Specific Goals & Expectations
HIV Medicine Clinical Service Curriculum
HIV Medicine Rotation: During this service rotation, Fellows focus on the HIV Medicine consultation and continuity clinic experience.
A. HIV In-Patient Consultation Service
Goals: To provide the Fellow experience in evaluating and managing inpatient HIV seropositive (HIV+) patients at all stages of their disease. Fellow responsibilities will include consultation for inpatent primary care services in the overall management of HIV-infected patients admitted for a wide variety of medical or surgical reasons. A primary objective of this clinical experience is to develop expertise in recognizing and managing opportunistic infections and malignancies complicating advanced HIV infection, (e.g., Pneumocystis pneumonia, cryptococcal meningitis, non-Hodgkin’s lymphoma) and relevant diseases encountered at all stages of HIV infection (e.g., bacterial pneumonia, tuberculosis, hepatitis C) and complications of HIV therapy. The HIV/ID fellow provides consultation on all patients with HIV infection admitted to the hospital, irrespective of the reason for admission, to ensure continuity of HIV therapy, etc. Along with these objectives, the Fellow will become skilled in coordinating multiple subspecialty services and/or resources, including Nurse practitioners, social workers, psychologists, registered dieticians, and financial case managers. An integral role of the HIV/ID Fellow will be to supervise and instruct Residents in the management of HIV+ patients. These goals are designed to address the six competencies outlined by the RRC / ACGME.
Format: The Fellow will round with the Attending Physician and other members of the HIV consult team on a daily basis. The Fellow may be asked to provide didactic sessions pertaining to the diagnosis or treatment of HIV infection for purposes of Resident education as determined by the Attending Physician. Requests for switching coverage periods with another HIV/ID Fellow will require written 45-day advanced notice, to be approved by the HIV service Director (also see below). Both Fellows involved in the coverage switch will be required to submit a written record of the agreement to the HIV service Director and the Infectious Disease service Director. In cases of emergency (eg., urgent medical situations), the Fellow must contact the HIV clinic Director at his/her earliest possible opportunity.
B. HIV Continuity Clinic Service
Goals: To offer Fellows relevant experience in evaluating and managing ambulatory HIV seropositive (HIV+) patients at all stages of infectious disease. Resident responsibilities will include the management of patients discharged from the hospital following an acute opportunistic infection, malignancy, or other HIV-associated complication, patients with recently diagnosed HIV infection initiating therapy, and patients well-controlled HIV infection. An important goal of this experience will be for the Resident to establish a continuity of care for a cohort of HIV+ patients through a regular and focused interaction with these individuals. The Resident will also acquire experience in considering ethical issues related to HIV infection and AIDS (e.g., confidentiality / HIV disclosure/ partner notification issues, hospice options, conservatorships, and specific non- resuscitation orders). These goals are designed to be consistent with the six competencies outlined by the RRC / ACGME.
Format: The ID/HIV Resident will see patients under the supervision of an attending Faculty member in the clinic setting. Additionally, the Fellow will learn to integrate care with an array of multidisciplinary supportive resources in the HIV clinic, including Nurse practitioners, social workers, psychologists, a registered dietician, and financial case managers. These resources will be present in the clinic to provide specific areas of expertise related to the overall management of HIV+ patients. The HIV/ID Resident is assigned to one half-day (4 hours) clinic per week throughout the two year fellowship, with an additional half-day clinic session assigned each during the HIV inpatient rotation for hospital discharge visits. The Resident has a reduced clinic patient load when they are serving on the in-patient ID consult service. The clinic schedule is designed for each ID Resident to evaluate and manage as many as 2-3 new consultations, and 3-6 follow-up consultations, during each clinic session. The Resident is assigned by the HIV Clinic Director to a specific clinic session each week throughout their two years of fellowship.
C. HIV Medicine Service Expectations
The HIV/ID Fellow is expected to meet several performance milestones during the HIV in patient consult service and HIV clinic experience:
Harbor-UCLA Medical Center is an active and integral training campus of the broader David Geffen School of Medicine at UCLA
Join us as we meet the challenges of infectious diseases in the 21st century