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

Barakat, Lydia; Dunne, Dana; Tetrault, Jeanette M.; Soares, Sarita; Chia, David; Ogbuagu, Onyema; Moriarty, John; Huot, Stephen J.; Green, Michael L.

doi:10.1097/acm.0000000000002317

Cited by 7 publications

(2 citation statements)

References 8 publications

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“…We found this decrease in workforce to be concerning. Data from other graduate medical education (GME) pathways show high satisfaction with such training programs and favorable graduate outcomes regarding longitudinal care for PLWH, findings that are similar to our 2015 survey [7, 8]. The decrease noted in the UW cohort, however, suggests that early graduate outcomes data may not be predictive of long-term outcomes and that such surveys should be repeated over time.…”

Section: Discussionsupporting

confidence: 74%

Building HIV Workforce Capacity Through a Residency Pathway: Outcomes and Challenges

Budak

Volkman

Wood

et al. 2018

Open Forum Infectious Diseases

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To help address the impending HIV physician shortage, we launched an HIV Medicine Pathway within our Internal Medicine Residency in 2008. Between 2015 and 2017, surveys showed a decrease in the number of graduates providing primary care for people living with HIV. We suggest evaluation of long-term outcomes from similar training programs and stronger support for HIV primary care career development.

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Section: Discussionsupporting

confidence: 74%

Building HIV Workforce Capacity Through a Residency Pathway: Outcomes and Challenges

Budak

Volkman

Wood

et al. 2018

Open Forum Infectious Diseases

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show abstract

“…Taken together, our findings suggest PCPs expect higher compensation when managing HIV patients. Barakat [20] found patients are happy with this integrated model confirming they prefer this model, because they can receive comprehensive care (i.e., primary and HIV care) from one clinician [20]. This finding that patients with HIV prefer seeing PCPs, who provide primary and HIV care is important for PCPs as it may encourage them to consider getting more involved with HIV medicine.…”

Section: Discussionmentioning

confidence: 94%

Management and treatment of HIV: are primary care clinicians prepared for their new role?

Wijesinghe

Alexander

2020

BMC Fam Pract

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Background: Current literature suggests the number of HIV clinicians in the United States is diminishing. There are 294,834 primary care providers (PCP) in the United States, and, of these, 3101 provide care to HIV-positive patients. More PCPs to treat and manage HIV patients may be the solution to alleviate the HIV provider shortage. However, PCPs also face challenges, including workforce shortages. We surveyed PCPs to determine perceived barriers, beliefs, and attitudes about their readiness to manage and treat HIV patients. Methods: Following a quantitative, descriptive, cross-sectional survey design, currently practicing clinicians in primary care (physicians, residents, physician assistants, family nurse practitioners) were emailed a link to the study survey. Three hundred forty-seven family medicine clinicians from 47 states met the study inclusion criteria. Results: Most (245/347, 70.6%) of the PCPs agreed that PCPs should take care of HIV patients. PCPs practicing HIV medicine (n = 171) were more likely than those not practicing HIV medicine (n = 176) to agree that PCPs should help with the HIV provider shortage (U = 10,384, p < 0.001) and that PCPs are the best solution to the HIV provider shortage (U = 10,294, p < 0.001). The majority (206, 59.4%) believed PCPs are the best solution for the HIV provider shortage. Of 133 physician assistants (PAs) and family nurse practitioners (NPs), seventy (52.6%) believed they could be ready to manage HIV patients with some training. Conclusion: The HIV provider shortage in the United States is likely to continue. To alleviate the provider shortage, PCPs should be offered additional training, decreased workload, and increased compensation when treating and managing HIV patients. Also, encouraging PAs and family NPs to be involved with HIV medicine may be a solution.

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Development of a Novel Competency-Based Evaluation System for HIV Primary Care Training: the HIV Entrustable Professional Activities

et al. 2019

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BACKGROUND: There is an anticipated shortage of primary care providers trained to care for patients with HIV. The Yale School of Medicine developed and implemented a novel HIV training track within our Primary Care Internal Medicine Residency Program. A set of 12 Entrustable Professional Activities (EPAs) were developed to guide curriculum development and resident assessment. AIM: To describe the process of implementing a novel EPAbased curriculum for the HIV Primary Care Training Track including EPA-based trainee evaluation tools. PARTICIPANTS/SETTINGS: Two to three residents were enrolled annually from 2012 to 2017 (total n = 11). Training sites included the outpatient academic center HIV clinic and inpatient HIV ward. PROGRAM DESCRIPTION: An expert panel developed 12 HIV-specific EPAs. These were mapped to curricular and reporting internal medicine milestones. Curricular activities and evaluation tools were developed to guide EPA progress. PROGRAM EVALUATION: Graduating residents were ready for unsupervised practice in 91% of EPAs at the end of the 3-year program. DISCUSSION: Development of HIV-specific training EPAs was effective for driving curricular development and resident evaluation, and served as an effective method to communicate expectations to resident participants. These HIV-specific EPAs could serve as a useful template to enhance HIV education in academic settings.

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

Cited by 7 publications

References 8 publications

Building HIV Workforce Capacity Through a Residency Pathway: Outcomes and Challenges

Building HIV Workforce Capacity Through a Residency Pathway: Outcomes and Challenges

Management and treatment of HIV: are primary care clinicians prepared for their new role?

Development of a Novel Competency-Based Evaluation System for HIV Primary Care Training: the HIV Entrustable Professional Activities

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