This project includes two areas of focus that will be implemented in a longitudinally over three years of residency training. These two additional curricular areas will be added to the existing curriculum to enhance the scope of the family medicine resident’s knowledge base and skills. This curriculum and the evaluation components are competency-based. Objective 1 will focus on improving residents’ ability to better understand and meet the primary care needs of adults with disabilities. Exposure to the scope of personal health problems that adults with disabilities face and effectively communicating with patients and families in clinical settings is included. This additional curriculum will be incorporated in to all three years of residency training and will include didactic presentations, outpatient clinical experiences and home visits. Objective 2 will enhance the education and skills of residents in meeting the needs of adult and adolescents living with HIV. This objective will include additional conference topics for residents in all three years of training and residents will rotate to a clinic for new experiences with patients living with HIV in years two and three. Enhancing medical knowledge and communication skills are overarching goals. The curriculum of the residency will be changed to allow inclusion of didactic and hands on clinical experiences in these two areas. Existing departmental projects, expertise of department faculty, and relationships with local community partners make these two areas of focus logical choices for this residency program. Additionally, there are added group experiences which will focus on unique communication barriers and challenges between the physician, the patient, and family.