The Changing Face of HIV Care: Expanding HIV Training in an Internal Medicine Residency Program

• Published in: Academic medicine Vol. 93; no. 11; pp. 1673 - 1678
• Main Authors: Barakat, Lydia Aoun, Dunne, Dana W., Tetrault, Jeanette M., Soares, Sarita, Chia, David, Ogbuagu, Onyema E., Moriarty, John P., Huot, Stephen J., Green, Michael L.
• Format: Journal Article
• Language: English
• Published: United States by the Association of American Medical Colleges 01-11-2018
• ISSN: 1040-2446; 1938-808X
• DOI: 10.1097/ACM.0000000000002317

PROBLEM:HIV-infected patients are living longer and are at increased risk of comorbidities. A qualified physician workforce is needed to care for this growing HIV population.
APPROACH:This report describes the first 5 years of the development and implementation of a novel 3-year HIV Training Track (HIV TT) within the Primary Care Residency Program from 2012 to 2017. It outlines the process of building the infrastructure of the HIV TT, describes the curriculum development based on HIV-specific Entrustable Professional Activities (EPA), and provides the results of the program evaluation in the 5 year period
OUTCOMES:The program enrolled a cohort of 11 trainees with 5 graduates. Each trainee managed a panel of 30-40 HIV patients with diverse demographics. A medical record review revealed high performance measures in the management of HIV and non-HIV medical conditions. All trainees exhibited progress on their EPAs and showed increase in their knowledge assessment test scores. There was 100% retention of trainees and faculty. Trainees and patients demonstrated satisfaction with the program.
NEXT STEPS:Establishing an HIV TT is feasible and can be successfully implemented. This report highlights the first steps and early-stage initiative at a single institution and lays groundwork toward building a workforce of providers to meaningfully care for the HIV population. The next steps include enhanced coordination of trainees’ schedule, improved EPAs documentation, evaluation of trainees in HIV and non-HIV competence beyond residency, and monitor graduates career trajectory.