As a former Yale fellow trained in infectious diseases and microbiology, Marwan Mikheal Azar, MD, draws on his own experiences in his new role as fellowship program director for the section of infectious diseases in the Department of Internal at Yale School of (YSM).
After beginning his new position in October 2021, Azar and his team made several changes to address the stress the trainees experienced during the COVID-19 pandemic while also enhancing their training.
“We want our fellows to be fulfilled and happy, recognizing that no matter what we do, this is a very rigorous fellowship, ” said Azar, an assistant professor (infectious diseases).
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Azar’s clinical expertise is in transplant and infectious diseases with a focus on immunocompromised patients. His particular interest is in fungi diagnosis and treatment of fungal infections.
During the early days of the COVID-19 pandemic, he served on a committee led by Maricar Malinis, MD, associate professor of (infectious diseases) and surgery (transplant) that developed an algorithm that standardized treatment for COVID-19 patients across the Yale New Haven Health System. He also was instrumental in diagnosing and treating a pneumocystis outbreak among transplant patients at Yale New Haven Hospital.
Azar got to work as fellowship director after his predecessor, Manisha Juthani, MD, took a leave of absence from YSM to serve as the commissioner of the Connecticut Department of Public Health.
Sheela Shenoi, Md, Mph < Yale School Of Medicine
The fellowship program has three clinical-track fellows who complete a two-year training program, and two academic track fellows, also known as T32 track fellows, who complete three, sometimes four years of training. Many of his initiatives address feedback from the fellows, with burnout mitigation measures that address the effects of the pandemic on the trainees rising to the top of the list.
As fellowship director, Juthani had offered fellows several weeks in outpatient clinics as a break from the hospital, followed by a weekend off. But after the Omicron surge, which was exhausting for health care workers including himself, Azar said, additional changes were needed. One of these was an “emergency week off” meant to alleviate the effects of the pandemic on the trainees, recognizing that “they need help in order to be able to help other people, ” he said.
For years, the schedule for trainees called for 12-day stretches of work, followed by two days off. “Having been a fellow myself, I remember those 12 days as being really tough – like really intense days, ” Azar said.
Center For Infection & Immunity < Center For Infection & Immunity
Thanks to second-year fellows, who agreed to take on additional shifts, he was able to add additional days off to interrupt the 12-day stretch. Azar credits Chief Fellow Mollie Tucker, MD, with organizing this effort with input from Jaimie Meyer, MD, MS, and Ann Fischer, MD the associate fellowship directors.
Another helpful change came when Infectious Diseases Chief Erol Fikrig, MD, and Clinical Chief Vincent Quagliarello, MD, approved an emergency service dubbed, “the solo service.” This service is for attending physicians who rotate onto a hospital shift in order to reduce the burden on fellows and has already had a significant impact on fellow wellness.
Azar and his team are working on other initiatives as well, including giving fellows greater exposure to microbiology and antimicrobial stewardship through new training blocks. He also is working with YSM colleagues to develop a fourth clinical track focusing on neuro-infectious diseases.
Infectious Diseases Faculty < Infectious Diseases
He and his team introduced Career Week, so first-year fellows can plan their second and third years, and adapted a mentor-advisor-coach (MAC) program from Seonaid Hay, MD, associate program director of the Internal Traditional Residency Program. The MAC program connects trainees to faculty members for mentorship and coaching, including advice on how to find a job when their fellowship ends.
The Infectious Diseases Section of the Department of Internal engages in a broad range of patient care, research, and educational activities. To learn more about their work, visit
Your browser is antiquated and no longer supported on this website. Please update your browser or switch to Chrome, Firefox or Safari.The Section of Infectious Diseases played a leading role in COVID-19 research and clinical trials while continuing its work in HIV/AIDS, Lyme, and other infectious diseases. Seventy-four faculty, 51 staff, and 57 postdocs, postgrads, and clinical fellows make up the section, led by Section Chief Erol Fikrig, MD, and Clinical Chief Vincent Quagliarello, MD.
