UCLA Emergency Medicine Emerging Infections Fellowship Program
The Importance of Emergency Department Infections
Infectious diseases account for a substantial proportion of emergency department (ED) care. In terms of number of US ED visits in 2018, the Agency for Healthcare Research and Quality ranked respiratory, urinary, and skin and soft tissue infections, and otitis media rank among the top 20 ED diagnoses, and the # 1 diagnosis - abdominal pain - includes many infectious presentations, ranging from appendicitis to infectious diarrhea. Further, the sickest patients from the community with infection present through the ED. Sepsis is the 3rd leading cause of death in the US. It is estimated that about one-half off all US sepsis cases present through the ED – about 850,000 patients annually, or approximately 1 out of every 120 ED patient presentations (Crit Care Med. 2017;4:1443-9). In addition, people who are most susceptible to infection disproportionately seek care in EDs (Acad Emerg Med. 2011;18:e64-e69). Infections that become epidemic, such as skin abscesses due to methicillin-resistant Staphylococcus aureus (MRSA) around the millennium change, were first recognized among ED patients (Ann Emerg Med. 2008;51:291-8). The ED is the healthcare setting where the first impact of a pandemic is seen, such as during the onset of COVID-19 infections in 2020, and when understanding how to protect a critical healthcare workforce was paramount.
Goals of the UCLA Emergency Medicine Emerging Infections Fellowship Program
The goals of the UCLA Emergency Medicine Emerging Infections Fellowship Program are to train Emergency Medicine specialist leaders in infectious diseases who will 1) teach providers, including emergency medicine residents and community physicians, 2) conduct research of infections in the ED in collaboration with leading public health agencies, such as the US Centers for Disease Control and Prevention (CDC), and supported by federal agencies, such as the National Institutes of Health, in order to improve health outcomes of patients with and at risk of infectious diseases, and 3) successfully complete an MPH in Epidemiology (unless this degree or equivalent has already been obtained).
The Dr. James A. Ferguson Fellowship Program
The UCLA Emergency Medicine Emerging Infections Fellowship Program is supported through the Dr. James A. Ferguson Emerging Infectious Diseases Graduate Fellowship. Dr. James A. Ferguson, an alumnus of Tuskegee University School of Veterinary Medicine was passionate about providing opportunities for medical and veterinary students and encouraged students to explore public health career options in infectious disease research including in the areas of health promotion and emergency preparedness. In 1989, Dr. Ferguson played an instrumental role in the establishment of the National Center for Infectious Diseases Summer Research Fellowship Program. Dr. Ferguson's legacy continues 35 years later, through the Dr. James A. Ferguson Emerging Infectious Diseases Graduate Fellowship Program. CDC's Office of Health Promotion administers the Dr. James A. Ferguson Emerging Infectious Diseases Fellowship.
Background of UCLA Infectious Diseases Education, Research, and Faculty Development
UCLA Department of Emergency Medicine has been a leader in infectious diseases education and research. Drs. David Talan and Gregory Moran, who have been UCLA faculty for over 30 years, were the first physicians who were residency- and fellowship-trained, board-certified specialists in Emergency Medicine and Infectious Diseases. In response to a CDC initiative to enhance infectious disease surveillance, they proposed EMERGEncy ID NET, a US ED-based sentinel network for research of emerging infections, which has been continuously funded by CDC since 1995 (https://www.emergencyidnet.org/) In addition to Drs, Talan and Moran, EMERGEncy ID NET has been led by Anusha Krishnadasan, PhD (Epidemiology), and William Mower, MD (Emergency Medicine), PhD (Biostatistics; PI of the NEXUS research group). Jesus Torres, MD, MPH, who worked Drs. Talan and Moran as a as a pre-med student research coordinator, now works with the group as a UCLA Department of Emergency Medicine faculty member, and has a focus on health promotion. Matt Waxman, MD is a UCLA Emergency Medicine faculty member who trained in tropical medicine at the Gorgas course in Lima, Peru and served in the International Medical Corps’ response to an Ebola outbreak in Africa. Robert Rodriguez, MD has researched vaccination status and willingness among ED populations. The group also closely collaborates with the University of Iowa Emergency Medicine, Critical Care, and Pharmacy faculty, specifically, Nick Mohr, MD, MS, and Brett Faine, PharmD, MPH.
