Microbiology is a branch of medicine concerned primarily with the
prevention, diagnosis, and treatment of infectious diseases. The
profession of Medical Microbiology consists primarily of four major
spheres of activity:
In addition to these primary activities, medical microbiologists are often responsible for teaching of undergraduate and postgraduate medical students, students in other health disciplines, postgraduate science students and other residents. They also provide continuing education to medical and other health care professionals. Many are involved in medical research and in the supervision of research projects of graduate students. They also are often consultants for the prevention, diagnosis, and therapy of infections in the community environment.
Microbiology training should provide residents with knowledge which is up to date. Microbiology residents shall be prepared to conduct their practices in a ethical, cost effective manner. Emphasis is placed on effective communication in partnership with laboratory technologists, physicians and other health care providers, patients, and the community.
On completion of the education program, the resident's position will be competent to function as a consultant in medical microbiology.
The resident should demonstrate:
The resident will demonstrate:
AND ORGANIZATION OF THE RESIDENCY PROGRAM:
There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfill the educational requirements and achieve competence in the specialty.
The content and organization of each accredited program in medical microbiology must be consistent with the specialty training requirements.
In addition to offering the components noted in the specialty training requirements all accredited programs in medical microbiology should offer community-based learning experiences.
Residents must be provided with increasing individual professional responsibility, under appropriate supervision. This responsibility must include the interpretive and technical skills that relate to the specialty, as well as the provision of consultations and the management of microbiological laboratories.
During the whole period of training, residents should be in regular contact with their clinical colleagues, whom they should assist in their activities related to the diagnosis and management of patients and the prevention of infections.
RESOURCES:There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the specialty training requirements in medical microbiology.
In those cases where a university has sufficient resources to provide most of the training in medical microbiology but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training.
Learning environments must include experiences that facilitate the acquisition of knowledge, skills, and attitudes relating to aspects of age, gender, culture, and ethnicity appropriate to medical microbiology.
There must be a sufficient number of qualified teaching staff to supervise residents and provide teaching in the basic and clinical sciences related to the specialty. The teaching staff should have an appropriate nucleus of full-time teachers.
There must be a minimum of three medical microbiologists, one of whom is the program director, involved in the direct training of the residents. A medical microbiologist is defined as a medical graduate who is certified in medical microbiology.
Laboratory training must be based on adequate resources to ensure full training for each resident in all areas of medical microbiology. The description of the integrated program should specify how the responsibility for each of the components of the program is shared by the participating institutions. The resources of the program, including volume and variety of specimens, laboratory space and equipment, and medical, scientific, and technical staff, must be satisfactory in relation to each of the following components:
There must be adequate laboratory facilities and adequate volume and variety of material to ensure full training in microbiological techniques, the reporting of test results, infection control, and consultations. The laboratory should be under the full-time direction of a medically qualified microbiologist who holds certification in medical microbiology. The director of the laboratory should have a university appointment in the department of medical microbiology in the medical school, and will be responsible for the conduct of the training program in the institution. There must be a sufficient number of qualified medical microbiologists on the staff of the laboratory to provide continuous instruction and supervision.
The following are the essential components of the laboratory training program: bacteriology, mycology, parasitology, virology, molecular epidemiologic and diagnostic methods, and the immunology relevant to these areas.
The necessary range of experience of each resident should be assured by rotations or other mechanisms, in order to provide full training in the microbiology of acute and chronic cases in both adult and pediatric medicine and surgery. It is recommended that arrangements be made, for short periods, in laboratories outside the program, when this is necessary, to ensure experience in areas of microbiology only carried out in reference laboratories such as syphilis serology, molecular finger-printing, and enteric reference bacteriology.
Instruction and experience must be provided in the procedures essential to the operation of a full service diagnostic microbiology laboratory, including bacteriological and serological quality management, data processing, media preparation, maintenance of equipment, antimicrobial agent sensitivity testing, anaerobic technology, electron microscopy, and immunofluorescent techniques.
Residents should also develop experience in the area of information technology, developing competence in the use of relational databases, spreadsheets, and presentation software, as well as familiarity with the organizational structure of laboratory information systems.
