational Impact of #IDJClub, a Twitter-Based Infectious Diseases Journal Club – Dr. Nico Cortés-Penfield

This article discusses the creation of a virtual ID journal club ran on Twitter (#IDJClub). It involved a live 1 hour discussion of a recent publication by tweet. Over the 31 journal clubs held, a median of 42 participants from all stages of ID training/practice participated in this educational experiment, with 95% of them agreeing that the experience provided clinically useful knowledge and 72% agreeing that this journal club was more educational than the traditional forms. For a concrete example of social media being utilized to improve medical education, click the link above!

Research Digest: Healthcare Workers, COVID-19, and Burnout

While most research we highlight focuses on medicine and clinical care of patients, there is just as much value to be gained in researching the workforce and healthcare community at large. Understanding the trends and problems within our own field can lead to profound improvements in the daily lives of healthcare workers everywhere. In this alternative arena of research, UNMC ID has made major strides. Read on for digests of recent articles published by UNMC ID faculty that pertain to matters of personnel.

Dr. Selby, author of a recent paper (along with Drs. Hewlett, Rupp, and Starlin) about COVID-19 spread among healthcare professional

The hospital or clinic is not the only place that healthcare workers can be exposed to SARS-CoV-2. Just like the rest of the public, household exposures are understandably a major risk factor for contracting the virus. As data from the delta variant became available early this year, Drs. Selby, Hewlett, Rupp, and Starlin of UNMC ID conducted a study on vaccinated healthcare professionals with home exposures. They concluded that the delta variant, along with numerous environmental factors, contributed to a sharp increase in the COVID-19 attack rate. This rose from around a 20% chance of contracting the virus from a COVID-19 positive household member before the delta variant, to a ~50% chance of COVID-19 contraction during the delta wave, underscoring the large jump in infectivity possible with a mutating virus. Read the full research brief here.

Dr. Lawler, author on a recent paper outlining the ethics of ‘essential workers’ during a pandemic.

Stepping away from the healthcare workforce, Dr. Lawler and colleagues recently published a paper examining the intersection of ethics, the meat-processing industry, and COVID-19. This paper explores a group of workers who, because of their ‘essential industry’ status and working conditions which facilitated the spread of SARS-CoV-2, were expected to put their health and lives at risk during the pandemic. In the words of the authors: “This paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion.” Read more here.

Dr. Cawcutt, author of a recent article on medical burnout.

Lastly, on the topic of healthcare burnout, Dr. Cawcutt recently published an article exploring the relationship between bias, the impostor phenomenon, and burnout. A significant problem in medical fields, burnout afflicts 30% of nurses and greater than 50% of physicians. The paper argues that the interaction of these three concepts, previously considered separate, create a cycle which perpetuates burnout within the medical community. Targeting these components may then help guide interventions in the future. Read on here for more details.

Our Fellowship Leaders can’t wait to review your applications!

The following content was provided by Dr. Abbas (R) and Dr. Van Schooneveld (L), UNMC ID fellowship program directors. Read on to learn about our great program and please share with those who may be interested!

Fellowship application season is open, and as the leaders of our ID fellowship, we wanted to highlight some of the exciting aspects of our program. Our program and our division are growing. We began in 2011 with 2 fellows, grew to 4 in 2017, 5 in 2020, and our full complement now includes 6 fellows. Our faculty also continues to grow, as we now have 28 physician faculty and 4 full time ID pharmacists with diverse expertise. Dr. Trevor Van Schooneveld is the Program Director and Director of the Antimicrobial Stewardship program and Dr. Anum Abbas is the Associate Program Director. This year we are looking forward to meeting you on our remote interviews via zoom!

Dr. Casey Zelus teaching medical students about blood cultures

Fellows at UNMC enjoy a robust clinical experience that includes not only the typically complex patients seen at a tertiary referral center, but also includes extensive experience caring for immunosuppressed patients.  In addition to our General ID service, where our fellows gain experience in teaching medical students and Internal Medicine residents, we have two separate immunocompromised services that care for oncology and solid organ transplant patients.  We also have an orthopedic infectious diseases rotation where fellows gain experience managing these complex patients and work with faculty who have extensive experience in this area.  We have expanded our ambulatory offerings with the creation of a non-tuberculous mycobacteria (NTM) clinic and a travel clinic.  Fellows have the opportunity to spend time in the microbiology laboratory, as well as learn infection control and antimicrobial stewardship. The faculty at UNMC are nationally recognized experts in their field, and are also very approachable and devoted to the education and success of trainees. They have created extensive educational opportunities, covering topics from opportunistic infections in solid organ and hematopoietic stem recipients to emerging global pathogens and biopreparedness. Fellows gain knowledge in HIV/AIDS management working in our multidisciplinary HIV clinic which cares for over 1200 people with HIV. In addition to having access to world class ID expert antimicrobial stewardship, OPAT, and HIV pharmacists, our division also includes an ID pharmacy residency program and opportunities for research collaboration and rounding with pharmacy students, residents and faculty.

