Infectious Diseases Residency Program

TB Clinic

These clinics should provide an opportunity for graded responsibility.

Medical Expert/Clinical Decision Maker

The resident will be able to apply knowledge in the following areas to the management of the Tuberculosis (TB) infected patient:

1. Pathogenesis, natural history, pathology, clinical features, laboratory diagnostics,
and treatment of TB including:

a. acute TB;
b. latent TB

2. Antituberculous pharmacotherapy to include:

a. classification of antituberculous agents;
b. pharmacokinetics;
c. mechanism of action and resistance;
d. toxicity;
e. side effects;
f. clinical indications, contraindications, and use.

3. Immunotherapy including:

a. use of preventive TB treatment with biologic therapy (TNF-inhibitor)

Skills

The resident will be able to:

  1. Elicit a history that is relevant, concise, accurate, and appropriate, including the
    risk factors/epidemiologic exposures for TB
  2. Perform a physical examination that is relevant, accurate, and appropriate to
    diagnosing TB
  3. Select investigative tools in a cost-effective, ethical, and useful manner.
  4. Accurately place and interpret the tuberculin skin test.

Communicator

  1. The resident will effectively communicate the principles of TB prevention and
    management to other health care workers.
  2. The resident will effectively communicate the principles of TB prevention and
    management to patients and their caregivers, including contact tracing and
    infection prevention in the home setting.

Collaborator

  1. The resident will understand and comply with the duty to report TB infection as
    required by law to the Department of Health.
  2. The resident will understand the consultant’s role in TB management in relation to
    the patient’s primary care giver.
  3. The resident will work effectively within a multidisciplinary TB patient management
    team.

Manager

  1. The resident will learn how to effectively manage patients in a limited amount of time and with the limited resources available.
  2. The resident will learn how to effectively run an outpatient clinic and understand the importance of documentation in this practice setting.
    Health Advocate
  3. The resident will learn the importance of TB risk identification and reduction in
    promoting the health of the individual and the community.
  4. The resident will assist patients in accessing medications and address the other determinants of health which impact their care.
  5. The resident will learn to recognize the global epidemiology of TB as well as its associated challenges in diagnosis and treatment.

Scholar

  1. The resident will develop the skills to remain current in TB management through
    knowledge and utilization of available resources.
  2. The resident will develop the ability to critically appraise information related to
    management and prevention of TB.
  3. The resident will engage in quality assurance projects around TB management and/or the diagnosis based on current treatment guidelines.

Professional

  1. The resident will demonstrate personal and interpersonal behaviours that will be
    conducive to a therapeutic patient physician relationship.

Method of Evaluation

The resident will be evaluated by the attending staff during the TB clinics. An in-training evaluation report will be completed by the clinic attending and reviewed with the trainee.