Thank you for your interest in the Infection Management Service (IMS), formerly Infectious Diseases (ID), at Christchurch Hospital, Te Whatu Ora Waitaha. Christchurch Hospital has a distinguished history of providing an excellent training programme linked to an active clinical department involved in managing a broad range of infectious diseases. It has been our pleasure to host trainees and encourage them in their careers over many years.
The challenge of Infectious Diseases as a specialty is the breadth of conditions included in its scope. In addition to having particular expertise in patient groups such as HIV/AIDS, other immune-compromised hosts, travel medicine, home delivery of antimicrobial therapy, treatment of severe bacterial sepsis and chronic viral infections (Hepatitis B and C), infection management specialists interact and provide advice to all departments within the hospital. As infections are ubiquitous, training in Infectious Diseases provides important experience in many branches of internal medicine.
Infectious Diseases is an ever-evolving speciality. New challenges such as the spread of multi-resistant organisms, antimicrobial stewardship, emerging pathogens such as COVID-19 and new treatments for Hepatitis C mean that there is an ongoing need for well-trained ID physicians. It is possible to become dual-trained such as ID and a second specialty such as Microbiology or General Medicine.
There are eight ID consultants in the Infection Management Service. Five are also General Physicians (Dr Alan Pithie, Dr Sarah Metcalf, Dr Simon Dalton, Dr Heather Isenman and Dr Mark Birch), one does ID only (Dr James Yew) and two combine ID with academic positions at the University of Otago (Dr Nick Douglas, Dr Patrick Campbell). There are two ID Registrars, one typically being an Advanced Trainee in ID and the second often being a Basic or Advanced Internal Medicine trainee who rotates through the IMS. Additionally, there are several speciality nurses attached to the department for Outpatient Antimicrobial Therapy (OPAT), HIV and Viral Hepatitis and Research. We also have a dedicated Antimicrobial Stewardship Pharmacist (Dr Sharon Gardiner) who leads all our Antimicrobial Stewardship activities.
The Infection Management Service is primarily a consultative service. We visit all wards and departments within the hospital (other than paediatrics where there is a specialty ID Paediatrician). Important components of the work include skin and soft tissue infections, endocarditis, bone and joint infection, prosthetic device infection, respiratory infections, septicaemia, infections in immunocompromised hosts and febrile returned travellers.
Weekly meetings include:
There are at least weekly outpatient clinics for follow-up of patients seen as inpatients as well as patients with a large range of chronic infections such as HIV, Hepatitis B and C, extrapulmonary TB and non-tuberculous mycobacterial infections. There are approximately 40 patients on outpatient antimicrobial therapy at any one time. These are primarily patients with bone and joint infections, endocarditis, septicaemias and device-related infections.
In addition, the Infection Management Service provides telephone advice to other specialists and general practitioners in the region.
We have close links to the departments of General Medicine, Microbiology, Infection Prevention and Control and Public Health.
The Registrars do alternate weeks of:
Involvement in projects and research is encouraged and supported.
There is a weekly structured infectious disease teaching session that is shared between the IMS, microbiology, sexual health and infection prevention and control departments in Christchurch as well as other infectious diseases and microbiology specialists throughout the South Island. The sessions are designed to cover the syllabus given in the Australasian College of Physician training requirements. There is also a weekly journal club, patient review session, radiology meeting and regular morbidity and mortality meetings. Trainees are encouraged to attend and present at the annual Australasian Society of Infectious Diseases meeting. There may be opportunities to do the microbiology training requirements at the Canterbury Health Laboratories by arrangement.
Registrars are expected to provide initial consultation on the wards and see a broad range of outpatients. There will always be consultant review of cases with immediate access to consultants if needed. Consultant advice is available on a 24 hours, 7 days a week basis.
The Christchurch Hospital Infectious Diseases service has a strong research and publication record and trainees are expected to do some clinical research as part of their attachment of sufficient standard for publication and fulfilment of training requirements. Many projects are done in collaboration with staff at Canterbury Health Laboratories and the Department of Pathology at the University of Otago, Christchurch.
Christchurch Hospital offers a broad scope of experience provided by a large tertiary referral centre that is well established and has close links with an excellent Microbiology Department and an active academic unit at the University of Otago, Christchurch. Our department fosters a supportive and collegial environment. This is in the context of a cohesive, experienced team of supportive infectious disease specialists who have broad general medical and academic interests.
Dr Simon Dalton
Clinical Director
Email: simon.dalton@cdhb.health.nz