EMERGEncy ID NET, and other infectious diseases research funded by NIH and PCORI, has led to over 100 peer-reviewed publications including seminal articles describing the bacteriology of dog, cat bite, and human infections (N Engl J Med. 1999;340:85-92, Clin Infect Dis. 2003;37:1481-9), short-course outpatient antibiotic treatment of acute pyelonephritis (JAMA. 2000;283:1583-90), the emergence of MRSA (N Engl J Med. 2006;355:666-74), treatment of MRSA skin and soft tissue infections (N Engl J Med. 2016;374:823-32, JAMA. 2017;317:2088-96), emergence of fluoroquinolone- and extended-spectrum β-lactamase-mediated uropathogen resistance (Ann Emerg Med. 2021;77:32-43), nonoperative treatment of acute uncomplicated appendicitis, including with ED discharge (N Engl J Med. 2020:383;1907-19), and an estimate of the attributable and mitigatable risk of emergency providers contracting COVID-19 through direct patient care in 2020 (Plos One. 2022. 17[7]: e0271597).
The UCLA Department of Emergency Medicine infectious diseases group also has done research with leading molecular diagnostics companies, Biofire and Cepheid, which are developing point-of-care tests that will increasingly allow rapid infectious diseases diagnosis in the timeframe of emergency care. Collaborative research is conducted with the UCLA Director of Clinical Microbiology, Omai Gardner, PhD, whose focus is rapid molecular diagnostic testing. The group also has ongoing NIH-supported research of the immunological response associated with staphylococcal skin infection recurrence in conjunction with the development of an anti-staphylococcal toxoid vaccine, now about to enter an industry-supported Phase II human trial in which UCLA will participate.
Drs. Talan and Moran, and past trainees, have been active in educating Emergency Medicine residents and physicians practicing in the community. For 25 years, they presented the Olive View-UCLA National Emergency Medicine conferences, which focused on ED infectious diseases, and also were regular lecturers at the American College of Emergency Physicians Annual Scientific Assembly. Dr. Talan created a monthly series at UCLA titled, “Advanced ID for Emergency Medicine,” which he presented from 2019-2024 at UCLA residency conferences. Drs. Talan and Moran have also contributed to Emergency Medicine textbooks and EMRAP, the most popular Emergency Medicine podcast. Since its inception, EMERGEncy ID NET has overseen a regular article in the primary specialty scientific journal, Annals of Emergency Medicine, titled, “Update on Emerging Infections from the CDC,” to advance knowledge in this area of emergency physicians generally.
Most recently, the UCLA group assisted and collaborated with a University of Iowa Associate Professor in receiving his first NIH award to study patient-directed antibiotic duration for acute uncomplicated pyelonephritis, having completed a pilot in anticipation of a multi-center trial. Also, Dr. Torres received the Everyone Award from the NIH-funded Antibiotic Resistance Leadership Group (https://arlg.org/) to conduct an ongoing study the emergence of MRSA resistance among ED patients presenting with skin and soft tissue infections.
Description of Fellowship
Start date – July 1, 2026
Fellow qualifications – Current 4th year Emergency Medicine residents in an ACGME-accredited residency program and physicians who have completed a 3-year accredited program with at least one year of work experience are qualified to apply for the fellowship.
Duration – One year.
Faculty Appointment – The fellow will have a UCLA faculty appointment as a Clinical Instructor of Medicine in the UCLA Department of Emergency Medicine.
Fellow Compensation – UCLA School of Public Health tuition and healthcare benefits will be paid by the program. All fellows will receive an annual stipend for housing ($25,000), salary ($70,000), and laptop/software ($1,200). In addition, fellows will be expected to work one 8-hour shift per week in the Olive View-UCLA Medical Center emergency department for which they will be compensated at a rate of about $185/hour.
Duties/deliverables – The fellow will participate in the following didactic, research, and supplemental experiences:
1 – MPH in epidemiology (only for fellows without a past degree) - The UCLA Fielding School of Public Health has a 1-year MPH in Epidemiology professional degree program, which provides broad training in public health and epidemiology. Graduates gain skills in study design, data management, and data analysis, and are prepared to improve population health in any of a variety of settings, including government, non-governmental organizations, healthcare organizations, academia, and industry (https://ph.ucla.edu/degree-programs/master-public-health/mph-epidemiology).
Deliverable – Obtain MPH degree.
