Development of a Novel Competency-Based Evaluation System for HIV Primary Care Training: the HIV Entrustable Professional Activities



There is an anticipated shortage of primary care providers trained to care for patients with HIV. The Yale School of Medicine developed and implemented a novel HIV training track within our Primary Care Internal Medicine Residency Program. A set of 12 Entrustable Professional Activities (EPAs) were developed to guide curriculum development and resident assessment.


To describe the process of implementing a novel EPA-based curriculum for the HIV Primary Care Training Track including EPA-based trainee evaluation tools.


Two to three residents were enrolled annually from 2012 to 2017 (total n = 11). Training sites included the outpatient academic center HIV clinic and inpatient HIV ward.

Program Description

An expert panel developed 12 HIV-specific EPAs. These were mapped to curricular and reporting internal medicine milestones. Curricular activities and evaluation tools were developed to guide EPA progress.

Program Evaluation

Graduating residents were ready for unsupervised practice in 91% of EPAs at the end of the 3-year program.


Development of HIV-specific training EPAs was effective for driving curricular development and resident evaluation, and served as an effective method to communicate expectations to resident participants. These HIV-specific EPAs could serve as a useful template to enhance HIV education in academic settings.

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We would like to acknowledge our HIV Training Track residents; the staff of Nathan Smith Clinic, John Moriarty, M.D., Stephen Huot, M.D., Onyema Ogbuagu, M.D., and David Chia, M.D.; and all our wonderful patients.


We acknowledge AIDS Education and Training Centers (AETC) grant support: H4HA22762.

Author information

Correspondence to Dana Dunne MD.

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Conflict of Interest

DD—spouse holds stock in Pfizer, Inc.

Lydia Aoun Barakat served as a consultant for Gilead Sciences.

All other authors report no conflicts of interest.

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Dunne, D., Green, M., Tetrault, J. et al. Development of a Novel Competency-Based Evaluation System for HIV Primary Care Training: the HIV Entrustable Professional Activities. J GEN INTERN MED 35, 331–335 (2020).

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  • HIV training
  • EPA
  • residency training
  • primary care training