As new career opportunities develop for ID physicians, we have worked to provide our fellows with the skills to engage in these fields.  UNMC ID fellows receive extensive experience in the area of infection control and antimicrobial stewardship as well as dedicated biocontainment training.  UNMC also offers the opportunity to stay for an option third year to further develop a research portfolio or pursue additional clinical expertise in subspecialty areas.

Graduate Dr. Raj Karnatak presenting his research

An important part of fellowship is developing skills in interpreting and performing research, and we provide our fellows with six months of mentored research experience centered on their career goals.  A research committee assists fellows in mentor identification and project development.  Fellows also participate in a week-long UNMC sponsored research training program, and typically present their work at national conferences like IDWeek and SHEA.

Our goal as program directors is to provide fellows with an educational experience that provides them with skills and knowledge to make them successful in whatever career path they choose.  The opportunities available to ID physicians continue to expand and we hope you will consider UNMC ID.  If you are interested in more information, please feel free to visit our website where you can check out a video to learn more about us. You can also contact us at the following:

Dr. Trevor Van Schooneveld
Program Director, Infectious Diseases Fellowship
Medical Director, Antimicrobial Stewardship Program
University of Nebraska Medical Center
985400 Nebraska Medical Center
Omaha, NE 68198-9400
Email: tvanscho@unmc.edu

Dr. Anum Abbas
Associate Program Director, Infectious Diseases Fellowship
Assistant Professor, Division of Infectious Diseases
985400 Nebraska Medical Center
Omaha, NE 68198-9400
Email: anum.abbas@unmc.edu

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#PharmToExamTable: What Weight Should be Used for Dosing Daptomycin in Obesity?

A #PharmToExamTable question about daptomycin dosing, answered by Terese Lewis, PharmD, a Graduate of UNMC College of Pharmacy who is now a Pharmacy Resident at UNMC.

(Reviewed by Andrew Watkins, PharmD)

Daptomycin is an antibiotic used to treat complicated gram-positive bacterial infections as it has good activity against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE). At Nebraska Medicine, the susceptibilities of MRSA and VRE during 2021 were 100% and 75%, respectively. Daptomycin has been FDA approved for complicated skin and soft tissue infections, but due to its broader gram-positive coverage it is used off-label frequently. Off label uses include osteomyelitis (bone infections) due to MRSA, prosthetic joint infections caused by Staphylococcus spp. or Enterococcus spp., and left sided infective endocarditis (infection of heart muscle) due to Staphylococcus spp. or Enterococcus spp.  It is thought to work by depolarizing the bacterial cell membrane.1 The use of daptomycin in skin and soft tissue infection has dosing recommendations of 4-6 mg/kg/day. As we use the antibiotic to treat more resistant bacteria or diseases with higher mortality, dosing off-label may increase to 12 mg/kg/day.2  

Daptomycin’s most concerning side effect is a risk of myopathy. Creatinine phosphokinase (CPK) increases can be seen while on therapy, which can be indicative of stress or damage to the muscle. There is some concern about the frequency of adverse events as doses, and weights, get higher. 

Product labeling suggests the use of total body weight (TBW) to dose obese patients, but that is based on 4 mg/kg PK data for a single dose. Obese patients, however, have routinely shown larger than expected drug levels attributed to overdosing due to increased TBW. These increases contributed to changes in renal clearance.2

One trial compared obese patients who received actual body weight (ABW) vs adjusted body weight (AdjBW) dosing. The most common indications for daptomycin in this study included osteomyelitis, skin and soft tissue infections, and abscesses. Doses used in this study were <8 mg/kg/day, so extrapolation of results to doses greater than that will require more data. Treatment failure was found to be statistically equivalent between the two groups, as well as 90-day mortality, suggesting that adjusting dosing to AdjBW may not be necessary. 3

Another study concluded that does up to 12 mg/kg/day followed linear kinetics and were shown to be safe and efficacious. They found that the safety profile and clinical efficacy necessitated no dose adjustments solely based on BMI. 4

ACCP guidance for dosing in obesity recommends the use of actual body weight for obese patients to ensure treatment efficacy. They also recommend close monitoring of patients weighing more than 111 kg for increases in CPK as elevated BMI classes are inherently associated with increased CPK elevation.5

The first study that presented ideal body weight (IBW) dosing outcomes concluded that regardless of infection and bacteria type ABW and IBW dosing may provide similar outcomes. They do recommend that certain infections may favor one dosing weight over another and they recommend further studies. 6 More research with larger sample sizes are needed to firmly demarcate which specific pathogens may be better treated with altered dosing strategies.

