L. Aoun Barakat is associate professor of medicine, Department of Internal Medicine, Section of Infectious Disease, Yale School of Medicine, New Haven, Connecticut. D.W. Dunne is associate professor of medicine, Department of Internal Medicine, Section of Infectious Disease, Yale School of Medicine, New Haven, Connecticut. J.M. Tetrault is associate professor of medicine, Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut. S. Soares is assistant professor of medicine, Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut. D. Chia is assistant clinical professor of medicine, Department of Internal Medicine, Zuckerberg San Francisco General, and University of California, San Francisco, School of Medicine, San Francisco, California. O.E. Ogbuagu is assistant professor of medicine, Department of Internal Medicine, Section of Infectious Disease, Yale School of Medicine, New Haven, Connecticut. J.P. Moriarty is associate professor of medicine, Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut. S.J. Huot is professor of medicine, Department of Internal Medicine, Section of Nephrology, Yale School of Medicine, New Haven, Connecticut. M.L. Green is professor of medicine, Department of Internal Medicine, and director of student assessment, Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut.
Acad Med. 2018 Nov;93(11):1673-1678. doi: 10.1097/ACM.0000000000002317.
People with HIV/AIDS are living longer and are at an increased risk of comorbidities. A qualified physician workforce is needed to care for this growing population.
In 2012, a novel three-year HIV training track (HIV TT) was implemented as part of the Yale Primary Care Residency Program. To prepare for the implementation of this program, a needs assessment was performed, a web-based curriculum and 12 HIV-specific entrustable professional activities (EPAs) were created, and adequate clinical training opportunities in HIV and primary care were established. Program evaluation included process, learner, and outcome evaluations from 2012 to 2017.
Since its inception, the HIV TT has enrolled a total of 11 residents (6-7 at a time), with 5 graduating to date. Residents delivered high-quality HIV and primary care for a diverse panel of patients; improved their knowledge and performance in HIV care, including according to the HIV-specific EPAs; and were highly satisfied with the program. All faculty remained with the program, and patients indicated satisfaction.
Next steps include enhanced coordination of residents' schedules, improved EPA documentation, evaluation of residents' HIV and non-HIV competence beyond residency, and monitoring graduates' career trajectories. Expanding HIV training within internal medicine residency programs is feasible and effective and has the potential to alleviate the shortage of physicians trained to provide HIV care and primary care in a single setting.
艾滋病毒/艾滋病患者的寿命延长，且合并症的风险增加。需要有合格的医生队伍来照顾这一不断增长的人群。
2012 年，作为耶鲁初级保健住院医师培训计划的一部分，实施了一项为期三年的新型艾滋病毒培训轨道（HIV TT）。为了为该计划的实施做准备，进行了需求评估，创建了基于网络的课程和 12 项艾滋病毒特定的可委托专业活动（EPA），并建立了艾滋病毒和初级保健方面的充分临床培训机会。项目评估包括 2012 年至 2017 年的过程、学习者和结果评估。
自成立以来，艾滋病毒 TT 共招收了 11 名住院医师（每次 6-7 名），截至目前已有 5 名毕业。住院医师为多样化的患者群体提供了高质量的艾滋病毒和初级保健服务；提高了他们在艾滋病毒护理方面的知识和表现，包括根据艾滋病毒特定 EPA；对该计划非常满意。所有教员都留在该计划中，患者也表示满意。
下一步包括更好地协调住院医师的日程安排，改进 EPA 文件记录，评估住院医师在完成住院医师培训后的艾滋病毒和非艾滋病毒方面的能力，并监测毕业生的职业轨迹。在内科住院医师培训计划中扩大艾滋病毒培训是可行且有效的，有可能缓解在单一环境中提供艾滋病毒护理和初级保健的培训医生短缺的问题。
