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1.  Alton Ochsner Medical Foundation's Combined Family Practice and Internal Medicine Residency Program 
The Ochsner Journal  2000;2(4):228-232.
The impact of managed care in the 1990s and the need for more broadly trained primary care physicians led the American Board of Internal Medicine and the American Board of Family Practice to explore ways to collaboratively train primary care physicians. One proposed solution was a combined residency incorporating the training curriculums of both boards in an integrated fashion. In 1995, the Alton Ochsner Medical Foundation Combined Family Practice and Internal Medicine Residency Program was one of the first to be approved by the two boards. The first residents began training in July 1996. Due to overlap in curriculums, completion for both boards is possible in 48 months as opposed to the 72 months a consecutive approach would require. The first graduates completed the program in July 2000.
The combined residents rotate on both the Family Practice inpatient service and the General Internal Medicine wards and participate in continuity care clinics and precepting in both core programs. Facilities for the program involve only existing clinics and administrative personnel. Residents serve as primary care physicians for a mixed ethnic, middle-class patient population atOchsner's New Orleans East satellite clinic, provide longitudinal obstetric and pediatric care at an inner city clinic, and complete a rural primary care rotation. Inservice examination scores have been consistently high with several combined residents scoring at the top United States level on both examinations. The program has matched with our highest ranked students over each year of the program despite a marked decline in US graduates entering primary care fields. Graduates of the combined program are ideal staff for either medical schools or residency programs of either core program.
While this residency is in its early stages, both boards have mandated an indepth evaluation to determine the quality and outcomes of training. The results of a recent survey of current Ochsner residents assessing their perceptions of the combined program were encouraging. We plan to track our graduates and compare them with recent graduates of the two core programs in order to document long-term impact.
PMCID: PMC3117509  PMID: 21765701
2.  State-of-the-Art HIV Management:An Update 
The Ochsner Journal  2000;2(2):85-91.
Within the past 3 years, dramatic changes have taken place in the standard of care for HIV patients. Despite improvements in care (with decreased mortality), the rate of new infections remains unchanged if not increased within most at-risk groups. This general overview is intended for the physician who, while not providing ongoing HIV care, desires an update on the major treatment issues. Current demographic trends, new methods available for testing, and the use of the viral load test for both staging and gauging response to the new combination antiretroviral treatment regimens are detailed. It is suggested that physicians consult with an experienced HIV clinician before starting a treatment regimen in the newly diagnosed patient.
The primary HIV syndrome is reviewed in detail since this diagnosis is often missed and an opportunity for early intervention is lost. Physicians not providing ongoing HIV care must be comfortable making this diagnosis and doing an initial work-up. Focused prevention especially tailored to younger high-risk patients is reviewed. Treatment protocols (with an emphasis on new antiretrovirals), gauging success of treatment, and the management of treatment failures are reviewed in detail. Common antiretroviral drugs are listed with side effects, drug interactions, and average monthly costs. Care of pregnant patients and exposed healthcare workers is also briefly discussed. The need for more primary care-based prevention is also discussed.
PMCID: PMC3117544  PMID: 21765669

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