Education and preparation of physicians entering an international pediatric AIDS program: the Pediatric AIDS Corps

The Pediatric AIDS Corps (PAC) are a group of physicians that were hired to provide clinical care and treatment to children and their families infected with HIV/AIDS and to help educate local health care professionals in the management of children with HIV/AIDS located in the high prevalence areas of sub-Saharan Africa. Prior to their departure the PAC were required to participate in a 4-week educational training program that included travel and tropical medicine and HIV infections in children, teaching skills, bioethics, and good clinical practice in human research training. Evaluation of the program was done using a 50-question pretest/posttest design, a standard postcourse evaluation, and a PAC focus group follow-up. Fifty-two physicians were hired who had been trained in the following specialties: pediatrics (77%), medicine/pediatrics (9%), family medicine (8%), and internal medicine (6%). Posttest scores improved by a mean of 10 points for all PAC physicians (p < 0.001) but those that had been in Africa for 5 months or more prior to the course continued to score higher than the other participants. Reviewing the results by category demonstrated significant improvement in all areas (p < or = 0.002) except for general pediatrics for the HIV/AIDS infected patients (p = 0.124) and psychosocial issues (p = 0.376). Changes for the next training were implemented based upon the information obtained from the PAC focus group. The foundation provided by this educational course was an important beginning for the PAC physicians. Other groups providing specialized care to patients in developing countries might consider a similar educational program.