Elective opportunities, such as the those listed below, can be created for Urban Health Scholars and other students interested in working with urban and underserved communities.
Lemuel Shattuck Urban Health Sub Internship
This course emphasized patient care in a multifaceted approach treating physical and mental illness concomitantly with support for addiction, disease, and for emotional needs and sufferance. The rotation consisted of four weeks in which a patient was longitudinally followed from each of the above mentioned perspectives. The medical student worked with medical providers, social workers, psychologists, and addiction specialists to follow patients. Primary care and specialty clinics, group meetings, hospital floors, shelters, and group homes were used as teaching sites.
Objectives & Goals
- Diagnose disease and formulate plan of care for geriatric illnesses, HIV, and TB infections, post-acute care rehabilitation and end of life care;
- Evaluate for history of mental illness and when to refer to specialists;
- Identify patients at need for substance abuse treatment services;
- Distinguish between clinical interventions and supportive services ensuring patient stability upon discharge
- Recognize the notion of spirituality and sufferance, and the need of creating emotional support in patient recovery;
- Identify barriers in placement and the work needed to ensure safe discharge in community;
- Work with multidisciplinary team;
- Understand the medical, psychiatric, emotional and spiritual needs of hospitalized correctional patients.
Greater Lawrence Family Health Center
This clinical rotation provided an introduction to Family Medicine in both the inpatient and ambulatory settings. The students saw patients in one of the Health Center's four sites under the supervision of a clincian or senior resident. Students were also paired with physician/resident teams on the Adult Medicine and OB services. The rotation may have also included didactic sessions, as well as home visits and shelter visits accompanied by a HC physician. Students were required to have a background in medical Spanish.
Objectives & Goals
- Provide an experience in confronting the challenges of providing care to an underserved urban population and becoming aware of cultural differences in attitudes and practices regarding health and illness.
- Experience the full range of family medicine including adult medicine, women's health, pediatric care, prenatal care and preventive health care.
Medical students learned the importance of effective communication across barriers i.e. race, socioeconomic status, sexual orientation, gender, and more. Good health and health care begins with communication between professional and patient, between patient and the system, and among members in a community. When this communication is limited because of differences in cultures, values or language, health and well being can be compromised. To improve the quality of health care for people of various ethnic and linguistic backgrounds, the Harvard Pilgrim Health Care Foundation operates Culture InSight (CIS).
What did the Culture InSight do?
- CIS provided training for providers in culturally competent care and for medical interpreters.
- CIS consulted with health care organizations and institutions to design professional development programs to meet their specific requirements.
This elective provided an opportunity for students to be immersed in the activities of the Culture Insight Team and work with them to analyze data or explore resources that were beneficial to the team. This relationship would be an exciting, unique opportunity for our medical students to engage in the training of providers in culturally competent care, learn about utilizing medical interpreters and consult with health care organizations and institutions in the Boston area to meet their diverse needs.
This elective also provided an opportunity for students to learn by working in The MetroWest Free Medical Program (MWFMP) in Sudbury and Framingham, MA. MWFMP is a volunteer-physician led program providing free health care services to the medically underserved in the communities of Boston's MetroWest region. Through the dedication of 35 volunteer physicians and more than 150 volunteers, it is the mission of MWFMP to serve as an entry point to the health care system for those in MetroWest who are uninsured/insufficiently insured by:
- Providing general medical and specialty care to meet their immediate health care needs;
- Connecting them with social services, health insurance and a medical home;
- Engaging with community partners;
- Advocating for policy changes that assure good health for all people.
MWFMP provided care through walk-in clinics and scheduled appointments during our Tuesday and Thursday evening and Friday afternoon programs. The Program was open each Tuesday evening to offer general medical care, as well as specialty care in Diabetes, Dermatology, Psychiatry, Orthopedics, and Asthma Care. In 2008, the Program opened a second site at the First Parish church in Framingham to offer expanded women's health services, as well as Vision care. Last year, MWFMP provided 1575 patient care visits, representing 1115 distinct patients, an increase of more than 30% from 2008.
Objectives - At the end of this elective the student was able to:
- Describe the relevance, role, and training of medical interpreters.
- Bring what they learned back to Geisel by leading a seminar or workshop for their peers upon their return.
- Summarize their clinical experience in a final report