Prework – The most successful health departments shared multiple common existing activities and relationships that strongly facilitated the development and execution of an effective experience for the fellow.

• Create academic facility relationships – Successful health departments frequently had longstanding relationships with nearby and influential academic ID training programs. Ideally, faculty from the ID program held dual positions as health department staff, but at a minimum the health department and ID division had either ongoing programs (such as STI training rotations, epidemiologic studies or research projects) or frequent venues for communication between the HD and academic faculty, such as regular HD participation in the ID program’s educational conferences, or ID faculty serving on public health advisory committees. These existing connections appear to be the foundation required for larger cooperative efforts such as the LEAP program.

• Identifying potential health department mentors – The LEAP program requires that a health department have one or more persons that are able to serve as mentors to the fellow. Health departments interested in developing a local LEAP program should pre-identify staff members that are willing and well positioned to take up that role. These staff members should ideally be relatively senior staff (those most likely to know the logistical ins and outs of arranging for things within the HD). They should also be involved in a large number of ID-related HD activities such as infection control assessment and response visits/debriefs, reportable disease reviews, public health lab meetings, programmatic advisory councils, outbreak investigations and antimicrobial stewardship. Frequently, the HD mentor has been the medical director or epidemiologist of a hospital-associated infections and antimicrobial resistance program. To ensure redundancy, ideally two potential mentors should be pre-identified in case of staffing changes.

• Pre-identifying access requirements – Physical access to a health department, particularly access to health department data resources, often requires a complex approval process that can differ between HDs. To be successful, LEAP fellows require access to these venues and resources. Prior to recruiting a LEAP fellow, HDs need to pre-identify a pathway or process for an ID trainee to achieve this access, and make sure it can be acquired in a timely manner (typically within the first one to two months of the fellowship year). Previous LEAP HDs have templated LEAP fellow onboarding to those of unpaid interns or consultants.

• Compiling a listing of internal interests/projects – When potential candidates are applying to the LEAP fellowship, they must submit a project proposal. Projects in partnership with the health department are ideal; however, past feedback has noted that occasionally this represents a barrier to application, as the health department does not keep any clear track of planned or ongoing projects. Preparing a listing of projects that would benefit and be feasible in a single year by an infectious diseases clinician is an easy way to facilitate this process and increase the chances of successfully arranging for a LEAP fellow.

• Compiling a listing of internal data resources – Many LEAP fellow projects are developed from unique datasets that are available to a health department. Preparing a listing of the internal data resources that a LEAP fellow might be able to utilize for unique analyses/interventions will help.

• Compiling a listing of ID-related activities – Given the scope of health department activities, it is often difficult for a health department to know the variety of ID-related activities that they are engaged in. Prior to implementing a local LEAP program, compiling an internal listing of ID-related activities that could be accessed by a fellow in the LEAP experiential curriculum would be extremely helpful. It is useful also to have this listing include “key contacts” that are involved in coordinating or executing these activities, so the fellow can reach out to them early on in fellowship to arrange attendance or discuss involvement.