Fellows perform a mix of outpatient clinical work, inpatient teaching, self and collaborative study, didactics, conferences, on-line tools, quality improvement activities, and teaching.
a) Outpatient care: Each fellow will have a panel of approximately 30 HIV patients plus 515 non-HIV patients, or 545 total patient panel per fellow, commensurate with a 4 clinic per week schedule. In addition to the 30 HIV patients for whom each fellow will be primarily responsible, fellows also provide in-house consultation support to other HIV patient PCPs. Fellows will also see HBV and HCV patients for consultation and management visits during their clinics. They will maintain their primary care skills by seeing non-HIV patients, and are able to continue prenatal care so as not to lose these skills during the fellowship.
b) Inpatient teaching: Fellows meet with the ID rounding attending each week to review inpatient HIV cases, including the presentation, workup, diagnosis and treatment of opportunistic infections and other complications of HIV infection. Even though this fellowship does not accredit its graduates to be inpatient consultants, the teaching of inpatient HIV medicine is critical to the overall knowledge base needed to be an HIV expert.
c) Self-and Collaborative study: fellows use the AAHIVM Fundamentals of HIV Medicine Textbook and the on-line National HIV Curriculum, as well as the DHHS and IDSA HIV Treatment Guidelines as their primary HIV self-study resources. AASLD/IDSA (US), EASL (European), and WHO guidelines are the foundations of Hepatitis B and C learning. Each week the fellows spend “fellow time” with the Fellowship Director to present and review both topics and clinical cases. Self-study time is also used to work on QI projects or prepare presentations (see below).
d) Clinical Case Conferences: every other month the fellows, fellowship director and Dr. Cheeseman (of UMass Department of Infectious Diseases) convene a Clinical Case Conference, wherein challenging cases are reviewed and the group reviews new HIV and viral hepatitis literature.
e) Weekly ID Clinical Rounds: the fellows are scheduled to attend these meetings at UMass.
f) Conferences which the fellow may choose from:
- Harvard Medical School Annual HIV Update Conference (June)
- Ryan White HIV Clinical Meeting (December)
- Fellows may also use their allocation of CME time and funds to attend family medicine conferences such as STFM and to attend local and regional NEAETC HIV educational events.
g) On-Line Curriculum: fellows can choose from several options, including the National HIV Curriculum, Clinical Care Options HIV and Hepatitis, the University of Washington on-line question bank, and the HealthHIV HIV Primary Care Training and Certificate Program.
h) Quality Improvement: Fellows participate in the FHCW HIV Continuous Quality Improvement Program and design and implement a QI project during their fellowship year.
i) Teaching: Developing teaching skills and resources is one focus area for the fellowship. The fellows participate in UMass’s Teachers of Tomorrow workshop series to strengthen their skills as educators. Throughout the fellowship they are scheduled to teach on HIV/HBV/HCV topics in various settings, such as inpatient IM and FM resident/medical student teams, outpatient resident didactics, Family Health Center Learning Lunches, New England AIDS Education and Training Center events, and at other community-based venues such as AIDS Project Worcester.
j) Evaluation: Fellows are evaluated according to ACGME core competencies, namely patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice, in addition to the development of their teaching skills. Additionally, the fellows are expected to complete the AAHIVM HIV Specialist credentialing process, which includes passing a credentialing exam, by the end of the fellowship. Fellows also complete self-assessment modules within the National HIV Curriculum, which are monitored by the Fellowship Director. On-line CME tools, oral preceptor evaluation, and faculty and resident teaching evaluations of the fellows are also used.