Letter to Applicants 
 

Dear Applicant,

Thank you for your interest in our Pediatric Infectious Diseases Fellowship program. Duke University Medical Center (DUMC) is a nationally-recognized academic medical center with superb clinical and laboratory resources coupled with an intellectual environment that is supportive and conducive to the development of an academic career. DUMC includes Duke University Hospital, a tertiary and quaternary-care hospital, which is consistently rated as one of the top hospitals in the United States. DUMC is a vibrant, interactive, scientific community where ideas are actively discussed and exchanged among scientists with basic science and clinical research expertise, providing the opportunity for true multi-disciplinary clinical care and research.

The Department of Pediatrics at DUMC includes outstanding faculty, staff and environment whose combined efforts have resulted in exceptional research productivity, remarkable improvements in clinical care, and an outstanding training environment. While the 185 faculty in the Department of Pediatrics within 18 divisions are strong and balanced across all missions, the training and research productivity are further enhanced by the integration of department members throughout the intellectual resources of the wider University. Notably, the Department is currently training 69 residents, and 56 subspecialty fellows.

The Duke Children’s Hospital currently accommodates approximately 7,000 annual admissions and has 176 inpatient beds, including a 53-bed Neonatal Intensive Care Unit, a 16-bed Pediatric Intensive Care Unit, a 13-bed Pediatric Cardiac Intensive Care Unit, and a 16-bed Pediatric Bone Marrow Transplantation Unit (the largest in the world). The McGovern-Davison Children's Health Center is located adjacent to the Hospital and serves as the site for ambulatory pediatric subspecialty care, with approximately 70,000 annual visits.

Pediatric patients are referred to Duke Children’s Hospital from a large geographical area that includes most of the Eastern United States. In addition, the institution provides emergency and primary care facilities for children in our geographic area. The experience of our service ranges from complicated presentations of common infectious diseases to the unique problems seen at a tertiary medical center, like multidrug resistant nosocomial infections and infections in our large immunocompromised patient population. Illnesses that are indigenous to North Carolina include Rocky Mountain Spotted Fever, ehrlichiosis and others. We care for a significant number of children with human immunodeficiency virus infection and have become a referral center for these children because of our clinical trials studying new therapies through the International Maternal Pediatric Adolescent Clinical Trials (IMPAACT) group (formerly the Pediatric AIDS Clinical Trials Group).

During their clinical (first) year, the pediatric infectious diseases fellows have primary responsibility for managing the inpatient team and consult service. They also directly supervise the pediatric residents and medical students on the Infectious Diseases elective. Rounds are made with a member of the senior faculty on a daily basis. It is during this year that the fellow acquires the majority of the clinical knowledge and experience required to practice effectively and independently. During the first year, the fellow also spends one month in the general microbiology laboratory learning diagnostic methods of bacteriology, serology, mycology, and virology.

During the second and third year of the program, clinical duties are minimal and consist of on call coverage one weekend per month and coverage during periods of vacation for the junior fellow. During the second and third year, the fellow spends one day per month in the Pediatric Infectious Diseases Subspecialty Clinic evaluating the new patients and caring for a small group of infectious disease “continuity” patients. The primary focus of the second and third years is research, and the fellows are expected to develop a research program of their choosing in collaboration with faculty in either the basic or clinical sciences. The faculty has expertise in a wide variety of research areas. The Department of Molecular Genetics and Microbiology at Duke has a number of skilled investigators in the diverse areas of virology, bacteriology, and mycology. Our fellows have been welcomed into basic microbiology laboratories to conduct original projects and to learn research skills. The Human Vaccine Institute is active in researching candidate vaccines for HIV, tuberculosis, malaria and other infectious diseases via traditional and non-traditional methods. The Duke Clinical Research Institute (DCRI) is the largest academic clinical research organization in the world and has a significant pediatric program in place. Opportunities for collaboration abound and include possibilities as varied as areas of biodefense, emerging infections, international health, and large scale clinical trials with the DCRI as well as the other divisions within the Department of Pediatrics. Each fellow’s research efforts will be overseen by a mentoring committee specifically designed to help that fellow succeed in their research and career trajectories.

