Margaret Fikrig, MD, had a powerful experience in understanding the challenges facing HIV/AIDS patients when she was a resident. Another resident she was very close with learned he was infected with HIV in the late 1980s. The stigma against people with the virus was very strong at the time, and Fikrig was the only person he told.

“I felt so bad for him for facing this and having to keep it secret because he didn’t want to get fired,” Fikrig said.

The medication then available for treating HIV, AZT, initially had to be taken every four hours. In a time long before smartwatches, the two drove for hours to buy a watch they had found with an alarm to consistently remind him that he needed his medication.

When a clinical position in the Yale HIV/AIDS Program became available in 2011, Fikrig was happy to take it. “I knew it’s a tough thing to live with HIV, and I just wanted to help other people with that,” she said.

Fikrig, associate professor of medicine (infectious diseases) at Yale School of Medicine (YSM), who has been with the program since, retires on June 30. She will be much missed by her colleagues and patients, said Vincent Quagliarello, MD, professor of medicine and clinical chief of Infectious Diseases. Quagliarello has been Fikrig’s mentor for decades.

“She really embodies the soul of the department,” he said. “She does a lot of work behind the scenes and out of the limelight, but where it matters most. And as someone who works with marginalized communities, she is a very careful, thoughtful clinician and role model,” he said.

Fikrig first came to Yale for her postdoctoral fellowship in 1988. After finishing in 1992, she decided she preferred clinical work to research and took a position at the Hospital of St. Raphael. Later on, with two young children at home, she approached the internal medicine chair with a proposal for a job share with another physician, creating the first such job share at the hospital and modeling for others how it could be a successful option.

Fikrig continued at St. Raphael’s until 1998. After the birth of her third child, she and the children accompanied her husband, Erol Fikrig, MD, YSM professor of medicine (infectious diseases), on his sabbatical in the Netherlands. On their return to the U.S., she decided to stay at home with the children. In 2009, Dana Dunne, MD, MHS, YSM professor of medicine (infectious diseases), suggested Fikrig return to more permanent work by replacing Dunne as the part-time clinician at the City of New Haven STD clinic.

Dunne had worked with Fikrig at St. Raphael’s, and like Fikrig, had taken time off to be with her family. “We’d had similar paths with needing to shift our focus away from full-time medicine, so I thought she would be a perfect fit for the role,” Dunne said.

That Fikrig took time off and returned to many years of a rewarding career offers useful perspective for trainees, Dunne said. “They can see that there are alternative paths to take and that your path can go in many ways and you can still be successful as a clinician and an educator,” she said.

Fikrig moved to the Yale HIV/AIDS Program after two years with the STD clinic. In the program, she acts as both internist and HIV care provider for patients, taking a whole-person approach to care. That means establishing "a very intimate relationship with your patient because you have to know all their sexual habits and any drug use habits,” she said.

“Because of that, they feel comfortable letting me take care of everything, which helps them stay healthier. It would be harder for them if they had to also routinely go to see an internist or specialist,” she said.

Some of Fikrig’s patients have been with her since 2011. “I’m seeing people for their final visits with me, and they’re crying,” she said. “It makes me feel good that I was special in their lives.”

In addition to her work with patients, Fikrig has been an exceptional educator. In 2021, she received the Stephen Huot Award for Dedication and Excellence for a program she developed to help train infectious diseases fellows to care for people living with HIV. The one-year program includes an hour-long pre-clinic conference each week in which she and other providers in the Yale HIV/AIDS Program discuss important topics in HIV care.

“It takes a lot to schedule each year, and I arrive early to start each conference, but I think the program has been really important for the infectious diseases fellows’ training,” Fikrig said. “Medical schools cover issues in HIV much less than they once did since medication now controls the disease, but the infectious diseases fellows could be providing all the HIV care for the practice they join, and they need to know more,” she said.

Lydia Aoun-Barakat, MD, associate professor of medicine (infectious diseases) and the director of the Yale Center for Infectious Diseases, welcomed Fikrig into the position. She said Fikrig “blossomed” in the role.

“She quickly built a large cohort of patients. Her patients adore her: she knows their personal lives, so they feel very connected with her,” Barakat said. “And the staff loves her. She never misses an important staff event, and they appreciate her kind and approachable personality,” she said.

At Barakat’s encouragement, Fikrig took on additional roles, including becoming the co-chair of YSM’s quality management team for Ryan White HIV-AIDS funding and being secretary and newsletter editor of the Connecticut Infectious Diseases Society for several years.

“She puts in the work and takes whatever project she does very seriously. She’s so committed, and everything she does, she does extremely well,” Barakat said.

Fikrig plans to stay active in retirement, increasing her volunteering with the local library and Unitarian Universalist church. “I like the feeling helping people gives,” she said. “It makes my life feel more valuable, and I’d like to continue that.”

A 25-year member of a book club, she also plans to read extensively and, at Quagliarello’s suggestion, perhaps write for other physicians about her experiences.

“She is a very careful clinician and observer of medical practice and patient preferences and an expert in caring for marginalized communities,” Quagliarello said. “That is a very unique human experience, and the stories she could tell about being a bedside clinician could have a significant impact on clinical care and physician medical education.”

Infectious Diseases, one of ten sections in the Yale Department of Internal Medicine, engages in comprehensive and innovative patient care, research, and educational activities for a broad range of infectious diseases. To learn more, visit Infectious Diseases.