Internal Medicine HIV Track

Program Overview and Background:

Beginning in July 2014, SUNY Downstate Medical Center (now Health Sciences University) started to offer an HIV specialty track option within the Categorical Internal Medicine Residency Program.

The HIV Track Option will be offered to a select group of four residents and will continue throughout the three years of residency. All incoming PGY-I Categorical Medicine housestaff will be given the opportunity to apply to this program.

This track has been developed in response to a decrease in the number of primary care physicians in the U.S. who provide HIV care. As HIV has become a chronically-managed disease, there is an increasing need to incorporate primary care providers into the spectrum of HIV care. SUNY Downstate has been selected as one of only three sites to receive funding from the US Public Health Service’s Health Resources and Services Administration (HRSA) to develop an HIV track for Medicine residents. Our nationally-recognized HIV treatment and research programs, our large Medicine residency program, and our diverse patient population make us uniquely suited to offer this training opportunity.

Program Goals:

The overall mission of the program is to build the capacity of a generation of primary care / internal medicine physicians who can provide expert specialist care to people with HIV.

By the end of this three year program, selected residents will be able to:

• Perform key elements of the initial evaluation of a patient with HIV including risk assessment, history, physical examination, and laboratory assessment.
• Select and utilize appropriate antiretroviral regimens.
• Diagnose and treat opportunistic infections and co-morbidities associated with HIV disease in the primary care setting.
• Manage patients in the context of an interdisciplinary primary healthcare setting that provides prevention counseling, psychosocial management, and culturally competent care.

The HIV Track Option offers enhanced mentorship, integration of HIV-infected patients into a general medicine panel, and specialized education. Specifically:

• HIV specialist physicians will be assigned to mentor and supervise the residents in their provision of ambulatory HIV care.
• A panel of HIV-infected patients will be integrated into each resident’s panel of patients in the SUNY-Downstate outpatient department, with an increase of up to 30 HIV patients in the residents’ continuity panel.
• Didactic lectures on HIV care will be integrated into the residents’ pre-clinic lecture series. In addition, written and electronic educational material will be provided.
• HIV Track residents will also be invited to participate in additional on-campus and off-site HIV-related educational opportunities and have the opportunity to engage in research work.

Didactic topics include:

• HIV pathogenesis and natural history;
• Initial evaluation and laboratory assessment of the HIV patient;
• Antiretroviral (ARV) medication selection;
• ARV drug-drug interactions, sequencing, and resistance testing;
• Co-infection with Hepatitis C and other co-morbidities;
• Metabolic and chronic care issues in HIV;
• Prevention and screening in US and global epidemiology.

• Residents will receive individualized evaluation of their academic progress and monitoring of their patient panel.
• Process for application: Shortly after the Match, all incoming categorical medicine residents will be notified of the opportunity to apply and interview for the HIV Track Option. Interested candidates will be invited for interviews in May or June. Final selection of residents for the HIV Track Option will be made by the first week of July.