Program Director:	Max Brito, MD Assistant Professor of Medicine University of Illinois at Chicago
I. Length of rotation:	5 weeks.
II. Target start date :	July 1, 2008.
III. Objectives:

A) The main objective of this rotation is that our fellows gain clinical experience in the diagnosis and management of certain diseases uncommon in the US , such as:

MDR tuberculosis Leptospirosis Amebiasis Dengue (DF) and dengue hemorrhagic fever (DHF) Malaria Mycetoma and other rare fungal skin diseases

Selected AIDS opportunistic infections Tetanus Leprosy Filariasis

B) In addition, our fellows will gain experience in certain laboratory techniques and important epidemiological field programs. Examples include:

• Microscopic examination of blood smears for malaria
• Participate in field trips to areas with high prevalence of Malaria where they will learn about important vector control measures.
• Learn about the epidemiology of Malaria in the Caribbean and programs aimed at eradicating the disease.

IV. Participating Institutions:

1. Salvador B. Gautier Hospital, Section of Infectious Diseases
2. Dermatological Institute of Santo Domingo
3. National Center for the Control of Tropical Diseases (CENCET)

1) Salvador B. Gautier Hospital

	Supervising attending:	Monica Thormann, MD Chief, Infectious Diseases
	Duration of this rotation:	2 weeks

The Dr. Salvador B. Gautier Hospital is one of the largest teaching hospitals in the Dominican Republic serving a population of insured workers. It is administered by the Social Security Office of the Dominican government and provides service in most medical and surgical specialties. It has the only approved infectious diseases fellowship in the country.

Our fellows will rotate at this hospital for a total of 2 weeks on the inpatient consult service. They will participate in daily bedside rounds, case conferences and outpatient clinics.

2) Dermatological Institute of Santo Domingo

Components of this rotation:

1) Sexually transmitted diseases clinic

	Supervising attending:	Rafael Isa, MD Director, Instituto Dermatologico
		Claudio Volquez Director, STD clinic
	Duration of this rotation:	1 week

2) Leprosy clinic

	Supervising attending:	Juan Periche Fernandez, MD Director
	Duration of this rotation:	1 week

The "Instituto Dermatologico" is perhaps one of the most important centers for the care of patients with skin diseases in Latin America. Its residency programs attract physicians from other countries in the region interested in learning about rare skin pathology. In addition, the venereal disease clinic of this center is perhaps the busiest in the country with more than 500 visits per day.

During the first week, trainees will attend the outpatient venereal disease consultation under the supervision of the responsible attending. They will also have the opportunity to participate in rounds at the microbiology laboratory and will have the chance for some "hands-on" experience performing routine laboratory procedures such as Gram stains of penile/cervical discharges, wet mounts and darkfield examinations.

The second week will be spent at the Leprosy clinic. Attendance to this clinic represents a unique opportunity for our trainees to see a significant number of patients afflicted by this rare disease. Trainees will also be able to participate in home visits with the leprosy nurse and a visit the Leprosy hospital on the outskirts of Santo Domingo.

3) National Center for the Control of Tropical Diseases (CENCET)

	Supervising attending:	José Puello , MD Director.
	Duration of this rotation:	1 week
	Components of this rotation :	- Entomology laboratory (1 day) - Malaria diagnostic laboratory (2 days) - Field trip (2 days)

The "CENCET", a branch of the Ministry of Health of the DR, is the center responsible for the control and eradication of tropical diseases in the country. Among their functions are the control of the mosquito vectors that cause Malaria and Dengue and the diagnosis and treatment of patients affected by those diseases. Through a very sophisticated network of "evaluadores" (community individuals trained at recognizing Malaria signs and symptoms), the CENCET is able to detect and treat cases of Falciparum Malaria in its initial stages. This valuable field work has resulted in a low incidence of Malaria cases in the country despite the large numbers seen in neighboring countries.