Infectious Disease Fellowship

Creighton’s infectious diseases fellowship trains internists seeking careers as clinical consultants in infectious diseases. In addition, some trainees have embarked on careers in internal medicine with an emphasis on infectious diseases, careers in state and federal public health agencies, careers with significant commitments to medical education, and careers in basic research.

In the fellowship can be seen Creighton’s Jesuit commitment to individuals in particular need of help–such as recent immigrants and economically disadvantaged individuals—in our clinical service to such individuals. The fellowship embodies the value of cura personalis that is inherent in excellent medical care for the individual and also in its opportunities to tailor the fellowship to the needs and interests of individual learners. The fellowship seeks to maintain an environment that promotes learning, an environment that goes beyond its setting in a community with affordable housing and manageable traffic.

Our fellows’ experiences include clinics (continuity, HIV, travel), inpatient rotations (including transplant ID and oncology ID), research, quality improvement, and telemedicine. We also provide educational experiences including antimicrobial stewardship, hospital epidemiology, and teaching.

Ultimately, the program aims to prepare physicians for the practice of infectious diseases. The program is accredited by the Accreditation Council for Graduate Medical Education (ACGME). It seeks to prepare trainees for certification in infectious diseases by the American Board of Internal Medicine (ABIM).

1. To promote a positive learning atmosphere as we aim for collegiality, kindness, and respect amongst all members of the ID Division within Creighton University.
2. To foster a collaborative environment in a diverse culture of teachers and learners. Our division is grounded in efforts to improve upon current Diversity, Equity, Inclusion, and Belonging (DEIB) initiatives and remains dedicated to serving LGBTQIA2S+ patients and underserved communities. Over the years, individuals with various positions in our division have come from six continents, and a variety of belief systems, - including Buddhism, Hinduism, Judaism, Christianity, and Islam.
3. To provide an effective and efficient education by balancing patient care and educational training. We have protected didactic time combined with a diverse patient population, including Veterans, people living with HIV, and people living with transplants, providing broad clinical exposure.
4. To be innovative. Infectious Disease Fellows have the opportunity to improve clinical care through scholarly activity via publications, presentations, quality improvement projects, and multi-disciplinary initiatives.
5. To foster individual development, tailoring training to areas of interest, including opportunities to seek additional training in: antimicrobial stewardship, travel medicine, HIV, telemedicine, and infection prevention and epidemiology. The division maintains strong ties with the Creighton Heider College of Business and supports ongoing professional development programs, including those within Creighton’s Chapter of Women in Medicine (WIMs).

• Opportunity for ID/critical care training as a result of large number of critical care beds and faculty, with Creighton’s standalone 1-year critical care fellowship
• Collegial learning environment with great faculty mentoring
• Good work/life balance
• High quality of living in the Midwest (little traffic; affordable housing)
• CHI Health Creighton University Medical Center - Bergan Mercy cited as one of “America’s Great Hospitals” (https://www.beckershospitalreview.com/lists/great-hospitals-in-america-…). This 2024 list included 103 hospitals. We were the only one in Nebraska. Our citation recognized our achievements in infection prevention.

Fellowship One Page Description

Infectious Disease Critical Care

• VA continuity clinic including longitudinal care of HIV patients (half-day clinic, weekly, throughout the fellowship)
• Travel Clinic (half-day clinic, weekly, 4 months a year)
• Bergan clinic focusing on HIV with some hepatitis B and hepatitis C (half-day clinic, weekly, 4 months a year)

• 1 month a year of inpatient solid organ transplant and oncology ID
• Subacute and long term transplant patients seen at CUMC-Bergan Mercy and at VA from time to time; recent example: sepsis in a renal transplant patient
• Subacute and long term transplant patients part of VA continuity clinic; recent example: long term itraconazole for histoplasmosis in a transplant patient

• Substantial portion of VA continuity clinic (half-day, weekly, throughout the fellowship)
• Substantial portion of Bergan ID clinic (half-day, weekly, four months a year)
• Challenging patients often admitted to CHI Health CUMC-Bergan Mercy

• 4 months of inpatient at Creighton University Medical Center-Bergan Mercy
• 4 months of inpatient at VA Medical Center in Omaha
• 1 month of solid organ transplant and oncology ID
• 3 months research/scholarly, including quality improvement

VA inpatient

• Interprofessional experience with pharmacy faculty and students (J Osteopath Med; 116(9): 588-593 https://doi.org/10.7556/jaoa.2016.116)
• Routine part of rounds
• Includes discussion of patients and interventions with primary teams
• Emphasize motivational interviewing

CUMC-Bergan Mercy program

• Grew out of program developed by division chief that saved system hundreds of thousands of dollars
• Remote stewardship an interest of faculty

• Monday: board review weekly
• Tuesday: HIV roundtable 2 weeks a month, journal club 1 week a month
• Thursday: citywide ID case conference weekly
• Friday: ID grand rounds weekly

• CUMC-Bergan Mercy
  • Academic service is generally capped at 15 patients so service doesn’t overwhelm education
  • Service generally includes a fellow and one or two residents
• VA inpatient
  • Experience includes eConsults—focus on evaluating and answering a question
  • Service is small enough to facilitate didactics and study in relation to the patients

• Monitoring beta lactam levels in ECMO patients (recognized as the most outstanding research project presented at Creighton’s 2024 graduate medical education research symposium)
• Racial and ethnic differences in zoster vaccine uptake: A cross-sectional study in a Veterans Health Administration primary care clinic. PMID: 34710295 (a quality improvement project which led to a research project currently involving fellows)
• Outbreak of central-line-associated bloodstream infections (CLABSIs) amid the coronavirus disease 2019 (COVID-19) pandemic associated with changes in central-line dressing care accompanying changes in nursing education, nursing documentation, and dressing supply kits PMID: 35361306
• Legionella pneumophila urine antigen testing in community-acquired pneumonia: A quality improvement initiative in diagnostic stewardship PMID: 38343479
• Diagnosis and outcomes of fungal co-infections in COVID-19 infections: A retrospective study PMID: 37764170
• Appropriate use of statins in people living with HIV (a quality improvement project)
• Improved utilization of sputum cultures in people admitted to the ICU with pneumonia (a quality improvement project) 

Dr. Tierney and Dr. Vivekanandan worked with the Nebraska Department of Health and Human Services during the COVID-19 pandemic.

Dr. Tierney’s recent public health awards:

• National: Inaugural Awardee of the McKnight Prize for Healthcare Outbreak Heroes 2020
• Nebraska Infection Control Network Distinguished Service Award 2020
• Council of State and Territorial Epidemiologists: Selected HAI Mentor for Peer to Peer Mentorship Program 2018

Dr. Vivekanandan’s award for her work on COVID-19:

• Creighton University Distinguished Faculty Service Award 

Other faculty played active role in promoting mask mandate laws, writing infection prevention protocols and treatment protocols during the pandemic, promoting vaccine confidence, and participating in vaccine trials

Fellows have available resources related to physical and mental health with an on-staff psychologist available at no cost. Other resources include fitness programs, safe ride home program, and more.

Creighton offers a Women in Medicine Program to provide both female and male fellows with the necessary tools to succeed in academic medicine. It serves as a venue for communication and discussion about topics relevant to the careers and lifestyles of women in medicine and the sciences.