Infectious Diseases Residency Program

HIV Clinic

Medical Expert/Clinical Decision-Maker
Communicator
Collaborator
Manager
Health Advocate
Scholar
Professional
Method of Evaluation

 

These clinics should provide an opportunity for graded responsibility.

R4 (ID/MM) R2/R3 (MM) – residents should see patients on their own, review cases with attending and dictate consultations. Over the year, the resident will have graded responsibility leading to independent review of patients. Resident should be expected to follow-up on tests they order. The patient interactions will be more closely supervised than in future years and all work must be reviewed by the attending physician.

R5/R6 (ID/MM) R4/R5 (MM) – residents should have their own patients in the clinic and be responsible for management decisions, following discussion with the attending. Residents should be responsible for follow-up and trouble shooting any difficulties their patients encounter between clinics. Residents should respond to any calls from the outpatients and trouble shoot difficulties they encounter in the community.

Medical Expert/Clinical Decision Maker

The resident will be able to apply knowledge in the following areas to the management of the HIV infected patient:

1. Pathogenesis, natural history, pathology, clinical features, laboratory diagnostics,
and treatment of HIV including:

a. primary HIV;
b. chronic HIV;
c. AIDS;
d. vertical transmission.

2. Clinical features, laboratory diagnostics, treatment, and prevention of the
secondary major and minor opportunistic infections.

3. Clinical features, laboratory diagnostics, treatment, and prevention of co-infection
with hepatitis B and/or C.

4. Antiretroviral pharmacotherapy to include:

a. classification of antiretroviral agents;
b. pharmacokinetics;
c. mechanism of action and resistance;
d. toxicity;
e. side effects;
f. clinical indications, contraindications, and use.

5. Immunotherapy including:

a. use of immunomodulatory agents;
b. use of therapeutic and preventive HIV vaccines.

Skills

The resident will be able to:

  1. Elicit a history that is relevant, concise, accurate, and appropriate, including the
    risk factors/epidemiologic exposures for HIV, coinfection with hepatitis B and/or C,
    and the associated opportunistic infections.
  2. Perform a physical examination that is relevant, accurate, and appropriate to
    diagnosing HIV and the related coinfections and opportunistic infections.
  3. Select investigative tools in a cost-effective, ethical, and useful manner.
  4. Accurately place and interpret the tuberculin skin test.
  5. Properly obtain cervical PAP smears.

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Communicator

  1. The resident will effectively communicate the principles of HIV prevention and
    management to other health care workers.
  2. . The resident will effectively communicate the principles of HIV prevention and
    management to patients and their caregivers, including contact tracing and
    infection prevention in the home setting and with casual, sexual, and needle-
    sharing partners.

Collaborator

  1. The resident will understand and comply with the duty to report HIV infection as
    required by law to the Department of Health.
  2. The resident will understand the consultant’s role in HIV management in relation to
    the patient’s primary care giver.
  3. The resident will work effectively within a multidisciplinary HIV patient management
    team.

Manager

  1. The resident will learn how to effectively manage patients in a limited amount of time and with the limited resources available.
  2. The resident will learn how to effectively run an outpatient clinic and understand the importance of documentation in this practice setting.

Health Advocate

  1. The resident will learn the importance of HIV risk identification and reduction in
    promoting the health of the individual and the community.
  2. The resident will assist patients in accessing medications and address the other determinants of health which impact their care.
  3. The resident will learn the global epidemiology of HIV and the impact of resources on disease progression and outcome.

Scholar

  1. The resident will develop the skills to remain current in HIV management through
    knowledge and utilization of available resources.
  2. The resident will develop the ability to critically appraise information related to
    management and prevention of HIV and related opportunistic infections and co-
    infections.

Professional

  1. The resident will demonstrate personal and interpersonal behaviours that will be
    conducive to a therapeutic patient physician relationship.

Method of Evaluation

The resident will be evaluated by the attending staff during the HIV clinics. An in-training evaluation report will be completed by the clinic attending and reviewed with the trainee.

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