The resident should also be provided with experience in the areas of budget preparation, planning for the implementation of new laboratory procedures and programs and in their subsequent evaluation.
There must be opportunity for training in the medical microbiology and infections in the neonatal and pediatric age group, supported by an adequate volume and variety of patients and material and all necessary staff and facilities.
An active consultation service is essential to provide experience in acting as a consultant to colleagues on clinical services. Residents must participate in consultations, both elective and emergency, on a continuing basis during training. This training must take place on a teaching clinical infectious disease service with sufficient volume and variety of patients to ensure the medical microbiology resident develops the ability to:
The community experience might take the form of a public health laboratory experience, private sector microbiology experience or rotation in a regional hospital or free-standing diagnostic laboratory. Community experiences should be available which provide a learning environment with appropriate supervision and evaluation based on rotation specific objectives. This assumes administrative support and linkages with the program.
There must be appropriate liaison with teaching services in internal medicine, general surgery, obstetrics and gynecology, and pediatrics. There must be definite mechanisms within the faculty to ensure that training provided in internal medicine including infectious diseases, pediatrics, or surgery, in fulfilment of the training requirements, meets the needs of residents in medical microbiology. Hospitals with a major role in the medical microbiology program should also be engaged in the undergraduate teaching.
There must be appropriate opportunity for the resident to gain experience in the area of hospital infection control and antibiotic utilization management. The resident should regularly participate in activities relating to these areas of training.
AND SCHOLARLY ASPECTS OF THE PROGRAM:
The academic and scholarly aspects of the program must be commensurate with the concept of a university postgraduate education. The quality of scholarship in the program will in part, be demonstrated by a spirit of enquiry during clinical discussions, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice.
A coordinated educational program must be provided in medical microbiology and associated fields. The teaching program should also provide experience in participation in rounds and conferences, in developing ability in self-education, and the skills of formal and informal teaching.
The program must include a central program in the basic science of microbiology and systematic teaching in medical microbiology. This should involve course work and directed reading in pathogenesis, diagnosis and treatment of infectious disease; and in general medicine and surgery, sufficient to allow effective communication with colleagues in all specialties.
The academic program must ensure that residents gain an understanding of the basic principles and practice of biomedical ethics as it relates to medical microbiology.
The program must ensure that residents learn effective communication skills for interacting with patients and their families, colleagues, co-workers from other disciplines, and students. Clearly defined educational objectives for teaching these skills and mechanisms of formal assessment should be in place.
Residents must be given opportunities to develop effective skills in collaborating with all members of the patient care team.
Residents must be given opportunities to develop effective teaching skills by teaching junior colleagues and students, as well as through conference presentations, clinical and scientific reports, and patient education.
The program must provide the resident with the opportunity to acquire competence in microbiology and in laboratory management. In addition, the resident must develop the ability to undertake the education of physicians and other members of the hospital staff in microbiology and infectious diseases in informal seminars, ward rounds, and formal lectures.
Residents must be given opportunities to develop skills in management as applied to medical microbiology such as efficient practice and records management and the ethical use of health care resources. Residents should also be prepared for their role as a health care advocate.
The program must provide residents with opportunities to gain an understanding of the principles and practice of continuous quality improvement/total quality management. Opportunities must be provided for residents to participate actively in such programs in their hospital departments.
There must be a faculty member with the responsibility to facilitate the involvement of residents in research and other scholarly work. The academic program must provide the opportunity for residents to learn biostatistics and the critical appraisal of research methodology and medical literature. Such teaching must include issues related to age, gender, culture, and ethnicity in research protocols and data presentation and discussion. The program should be capable of providing a year of full-time study in basic sciences, or other investigative experience relevant to medical microbiology.
A satisfactory level of research and scholarly activity must be maintained among the faculty identified with the program.
All programs must promote development of skills in self-assessment and self-directed life-long learning. To promote this end, the program should provide opportunities for residents to attend conferences outside their own university.
Five years of approved residency training. This period will include:
PROGRAMS (WITH TRAINING REQUIREMENTS):
Eighteen months of approved training.
Thirty six months of approved training.
Forty eight months(four years)of approved training.