Division of Infectious Diseases

Elective Rotations

The North Park Family Health Center

The North Park Family Health Center is one of the community clinics of the Family Health Centers of San Diego (FHCSD), operated as part of the San Diego Department of Health. This outpatient clinic provides educational opportunities for the I.D. fellows in the outpatient management of a variety of infectious diseases, primarily focused on sexually transmitted diseases, acute presentations of HIV infection, acute communicable diseases, and the continuity management of populations at high risk for HIV and other sexually transmitted diseases. Each fellow rotating at the FHCSD participates in a weekly outpatient clinic, usually a Tuesday night clinic from 5:30-8:30 p.m., for a 48 week period. A UCSD I.D. Division faculty member staffs the clinic at the same time and is responsible for the supervision of the fellow at all times. The North Park Family Health Center patient population is an ethnically diverse population largely derived from the immediate surrounding area of North Park, with a large proportion of young and Hispanic individuals. A substantial number of clients are indigent and receive their care through the San Diego County healthcare system; UCSD Medical Center-Hillcrest is an integral part of the San Diego County healthcare system.

Weekly outpatient sessions conducted at the FHCSD focus on developing a deeper understanding of the pathogenesis, epidemiology, natural history and management of sexually transmitted diseases. Fellows rotating in this setting will see outpatients presenting with acute sexually transmitted infections (including HIV) and/or other acute communicable diseases, will do the initial evaluation, history, physical examination, order appropriate diagnostic tests, and make recommendations regarding the assessment and management of the patients. Each patient will be discussed with the supervising attending physician and a treatment and followup plan will be formulated. Direct patient management and followup will be the responsibility of the fellow under the supervision of the UCSD faculty member. Through this rotation fellows will be able to formulate a basic approach to the evaluation of patients with potential sexually transmitted infections, including appropriate utilization and interpretation of diagnostic tests and development of prioritized differential diagnoses. Fellows are expected to master the following: 1) Understanding the pathophysiology of common sexually transmitted diseases in adult patients seen in an outpatient setting; 2) recognize and treat common sexually transmitted diseases including syphilis, gonorrhea, HIV, chlamydial infections, lymphogranuloma venereum, genitourinary infections, hepatitis B and C; 3) recognize indications, side effects, and drug interactions of diverse classes of antimicrobial agents utilized to treat adults with STDs; 4) develop an understanding of public health approaches to the prevention of these STDs and the appropriate use of public health resources for case finding and treatment; 5) development of increased cultural competence related to interactions with person with or at risk for sexually transmitted diseases.

All clinical and educational activities at this site are directly supervised by a UCSD I.D. Division faculty member, Dr. Smith, as described above, or by a designated UCSD I.D. Division faculty member, and the full responsibility for all teaching, supervision, and formal education and evaluation of the fellow’s performance rest with the attending faculty member(s). Evaluations are both informal and formal. Dr. Smith or other relevant UCSD faculty who have contact with fellows rotating through this outpatient clinic experience will complete an evaluation form after each rotation or, if the fellow attends this elective experience over an annual 48 period, at least every six months during the year. The supervising attending physician and/or the Program Director will be responsible for discussing performance issues with the fellow periodically throughout the rotation, but at a minimum, every six months for a rotation period of at least 48 weeks duration.