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Editorial Commentary: Infectious Diseases/Critical Care Medicine: Time to Embrace a New Subspecialty of Infectious Disease

  1. Wendy S. Armstrong
  1. Division of Infectious Diseases, Emory University, Atlanta, Georgia
  1. Correspondence: W. S. Armstrong, Ponce de Leon Center, Grady Health System, 341 Ponce de Leon Ave, Atlanta, GA 30308 (wsarmst{at}emory.edu).

Key words

(See the Major Article by Kadri et al on pages 868–75.)

Infectious diseases (ID) is a broad specialty with many areas of specialization. In the past, academic ID physicians became experts in areas based on their research focus, but in recent times, ID clinicians are increasingly subspecialized with areas of expertise in hospital epidemiology and antimicrobial stewardship, transplant ID, human immunodeficiency virus (HIV)/AIDS, hepatitis C, and global health, to name a few. As a field, we have embraced many of these pathways, often developing additional curricula for fellow trainees interested in pursuing further subspecialization, although there is no formal additional certification. Increasing enthusiasm is now developing for combined infectious diseases/critical care medicine (ID/CCM) training, which, unlike these other pathways, combines 2 fellowships with 2 separate board certifications and involvement of 2 or more academic divisions or departments. As a result, achieving specialized training in this pathway is logistically more challenging. Nevertheless, 1 year ago in this journal, Kadri et al [1] documented increasing numbers of trainees pursuing dual ID/CCM training despite challenges coordinating the 2 fellowships. Program directors around the country report increasing numbers of fellowship applicants inquiring about the possibility of dual training. Fundamentally, it is not surprising that combined training would be appealing to those interested in ID. When trainees are asked why they developed an interest in ID, a common answer is that they have an interest in systemic illness rather than illness restricted to a single organ system, and an interest in complex patients. In addition, the acuteness of disease in hospitalized patients has increased dramatically and internal medicine residents may spend 3–6 months in critical care rotations throughout their 3 years of training, thus increasing their exposure to this field [2]. In this issue of Clinical Infectious Diseases, Kadri et …

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