Infectious Disease

National survey shows formal infection prevention training in ID fellowship is limited

Evan Vega January 23, 2024

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January 22, 2024

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Key takeaways:

Of programs surveyed, 90% reported some IPC/HE training, whereas 33.3% reported a dedicated IPC/HE training track.
Common barriers to IPC/HE training were funding, lack of curriculum and time constraints.

A national survey of ID fellowship program directors revealed that only about a third of programs have a dedicated infection prevention and control and health care epidemiology training track.

“During my second year of infectious disease (ID) fellowship in the Mass General Brigham (MBG) program, I subspecialized under the mentorship of Erica Shenoy, MD, PhD, and Alyssa Letourneau, MD, MPH, in infection prevention and control and health care epidemiology (IPC/HE) and antimicrobial stewardship,” Marisa L. Winkler MD, PhD, assistant professor at Emory Healthcare, told Healio.

IDN0124Winkler_Graphic_01_WEB

Data derived from Winkler ML, et al. Infect Control Hosp Epidemiol. 2024;doi:10.1017/ice.2023.281.

“This subspecialized track was one of the factors that led me to choose the MGB program for my fellowship training and provided timely education during the COVID pandemic and mpox global outbreak that occurred during my fellowship,” she said.

Winkler said that spending this time focused on IPC/HE highlighted how unique this opportunity was and made her want to better understand the landscape of training available to fellows.

“The last study describing IPC/HE training in infectious disease fellowships was published more than 20 years ago, and when surveyed, half of infectious disease physicians reported job responsibilities in IPC/HE,” she said.

To evaluate availability of specialized IPC/HE training in ID fellowship programs, Winkler and colleagues conducted a national survey of all ID fellowship program directors in the U.S. and Puerto Rico. According to the study, the surveys — which assessed current IPC/HE training components in programs and barriers to implementation — were distributed using to program directors in March 2023, followed by two reminder emails, with 4 weeks for respondents to participate.

In total, 54 of 166 program directors contacted (32.5%) responded to the survey. Responses to the survey revealed that 49 (90.7%) of the programs reported didactic training in IPC/HE, averaging 4.4 hours over the course of the fellowship, whereas 18 (33.3%) reported a dedicated IPC/HE training track.

The survey also showed that nearly half of the programs (42.6%) reported barriers to expanding training. These barriers to implementation included lack of funding as the largest barrier to implementation (65.2%), lack of curriculum (65.2%) and time constraints (60.9%). Another notable barrier mentioned in the comments of the survey included lack of fellow interest because of perceived burnout, although no specific data on this as a barrier were available.

“There continue to be opportunities to increase IPC/HE training in ID fellowship programs in the U.S. and to better prepare ID fellows for the responsibilities they are likely to have during their career,” Winkler said. “Offering dedicated training in IPC/HE may also be a mechanism to recruit trainees into this exciting and practical ID subspecialty.”

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