Underserved Health Experience

Our Residency Program has a strong commitment to training physicians who are interested in learning how to care for underserved populationsWe believe this is rooted in family medicine's social responsibility to care for the whole community. The purpose of our underservered curriculum  is for a residentto develop the skills, attitudes, and knowledge that will assist them in caring for . vulnerable populations in a number a different settings. This is achieved through providing care to the underserved populations, working to improve healthcare delivery for these patients, understanding the public health system, learning how to advocate for change, and contributing to the community through service and research.

Our underserved health curriculum has a strong integration with our International Health curriculum, as we believe that both help prepare physicians to care for vulnerable populations. An overall focus to the  curriculum is the issue of how poverty, justice and health impacts the populations we serve and the choices we make as physicians. Whether the patient is an uninsured mother in Cincinnati or Honduras, we believe a physician needs to be able to understand and examine how health and the health care system interacts, and how it is impacted by the societal forces related to poverty (access to care, neighborhood conditions, safety, income inequality) and the role of justice (advocacy, eliminating health disparities).

To achieve the above objectives, we have structured the curriculum as follows:

• Thursday Lecture Series: We have two hours of lectures per month specifically dedicated to the area of Underserved and International Health. Here is a list of some of the topics we have covered over the past two years. For the Underserved Health curriculum, we will be using the text "Social Injustice and Public Health" and "Medical Management of Vulnerable Populations" as the basis for our curriculum.
• October and April two-week course: Prior to our two international health trips to Honduras, we provide a two week course for our residents. The October course focuses more on Tropical Medicine while the April course concentrates more on public/community health.  Each resident participates in each of these courses. Other learners include medical, pharmacy, and nursing students.
• Electives
  • Health Policy Elective
    We offer a 2 to 4 week elective for residents which focuses on health policy topics in the following areas: Local safety-net, Medicaid, Medicare, uninsured, Employer base healthcare, quality of care, and the Family Medicine Specialty. Residents meet with local and regional experts in these areas of health policy, study a specific area of interest and develop a position paper or presentation.
  • Underserved Health Elective
    Residents can choose to take a one month elective along with other primary care residents (Peds / Med-Peds/ IM), that focuses on gaining a better understanding of the health problems, barriers, and resources of the local underserved population.
  • Crossroads Community Health Center
    As an inner city health center that focuses on the African American community living downtown and growing Hispanic population, residents can choose to spend elective time at this center.

Additional Curriculum Included:

• Continuity Clinic
  

  Forest Park Family Medicine Center
  As the residency continuity site, the office has a mission that includes caring for the Medicaid population. Access to care for Medicaid patients is an issue locally, and we use this as an opportunity for teaching the residents about access to care and understanding the community.

• Longitudinal underserved continuity clinics

   

  • Residents spend one to two half days a month at these clinical sites on months that allow (non-inpatient months for Family Medicine R2/R3; Family Medicine/Psychiatry R3/R5). The goal is to increase the resident's knowledge and skills of working with different types of underserved patients, understanding their needs and learning potential resources that are available.

    • Homeless Van
      The homeless van is a mobile, medical van which is staffed by physicians from our Department of Family Medicine. Residents provide medical care for homeless patients and work with the staff to case manage patients with chronic illness.
    • Pre-natal Clinic
      The residency and Christ Hospital operate a pre-natal clinic for uninsured and Medicaid woman in the Cincinnati area. Residents  provide pre-natal care and learn about community resources for this population of obstetrical patients.
  • Residents in their second and third year also have the option of spending time working one on one with a community physicians in an underserved site (such as a community health center). This year two of our third year residents have chose this option and are working with one of our graduates in a community health center two half days a month. These visits count towards their resident numbers, and we believe they offer an excellent opportunity for mentorship for working with vulnerable populations.
    
    
• Serving local underserved populations
  Our residents and faculty have identified vulnerable populations in our community that are lacking access to health care and at the same time offering an opportunity for the combination of service, teaching and learning.

  • Race Track Clinic
    Three years ago a free clinic was started by the residency program for the workers that live and work on the backside of a local racetrack. One night a week from May until September residents provide healthcare for the workers and have the opportunity to teach medical students at the clinic. The faculty serves as preceptors. About 45% of the patients are Spanish speaking and 80% are uninsured.

  • Medical Student Run Homeless Clinic
    Residents and faculty precept medical students at homeless clinic. This is a volunteer opportunity and occurs from October to March
    

• Book Discussions

  The residents and faculty have joint book discussions as part of this curriculum. Twice a year we read and discuss a book at a faculty member's house over a dinner (or two). The books include:

  • The Spirit Catches You and You Fall Down
  • Nickel and Dimed
  • Mountains Beyond Mountains
  • Pathologies of Power
  • Complications
  • Not All of Us are Saints