The AIDS Commentaries have focused primarily upon the clinical aspects of infection due to the human immunodeficiency virus as documented in academic centers based in large metropolitan areas. Clinicians outside the epicenters of the epidemic face a different set of problems. Dr. Verghese has previously shared his experience in caring for persons with AIDS in rural Tennessee (J Infect Dis 1989;160:1051-5). In this latest contribution, he discusses the potential value of training infectious diseases physicians to perform procedures that they usually do not learn in fellowship programs but that are required for optimal management of patients with AIDS. This is a controversial issue that reflects a shift in the infectious disease specialty from a consultative to a primary care practice as a result of the AIDS epidemic. It is an issue worthy of consideration by the directors of infectious disease training programs.