In conclusion, even though we do not have randomized control trials or retrospective studies analyzing all doses, the data we have points to the safety of using TBW in obese and extremely obese patients. Consideration should be made to close monitoring of CPK levels.

References:

  1. Daptomycin. In: Lexi-Drugs [online database]. Hudson, OH: Lexicomp (accessed 2021, August 6).
  2. Daptomycin [package insert]. Whitehouse Station, NJ. Merck & Co., Inc. 2017. 
  3. Fox, AN, Smith WJ, Kupiec KE, et. al. Daptomycin dosing in obese patients: analysis of the use of adjusted body weight versus actual body weight. Therapeutic Advances in Infectious Disease. 2019 Jan 30.
  4. Gonzalez-Ruiz A, Gargalianos-Kakolyris P, Timerman A, et al. Daptomycin in the clinical setting: 8-year experience with Gram-positive bacterial infections from the EU-CORE(SM) registry. Adv Ther. 2015;32(6):496–509
  5. Meng L, Mui E, Holubar M, et al. Comprehensive Guidance for Antibiotic Dosing in Obese Adults. ACCP Journals. Pharmacotherapy 2017;37(11):1415–1431. 
  6. Ng JK, Schulz LT, Rose WE, et al. Daptomycin dosing on ideal body weight versus actual body weight: comparison of clinical outcomes. American Society for Microbiology. 21 October 2013. 

UNMC ID Welcomes Dr. Sunagawa to the ID Pharmacy Residency Program

Dr. Shawnalyn Sunagawa recently began her ID pharmacy residency after completing her PGY1 pharmacy residency here at UNMC. Welcome to UNMC ID Shawnalyn!

Read on to get to know this great addition to the UNMC ID team.

Tell us about the position you recently started

I recently started my second year of pharmacy residency where I am specializing in infectious diseases. This year I will receive comprehensive clinical training in both antimicrobial stewardship and infectious diseases pharmacy practice. I will have the opportunity to round with the inpatient infectious diseases consult services (general, orthopedic, oncology, transplant, and pediatric infectious diseases), work with our Antimicrobial Stewardship Program, and participate in outpatient and outreach activities (HIV clinic, Outpatient Parenteral Antimicrobial Therapy program, and our community outreach stewardship programs). 

Tell us about your background

I am originally from Kaneohe, Hawaii (aka 20 minutes outside of downtown Honolulu/Waikiki beach)! I left the gorgeous mountains and ocean for a landlocked state where I completed my Bachelor of Science in Chemistry and Mathematics from Creighton University in Omaha, Nebraska and then continued on to earn my pharmacy degree. I then completed by Post Graduate Year 1 (PGY1) pharmacy residency here at Nebraska Medicine. Safe to say the people in the Midwest have made up for the lack of mountain and ocean views!

Why did you choose to come to work at UNMC

The people! When looking at residency programs, I knew UNMC/Nebraska Medicine had a well-established infectious diseases and antimicrobial stewardship program. However, what I was blown away by was the opportunity to work with not only some of the top infectious diseases clinicians in the nation who are providing extraordinary care to patients, but who are also commited to teaching and developing future infectious diseases clinicians! The outstanding preceptors and welcoming atmosphere truly make me so grateful to be able to complete my infectious diseases training here at Nebraska Medicine.

What makes you excited about working in ID

Every patient case is a unique puzzle where you have to try to piece together the microbiology, antimicrobial resistance, stewardship, drug PK/PD, and patient specific factors to create the best treatment regimen. Every case is truly one of a kind and the opportunity to learn about all the nuances that go into creating the best possible treatment plan for each patient is exciting! There are also constantly evolving new concerns and issues within the realm of infectious diseases (multi-drug resistant organisms, pandemics, new antimicrobial therapeutics, etc.) and I am excited to be able to play a role in helping solve many of these therapeutic puzzles/challenges!

“My husband and I at an Arizona Diamondbacks game pre COVID-19 pandemic. Looking forward to being back in the stands!” – Dr. Sunagawa

Tell us something about yourself that is unrelated to medicine

I love attending sporting events, playing tennis, trying new restaurants, and hanging out with my husband and two pups! My husband and I also have a lifelong goal of trying to watch an MLB game in every stadium. COVID slowed us down a little bit, but hopefully we’ll be able to make it to a few more stadiums this upcoming year!

