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SOLID ORGAN TRANSPLANTATION - GOALS AND OBJECTIVES

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SOLID ORGAN TRANSPLANTATION - GOALS AND OBJECTIVES

 

MEDICAL EXPERT

A.  Knowledge:

Upon completion of this rotation, the resident should demonstrate the appropriate knowledge relating to:

  1. Factors that contribute to the “net state of immunosuppression” in an individual solid organ transplant recipient.
  2. The timeline of post-solid organ transplantation infections.
  3. Class, mechanism of action and immunosuppressive activity of the principal immunosuppressive agents used in solid organ transplantation including:

 

      1. prednisone
      2. azathioprine
      3. mycophenolate mofetil
      4. cyclosporine
      5. tacrolimus
      6. sirolimus
      7. anti-thymocyte therapies
  1. Major toxicities of the principal immunosuppressive agents used in solid organ transplantation, and appropriate monitoring of levels.

 

  1. Major drug interactions between antimicrobial agents (azoles, marcrolides, rifampin) and immunosuppressive drugs (cyclosporine, tacrolimus, sirolimus).
  1. Current donor and recipient screening policies in solid organ transplantation (both serological and clinical).

 

  1. The epidemiology, clinical features, diagnosis, prevention and management of common infectious diseases occurring in the solid organ transplant recipient.
    1. viral pathogens ( CMV, EBV, HSV, VZV)
    2. fungal pathogens including Candida and
      Aspergillus species
    3. other opportunitistic pathogens, including moulds
    4. fever of unknown origin.
  1. The etiology and investigation of pulmonary infiltrates in the solid organ transplant patient.

 

  1. Complications of living-related donor infections.

B.  Skills:

The trainee is expected to:

  1. elicit a history that is relevant, concise, accurate and appropriate to the patient’s problem(s), including the relevant exposure history.
  2. perform a physical examination that is relevant and appropriate.
  3. select medically appropriate investigative tools, including microbiologic tests, in a cost-effective, ethical and useful manner.

 

COMMUNICATOR

Upon completion of this rotation, the resident should:

  1. Exhibit effective verbal communications with patient/families.

 

  1. Exhibit effective communication skills with members of the interdisciplinary Solid Organ Transplantation team.
  1. Present a complete consultation (history, physical examination, differential diagnosis, and management plan).

 

  1. Present and convey information clearly in consultation and progress notes.
  1. Present and convey information in formal presentation settings (Immunocompromised Host Journal Club, Transplant Case Presentations).

 

COLLABORATOR

Upon completion of this rotation, the resident should:

    1. Consult effectively with other physicians.
    2. Collaborate with members of the interdisciplinary transplant team (Transplantation Coordinator, Medical and Surgical Transplantation Physicians and Pharmacists) to provide high quality patient care.
    3. Demonstrate the ability to accept, consider and incorporate opinions from other team members.

 


 

MANAGER

Upon completion of this rotation, the resident should:

1.        Make cost-effective use of healthcare resources based on sound clinical judgment.

2.        Demonstrate skills in prioritization and effective time management when executing the concurrent roles of clinician and learner.

3.        Utilize information technology to optimize patient care.

4.        Utilize information technology to optimize self-directed, lifelong learning

 

HEALTH ADVOCATE

Upon completion of this rotation, the resident should:

  1. Recognize and respond appropriately in advocacy situations.

 

  1. Identify important determinants of health for solid organ transplantation recipients..
  1. Identify opportunities for health promotion. including immunization strategies and chemoprophylaxis in the pre/ post-transplantation settings.

 

SCHOLAR

Upon completion of this rotation, the resident should:

1.        Understand the need to for self-reflection / self-assessment and self-regulation for lifelong learning.

2.        Develop and implement a personal continuing education strategy.

3.        Critically appraise medical information relating to Transplantation Infectious Diseases.

4.        Contribute to the development of new knowledge in Transplantation Infectious Diseases through completion of research and quality improvement projects, when appropriate.


PROFESSIONAL

Upon completion of this rotation, the resident should:

    1. Demonstrate integrity, honesty, compassion and respect for diversity.
    2. Demonstrate the ability to meet deadlines and be punctual.
    3. Demonstrate an understanding of the principles of ethics and apply these in clinical situations related to transplantation medicine.
    4. Demonstrate insight into own limitations.
    5. Demonstrate the ability to balance personal and professional roles to avoid burnout.

Reviewed by the Adult Infectious Diseases Residency Program Committee – August 2012