Global Health Horizontals | Family Medicine | School of Medicine

During their time at QFHT, PGY-1 residents at the Kingston and 1000 Islands Site have the opportunity to round out their clinical experiences with a selection of horizontal clinical experiences. Some of these are directly pertinent to our Global Health and Health Equity curriculum including:

Street Health Horizontal
- Describe a methadone maintenance program with respect to its goals, benefits and risks to an individual with long term narcotic dependence.Describe the population served by Street Health.Describe the array of services provided by a Street Health Centre.
Prison Health Horizontal
- The resident will develop an awarencess of the unique aspects of primaryhealth care in the prison system.The resident will develop an approach to HIV and hepatitis C in inmates.The resident will develop an approach to mental health in the prison system.
HIV Horizontal
- Preamble:
  
  HIV infection is a common, manageable,chronic viral infection thatcan be effectively controlledovermany years with modern antiretroviral combination treatment. Family physicians are increasingly providing primary care for HIV patientsthatinclude the provision of antiretrovirals,while monitoring them for disease-and treatment-relatedcomorbidities. This rotation will work to serve the needs of future family physicians in becomingfamiliar with the broad scope of needs and conditions that face personsliving withHIV infection.
  
  Objectives: At the end of this rotation the resident will:
  
  1.Learn the importance of and basic principles forinitiating and maintaining patients on antiretroviral therapy.
  
  2.Learn about common comorbidities affecting people living with HIV infection, in particular the premature aging that occursin a proportion of HIV patients.
  
  3.Learn how to monitor patients on treatment for HIV,and indicationsfor specialist referral.
  
  4.Become familiar with HIVprevention strategies includingthe basics of pre-exposure HIV prophylaxis(PrEP).
  
  Outline of rotation experience:
  
  1.Formative pre-and post-rotation 10 question assessment test based on learning objectives
  
  2.Attend clinicswith ID physician supervisora.Assess andexaminepatients at clinic visit.b.Propose plan of care for patient under treatment or new HIV patient as applicable.
  
  3.One-hourdidactic sessionon basic aspects of HIV patient care(noon hour on first day)
  
  4.Home reading: selected literatureaimed at primary care providers of HIV care
  
  5.Final assessment with one of the supervising physicians to provide and review feedback to FM program.
  
  Time required:
  
  Ideally the resident would attend four sequential HIV clinics (each 3 hours in duration) theseare held on Monday & Wednesday mornings at HDH Jeanne Mance 3 clinic.On one day, the resident will stay an additionalhour for adidactic sessionon HIV primary care.