In Case You Missed It: Last Call for Antimicrobial Stewardship Summit Registrations

Today is the final day to register for the Nebraska Antimicrobial Stewardship Summit on Friday, August 12, at the Embassy Suites by Hilton in Downtown Omaha. Read on below for last week’s post detailing this important opportunity.

Nebraska ASAP will be hosting its annual Nebraska Antimicrobial Stewardship Summit in-person on Friday, August 12, at the Embassy Suites by Hilton in Downtown Omaha. There will be a combined morning session with speakers from CDC, Nebraska Medicine, and other organizations, followed by afternoon breakout sessions with targeted presentations in long-term care and acute care/outpatient settings tracks. Registration for the Summit is $99 per attendee, which includes parking, food, and CE credits for physicians, nurses, pharmacists, pharmacy technicians, and medical laboratory scientists. Read on below for more information and to register!

About the Summit:

With workload increases and staffing limitations due to COVID-19, the focus has been shifted away from antimicrobial stewardship in many facilities across diverse healthcare settings. Unfortunately, inappropriate antibiotic prescribing is common and can result in sub-optimal patient outcomes, development of antimicrobial resistance, and serious adverse reactions such as Clostridioides difficile infection. This summit is designed to highlight the importance of antimicrobial stewardship and focus on implementation strategies to promote facility-wide incorporation and improved antimicrobial use and patient outcomes.

Summit Date: Friday, August 12th

Location: Embassy Suites by Hilton Omaha—Downtown Old Market

Registration deadline: August 4th

For more information and to register, click here.

To see the summit agenda, click here.

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Acing Interviews: Top Tips for Fellowship Interviews

It is the end of July, and fellowship application season is upon us once again. Watch the UNMC ID blog in the coming weeks for fellowship application content. We begin with a practical guide to fellowship interviews. If you know someone gearing up for this important step, please share this post. A refresher on these skills can always be useful!

Multiple ID faculty contributed to this list and thus the credit goes to the entire UNMC Division.

As faculty, we have the amazing opportunity to both mentor and interview residents applying for fellowship in Infectious Diseases, and we have seen it all. From the great, well-prepared interviewee to the one who had the institutional information completely incorrect. We wish we could mentor every resident in person, but since that is not possible, we decided to do the next best thing and offer our tips and tricks to acing the ID (or any other) interview! Tips and tricks are in no particular order. 

  • Be yourself and relax.
  • Articulate why you are interested in this fellowship program, what your ID interests are and where you think you would like your career to go (even if you acknowledge that might change or be a little vague at this time).
  • Have an idea of how the program works and ask specific questions to help deepen that knowledge regarding the education you will receive. What are the strengths, weakness and unique aspects of the program you want to know more about?
  • Remember that you are interviewing the fellowship program as much as they are interviewing you. Do your research and come prepared with questions about everything from how the fellowship will prepare you for your career as an ID physician to where you will park.
    • Need suggestions on how to curate your list of questions?
      • Look up the program and Division on their website.
      • It is helpful to know a little about the faculty you are interviewing with, so if you get a schedule ahead of time find out what their clinical/research interests are and ask them about it – you can check out their publications on PubMed or Google Scholar to focus questions on specific topics.  If you don’t get a schedule ahead of time, ask them what their interests are or what their role is during your interview.
      •  Formulate questions important to you about the program, the institution and the local area regarding resources, lifestyle and more.
  • Be prepared to talk about your successes and the challenges you have encountered. For example, if you have an unexpected break in training, use that as example to illustrate what you learned from that experience. We do not expect perfection, but value honesty and clarity.
  • If you have something on your application that might be viewed negatively (academic difficulties, etc.) take the initiative and explain how you have overcome it and why you are a good candidate now before we have to ask you about it.
  • Consider a “highlight” reel handout for faculty on an updates to your CV since you submitted your application in ERAS. This can be incredibly beneficial if you have had a new publication, presentation or other activities demonstrating your interest in ID and future potential as a fellow.
  • Be friendly and treat everyone, including program coordinators and other office personnel kindly and with respect. Your interview starts from the moment some first meets you (a current fellow, administrative assistant or staff) and ends when you say goodbye to the last person. ALL opinions count. If you are rude to anyone, trust us, we will find out.
  • Be truthful and be yourself. Don’t answer questions with what you think the interviewer wants to hear (e.g. don’t say you want to do academic medicine if you are interested in private practice). This is the only way for both you and the program to determine whether or not you are truly a good fit.
  • Tell us something interesting about yourself, even if it doesn’t relate to ID.  It is important to be well-rounded, and hearing about hobbies, experiences and interests helps keep the interview conversation fun and flowing.
  • Thank the faculty for their time; the emails and cards with a personal comment regarding a specific detail of the interview are both appreciated and noticed.

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