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Maricar Malinis, MD: Jeffrey Topal, MD: Marwan Azar, MD: and Shana Gleeson, MD, led the Yale New Haven Health (YNHHS) COVID-19 treatment team. This multidisciplinary team of pharmacists, pulmonologists, allergists/immunologists, hematologists, OB/GYN specialists, and pathologists created treatment algorithms for people infected by the disease in inpatient and outpatient settings. Since the beginning of the pandemic, the inpatient treatment guidelines have been updated over 30 times, and recently were converted to an EPIC pathway to reflect rapidly evolving guidance. Due to multiple waves of COVID-19 infections and the immune-evasive Omicron variant, infectious disease and pharmacy faculty have been working tirelessly to adapt current guidance to incorporate newly available therapeutics. Topal, Malinis, and Azar also have led hospital and university-wide efforts to devise and update COVID-19 vaccination guidelines and testing strategies, including guidelines for immunocompromised patients for whom national guidance is scarce.
Richard A. Martinello, MD; Scott Roberts, MD; and pediatric infectious diseases physician Thomas Murray, MD, PhD; lead the Infection Prevention efforts at YNHHS hospitals and ambulatory sites in Connecticut, New York, and Rhode Island. When the second wave of the COVID-19 pandemic began in the fall of 2020, the team managed the protection of patients, clinicians, and staff through the coordination of personal protective equipment (PPE). When vaccinations became available in December 2020, the team partnered with Yale School of (YSM), Yale (YM), and YNHHS to outline each organization’s vaccination policy. They also advised on policies around exposed patients and health care workers. As vaccination centers opened throughout Connecticut, the team ensured that each location followed protocols for infection prevention. They worked with counterparts in infectious diseases and infection prevention across YNHHS to ensure standardization.
Roberts and Martinello collaborated with Michael J. Aniskiewicz, infection prevention manager at YNHH; Steven J. Choi, MD; and Christian M. Pettker, MD, on research that supported a vaccination mandate for health care workers. The study, “Correlation of healthcare worker vaccination with inpatient healthcare-associated coronavirus disease 2019 (COVID-19), ” published in
Albert C Shaw, Md, Phd < Yale School Of Medicine
, sought to determine whether there is a correlation between the vaccination of health care workers and COVID-19 infection. They found that units with health care workers with lower vaccination rates had more instances of health care-associated COVID-19 in patients.
Infectious diseases fellows responded to an unprecedented demand for expert consultation at Yale New Haven Hospital and the VA Connecticut Healthcare System while caring for patients. Clinical Fellow Shiv Gandhi, MD, PhD, worked with Albert Ko, MD, to describe the first de novo emergence of a remdesivir-resistant SARS-CoV-2 virus mutation in an immunocompromised patient with persistent COVID.
In the 2021-22 academic year, the Yale New Haven Transplantation Center performed the first liver transplant in Connecticut from a deceased donor who had tested HIV-positive to an HIV-positive patient as part of the HOPE act study led by Malinis. The patient, a male in his late 40’s, returned home within 10 days of the successful surgery.
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Project Commit is testing a new model of care in which opioid use disorder (OUD) is managed by infectious disease specialists concurrent with the management of OUD-related infections. The model uses injectable buprenorphine followed by referral after hospital discharge to community resources for OUD treatment. Led by Sandra Springer, MD, and Nikhil Seval, MD, the study began in August 2020
With plans to recruit 200 participants with OUD and addiction-related infections from hospitals across three sites in Connecticut, South Carolina, and Pennsylvania.
Lydia Aoun-Barakat, MD, was appointed director of the Yale Infectious Disease Ambulatory Services Program in November 2021. Aoun-Barakat will oversee infectious disease ambulatory services at both campuses of YNHH, including the Nathan Smith Clinic; the Haelen Center IDClinic; and the Yale Physicians Building outpatient ID clinic, and supervise the medical directors of each area.
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YNHHS and YSM were among 150 testing centers around the world to host COVID Phase 3 vaccine clinical trials, which contributed to the establishment of the vaccine’s 95% efficacy rate against the original virus. Onyema Ogbuagu, MBBCh, was Yale’s principal investigator for—and one of the earliest recipients of—the COVID vaccine, the first to be administered in the United States in December 2020. In addition to the trials for adults over age 18, Ogbuagu led the trials that evaluated the safety and efficacy of the vaccine for adolescents between 12 and 17 years, and for children aged 5 to 12, 2 to 5, and under 2 years to 6 months of age. He also is directing Phase 2 trials for an adjuvanted recombinant protein-based vaccine similar to influenza vaccines. Ogbuagu also conducted clinical trials for remdesivir. Yale has also been the site for studies of other treatments, including convalescent plasma, led by Mahalia S. Desruisseaux, MD.
Shelli Farhadian, MD, PhD, expanded her research to study the neurologic effects in COVID-19 patients, guided by what she had seen in those with HIV. In the spring of 2020, Farhadian and
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