Hillcrest Hospital (UCSD Health)
The UCSD Medical Center Hillcrest Hospital is located on the north side of downtown San Diego on the Hillcrest neighborhood campus. This rotation includes a busy infectious disease inpatient consult service, emergency department consults, and the weekly I.D. outpatient clinic held in the adjacent Ambulatory Care Center on the Hillcrest campus (Medical Offices South). The I.D. Consult Service receives on average 3-6 new consult requests per day from all inpatient services at Hillcrest. The hospital houses an urban trauma center, the regional burn center, a busy emergency department that receives walk-ins and transports from all over San Diego County, medical, surgical, and neurosurgical intensive care units, a coronary care unit/step down unit, and obstetrical delivery suites, in addition to general medical, surgical, and inpatient psychiatric wards. This service provides the fellows with a broad experience with infections related to medical, surgical, and other acute illnesses, viral, bacterial, mycobacterial, fungal, and parasitic infections. The patient population is enriched for patients who are undeserved and/or are from marginalized groups. Fellows gain experience in caring for marginalized patient populations including the management of infectious complications related to substance use. The hospital serves an urban patient population from the immediate area, as well as the surrounding metropolitan area of southern, central, and eastern San Diego County and the border with Mexico. Its geographic location near the Mexico border also provides access to patients who seek care for infectious diseases that are endemic to tropical and subtropical regions of Mexico and Central America. The third-party payer mix includes individuals with private insurance, managed care coverage, Medicare and Medi-Cal, and self-pay.
Jacobs / Thornton /Sulpizio Hospital (UCSD Health)
The UCSD Medical Center Thornton Hospital is located on the La Jolla campus of UCSD, 8 miles north of the Hillcrest campus. Thornton is a general medical hospital; the Jacobs tower was added in 2017 and includes an Onc/BMT floor, two medical ICUs, a neuro ICU, Labor and Delivery, and several Med/Surg floors. Adjacent to Thornton is the Sulpizio Cardiovascular Center where specialized cardiac and cardiothoracic surgical care are provided. There are three ID consult services at Jacobs/Thorton/Suplizio: General ID, Onc ID, and SOT ID. Each service sees an average of 3-6 new consultations per day. Fellows gain experience in general ID, cancer ID, and transplant ID while rotating on these services. Fellows attend outpatient clinic at Perlman, Moores Cancer Center, or Chancellor Park when they are on the General, Onc ID, and SOT ID services, respectively.
Veteran's Administration Medical Center (VAMC)
The VAMC is located on the UCSD La Jolla campus approximately 1.5 miles from the UCSD Thornton Hospital and immediately adjacent to the UCSD School of Medicine campus. This rotation includes consult services for inpatients at the VAMC and the weekly outpatient I.D. Clinic. The VAMC is a general medical hospital without obstetrics or pediatrics. The I.D. Consult Service receives on average 2-5 new consult requests per day from all inpatient services at the VAMC. The hospital houses a busy emergency department that receives walk-ins and transports eligible for VAMC care from the San Diego metropolitan area. The VAMC houses medical and surgical intensive care units, and a coronary care unit/step down unit, and obstetrical delivery suites, in addition to general medical, surgical, and inpatient psychiatric wards. This service provides the fellows with a broad experience with infections related to medical, surgical, and other acute illnesses, viral, bacterial, mycobacterial, fungal, and parasitic infections occurring in a primarily male veteran population. The I.D. Consult Service participates in the care of patients with HIV who are admitted to the medical or surgical services, controls the utilization of certain restricted antibiotics, and consults on all patients with medically important bacteremia. The VAMC also houses a large spinal cord injury service and a hemodialysis service for which infectious disease consultations are frequently sought for management of difficult infectious complications.
Outpatient ID Clinics (UCSD Health)
During the first year, clinical fellows attend one half day of clinic per week. Fellows attend clinic at the hospital site where they are currently rotating so that they do not have to travel between sites and so that they are able to follow the patients whom they consulted on in the hospital. Fellows see a combination of new outpatient ID consult patients as well as discharge/hospital follow up patients in ID clinic including patients enrolled in the OPAT program. Clinic encounters include a mix of in-person and telemedicine visits. Because fellows are focused on busy inpatient services, they are not responsible for patient care outside of the clinic session (this aspect is managed by the clinic Attending). Fellows attend clinics on different half days depending on which service they are currently rotating
Owen Clinic (UCSD Health)
The Owen Clinic is one of the oldest and largest HIV primary care clinics in the country. It is an extremely active Ryan White-funded, comprehensive care program that provides primary and specialty medical care and wrap around services to over 3,500 people living with and at risk for HIV. The clinic is fully staffed with internists, infectious disease specialists, psychiatrists and other mental health workers, a hepatologist, an oncologist, an obstetrician-gynecologist, an HIV neurologist, a colorectal surgeon, a high resolution anoscopist, clinical pharmacists, nurse practitioners, social workers, case managers, patient navigators, financial counselors, and other staff critical to the multidisciplinary care. First year fellows rotate in Owen Clinic once a week in the Discharge Clinic while they are on the HIV Medicine consult service at Hillcrest. Fellows have the option of having their HIV continuity clinic at Owen during their second and third year of fellowship. In this capacity, they serve as the primary care provider for a panel of 30-50 patients with HIV. Fellows have the option to rotate in any of the subspeciality clinics at Owen including the Women's clinic, Lipid Clinic, Medication Assisted Therapy Clinic, HCV/Liver Clinic, Anoscopy clinic, Gender Affirming Care clinic, and PrEP clinic.
VAMC Special ID Clinic (VA)
The VAMC Special ID (SPID) Clinic follows approximately 750 patients living with HIV and serves as another site where second- and third-year fellows can elect to do their HIV continuity clinic. This clinic includes all of the resources of the VAMC as well as ID pharmacists, social workers, nurses, nurse practitioners, a dietician, a psychiatric liaison and Attendings from the UCSD ID/GPH division. Fellows function as primary care physicians for their panel of patients with HIV. Fellows see 4-8 patients per session and participate is multidisciplinary clinic meetings to coordinate care for complex patients.