Improving Formal Medical Training Through Exchange Programs: A Pilot Experience In Two Distant Geographies

KROLEWIECKI A; QUIPILDOR M; TARANTO N; FIGUEROA M; FINK V; JUÁREZ M; CAJAL P; EGÜES M; PÉREZ H; CAHN P

Toronto, Canadá

Conferencia; XVI Internacional AIDS Conference.; 2006

International AIDS Society

Issues: Medical training in HIV is best achieved at reference centers with expertise in patient care and high patient load.  In Argentina, 127,000 HIV cases are estimated, 90% concentrates in large urban areas (Buenos Aires, Córdoba, Rosario). Orán, located in Salta, neighbouring Bolivia, has 70 cases diagnosed, most of them in the last year. In these areas, the growing epidemic goes underdiagnosed, and medical care of affected patients is suboptimally covered. Social issues related to HIV, also lag behind achievements in urban centers. Description: This program was developed as part of a project by the Fogarty Foundation. In a joint project of the residency programs of Infectious Diseases at Hospital Fernandez in Buenos Aires (pop. 12,000,000) and Family Medicine at Hospital San Vicente de Paul and the Instituto de Investigaciones en Enfermedades Tropicales in Orán (pop. 58,000), all in Argentina, but 2,000 Km apart; engaged in an exchange program of residents, spending a month at the visiting site. Upon return, the acquired knowledge is transferred to peers and mentors. Lessons learned: After two rotations, this program started to make an impact at the peripheral center in aspects that are no longer an issue at the urban center, like open discussions about HIV topics, physicians’ acceptance of HIV infected individuals and infection control issues. The availability of training in HIV care is best received at the peripheral center when the “experts” go to the peripheral place rather than visiting the reference center by personnel from the peripheral site. Bringing groups together also triggered the development of new projects. Recommendations: We recommend the continuity and reproduction of this experience for a better training in aspects of HIV management in different geographies. The main outcome of these programs should be the achievement of a uniform standard of care.