The fellows will perform a mix of clinical work (primarily outpatient but also some inpatient), self and collaborative study, didactics, conferences, on-line tools, quality improvement activities, and teaching.
Each fellow will work four primary care clinical sessions per week. These sessions will occur at the Jefferson Family Medicine Associates (JFMA) clinical site (or other sites at the discretion of the department and fellow such as the Mazzoni Center and Steven Klein Wellness Center), and will include one evening session per week. The fellow will also work two additional sessions per week with Dr. Miller in the Kendig Comprehensive HIV Clinic doing comprehensive HIV primary care and with ID attendings in their clinical hours providing HIV care and independently providing additional primary care visits for patients seen by ID who have identified unmet primary care needs.
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 within their normal clinical hours.
The fellow will also have regular clinical shadowing experiences at other locations in Philadelphia providing HIV care such as Esperanza Health center, Prevention point, Philly Fight and the Mazzoni Center.
HIV & Hepatitis Family Medicine Consultant (Longitudinal)
The fellow will be notified of any patient who has the diagnoses of HIV who is admitted to the Jefferson Family Medicine inpatient team. This is done independently of the condition for which the patient is admitted. The fellow will review the patient’s HIV related care and give appropriate recommendations while following the patient along with the primary team. The fellow will review the recommendations with Dr. Marshal Miller and determine if infectious disease consultation is warranted. This will be a longitudinal experience through the fellowship year. The JFMA inpatient service is a large and busy inpatient service at an academic hospital. It admits patients from several practices including the department of Family Medicine outpatient practice or JFMA, Mazzoni, Stephen Klein Wellness Center, 9th street internal medicine, as well as other community sites. The fellow will play a key role in the transition of care from inpatient to outpatient setting for those patients to improve care for patients and hopefully reduce preventable hospital readmissions. Since the fellow also has continuity clinics at some of those sites, this furthers facilitates that transition.
Inpatient ID Rotations
In collaboration with infectious diseases department the fellow will be able to rotate with the consultation service to gain exposure to broader infectious disease management including inpatient the management of HIV related complications and opportunistic infection.
Online, Self and Collaborative Study
Fellows will use on-line National HIV curriculum program and AAHIVM Fundamentals of HIV Medicine curriculum and online modules as their primary texts, as well as the DHHS and IDSA HIV Treatment Guidelines as a resource and guide to self-study. The fellow will also use AASLD (US) and EASL (European) guidelines on Hepatitis B and C management as well as other resources. Each week the fellows will have a case review of patient cases and other relevant topics with Dr. Miller as, as well as “preceptor time” during clinical hours with both Dr. Miller and the Dr. Spacek and the other ID attendings.
Clinical Case Conferences and Grand Rounds
The fellow will take part in and present at monthly HIV case conferences as well as attending weekly ID fellow conferences and management conferences as able. The fellow will be expected to attend weekly family medicine grand rounds and present a current and relevant HIV-related topic at family medicine grand rounds during the second half of the year. The fellow will also be expected to present at least one lecture during the family medicine residency conference series
The fellow will be expected to attend at least 2 HIV-related CME conferences during the course of the training year. Fellows may also use their allocation of CME time and PERK funds to attend additional family medicine or infectious disease conferences such as STFM and to attend local and regional NEAETC HIV educational events.
Fellows will participate in a quality improvement and patient-centered research study, and will design and implement a QI project during their fellowship year, culminating in a poster presentation which should be submitted to a national conference or local conference for presentation.
Developing teaching skills and resources will be one of the main focuses of the fellowship. The fellows will participate in both the infectious disease and family medicine didactic teaching programs as detailed above as well as on the inpatient family medicine service in conjunction with their consultation work for HIV positive patients admitted to the family medicine service. They will also be working with both medical students and residents in a preceptor role during their clinical responsibilities.
Fellows will be evaluated according to the 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, fellows will meet all requirements to be eligible for credentialing and complete the AAHIVM HIV Specialist credentialing process, which includes passing a credentialing exam, at the completion of the fellowship.