2 – Research meetings, which are almost exclusively videoconferences, with CDC and other co-investigators, weekly and bi-weekly, for the following ongoing projects:
a) EMERGEncy ID NET Ongoing Projects – Pandemic Respiratory Emergency Preparedness and Response with Environmental Surveillance (PREPARE; planning); Emerging Staphylococcus aureus Resistance and Current Antimicrobial Patterns in Emergency Departments (ESCAPED; analysis); and Diagnostic Characteristics of PCR Assay for Septic Arthritis (writing paper).
b) Study of Antibiotics You Stop for Treatment Of Pyelonephritis (SAYSTOP)
c) ANalysis of Toxin Immunology of recurrent STAPHylococcal infection (ANTI-STAPH)
d) Phase II Anti-Staphylococcal Toxoid Vaccine Trial
e) Regular contributions to the Annals of Emergency Medicine section, “Update on Emerging Infections from the CDC.”
Deliverable – Attend research meetings.
Deliverable - Fellow-assigned new EMERGEncy ID NET Project – The fellow will develop and implement a new EMERGEncy ID NET project - Management of Vaginitis Among Women Presenting to US Emergency Departments and Comparison of Clinical Outcomes by Appropriateness of Initial Treatment Based on Nucleic Acid Amplification Testing.
Deliverable – Author 2 articles per year in the Annals of Emergency Medicine section, “Update on Emerging Infections from the CDC.”
Deliverable – NIH (or equivalent) grant application for ED-based infectious diseases clinical trial. The fellow will be assisted in identifying a research question and in completing an NIH proposal with the intent to make a formal submission.
3 – Didactic clinical infectious diseases instruction – Drs. Talan and Moran will convene 1-hour weekly instruction based on the past format of the Advanced ID for Emergency Medicine series, and including discussion of new important literature. Dr. Matt Waxman will contribute sessions on tropical medicine. Residents and faculty will also be encouraged to refer ID cases and questions to the fellow, which will be discussed at these sessions and by the fellow at case conferences.
Deliverable – Attend didactic infectious diseases sessions.
Deliverable – Present monthly case conferences - The fellow will be expected to present and review interesting ID cases, at least once per month, with the resident and faculty at weekly residency conferences.
4 – Inpatient Infectious Diseases Consultation rotation - The fellow will spend 4 weeks on the Olive View-UCLA Medical Center Infectious Diseases consultation service focused on doing consultations on ED and ED-admitted cases.
Deliverable – Perform inpatient infectious diseases consultations and attend rounds/conferences.
5 – UCLA microbiology laboratory rotation – The fellow will spend 2 weeks in the UCLA microbiology laboratory to become familiar with methods particularly relevant of ED infectious diseases testing, specifically including introduction to rapid diagnostics. Visits to Biofire and Cepheid will also be explored.
Deliverable – Attend microbiology lab rotation.
6 – Antibiotics/pharmacology – The fellow will have 1-hour twice a month videoconference session with Brett Faine, PharmD, MS to review antibiotics, their pharmacology, and stewardship.
Deliverable – Attend antibiotics/pharmacology sessions.
7 – Mass casualty infectious diseases – The fellow will have 1-hour weekly videoconference sessions with Amesh Adalja, MD (https://centerforhealthsecurity.org/who-we-are/our-people/amesh-adalja-md-fidsa), who is an Emergency Medicine, Infectious Diseases, and Critical Care specialist who is a Senior Scholar at the Johns Hopkins Center for Health Security, an Adjunct Assistant Professor at the Johns Hopkins Bloomberg School of Public Health, and an Affiliate of the Johns Hopkins Center for Global Health. His expertise is in emerging infectious disease, pandemic preparedness, and biosecurity. The fellow will discuss current events occurring globally with relevance to these areas.
Deliverable – Attend mass casualty infectious diseases sessions.
8 – Global health experience – The fellow will be encouraged to participate (optional) in the UCLA Global Health Program, e.g., at Siriraj Hospital in Bangkok, Thailand (https://globalhealth.med.ucla.edu/medical-students/clinical-electives/primary-partner-electives/bangkok-thailand). Siriraj Hospital was established in 1888 as Thailand's first medical school and public hospital. It is now a 2,000-bed tertiary medical center and teaching hospital.
9 – Regular progress evaluation – The fellow will have initially every 2 weeks then monthly and as-needed meetings with the Dr. Torres to evaluate their progress and needs.
This trainee position is contingent upon the availability of federal funds.
For information on how to apply for this fellowship, please go to https://emergencymedicine.ucla.edu/education/fellowships/emerging-infectious-diseases