Every Friday morning, the Division has an administrative and educational conference for the fellows, faculty and other providers. We use these conferences to discuss issues within the Division and review interesting and informative cases from the inpatient service. These conferences are exciting interactive times where decisions and options are discussed and reviewed in a friendly environment. A didactic session following that meeting is run by the fellows and systematically reviews the background information and latest issues of pathogenesis and treatment for a broad range of infectious diseases. The goal of the meeting is to prepare the fellows for the American Board of Pediatrics Certification exam to be taken at the conclusion of the program, as well as provide continuing education for all. Other conferences that are strongly encouraged for the fellows include Pediatric Grand Rounds and Adult Infectious Diseases Grand Rounds. The Department of Pediatrics has several systems in place for education of all subspecialty fellows, including the Pediatric Fellow Research Conference and the Department Research Conference which each occur monthly. We place a high priority on fellow education, training, and giving each fellow the skills they will need to be successful in their own chosen career path.

The Pediatric Infectious Diseases faculty consists of 15 members with a broad range of clinical, research and administrative interests. All faculty members participate in the clinical care of patients and the teaching of students, residents and fellows. Special areas of interest and expertise of each faculty member are listed below:

• Daniel Benjamin, MD, PhD, MPH, develops a variety of multi-center pediatric anti-infective trials and has special expertise in the area of neonatal infections 
• Ann Buchanan, MD, conducts clinical research in Moshi, Tanzania on HIV-infected children and the opportunistic infections they acquire
• Dennis Clements, MD, PhD, Senior Advisor Duke Global Health Institute, is an expert in pediatric vaccine trials and international health
• Michael Cohen-Wolkowiez, MD, studies the safety, efficacy and pharmacokinetics of antimicrobials in infants
• Coleen K. Cunningham, MD, Chief of Pediatric Infectious Diseases, conducts research in the treatment of pediatric HIV, prevention of perinatal HIV transmission and HIV vaccine studies in children in US-based and international settings
• Robert Drucker, MD, is Director of Medical Student Education in the Department
• Ravi Jhaveri, MD, conducts studies on basic pathogenesis and pediatric clinical outcomes of Hepatitis C virus
• Samuel L. Katz, MD, emeritus, is an expert in pediatric vaccines and works in their delivery in resource-limited settings
• Kathleen McGann, MD, Pediatric Vice-chair for Education, conducts research on the treatment of HIV infection in children
• Ross E. McKinney, Jr., MD, conducts clinical research in treatment of Pediatric HIV infection
• Tony Moody, MD, works in the area of HIV and Tuberculosis vaccine design and development
• Patrick C. Seed, MD, PhD, conducts basic science research in bacterial pathogenesis
• Sallie Permar, MD, PhD, conducts basic research on HIV and CMV transmission, especially in breastfeeding
• Joseph W. St. Geme, III, MD, Chair of the Department of Pediatrics, maintains a very active research laboratory in the area of bacterial pathogenesis
• William J. Steinbach, MD, conducts basic and clinical research in invasive fungal infections with primary interest in Aspergillus pathogenesis
• Emmanuel (Chip) Walter, MD, conducts vaccine research in the Pediatric Primary Care Division and runs the pediatric travel clinic and the international adoption clinic
• Catherine Wilfert, MD, emeritus, is an expert in the treatment of HIV-infected children and prevention of mother to child HIV transmission in resource limited settings in her role as the scientific director of the Elizabeth Glaser Pediatric AIDS Foundation

In addition, the Division includes two outstanding Physician Scientists who work in Industry but who volunteer to attend and teach in the outpatient setting:

• Harmony Garges, MD, MPH, works in HIV drug development and clinical trials for Glaxo-SmithKline
• Cindy Jackson, DO, works in anti-infective drug development and clinical trials for Quintiles

Duke is located in Durham, a medium-sized city in the Piedmont region of North Carolina. Durham is situated within a two to four hour drive of beaches, mountains, various historical sites, Charlotte and Washington, DC. Durham is part of the Triangle, an area that includes Raleigh and Chapel Hill, and the greater area has a population of approximately 1.5 million people. Together these three locales encompass four large universities and Research Triangle Park, where a large concentration of research-based industries like Glaxo-Smith-Kline, IBM, and Becton Dickinson, and many other biotechnology companies are located. The Triangle area boasts many fine restaurants, an active arts and entertainment scene, as well as professional and collegiate athletics. The area is a comfortable place to live with relatively affordable cost of living and a temperate climate.

In summary, our fellowship program offers an active clinical program, a top quality research opportunity, and a desirable place to live. We have a vibrant faculty with a wide range of clinical and research interests, set in the background of a major university and medical center where there are countless experts in numerous infectious diseases-related fields. Please contact us if you have any further questions. We look forward to receiving your application.

Sincerely,

William J. Steinbach, MD
Associate Professor of Pediatrics, Molecular Genetics & Microbiology
Director, Pediatric Infectious Diseases Fellowship
Duke University Medical Center