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J Gen Intern Med. 2018 Jan 3. doi: 10.1007/s11606-017-4272-y. [Epub ahead of print]

Two Novel Urban Health Primary Care Residency Tracks That Focus On Community-Level Structural Vulnerabilities.

Author information

1
Department of Medicine, Yale School of Medicine, New Haven, CT, USA. benjamin.oldfield@yale.edu.
2
National Clinician Scholars Program, Yale School of Medicine and Department of Veterans Affairs, New Haven, CT, USA. benjamin.oldfield@yale.edu.
3
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
4
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
5
Chase Brexton Health Care, Baltimore, MD, USA.

Abstract

BACKGROUND:

Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so.

AIM:

To develop urban health primary care tracks for internal medicine and combined internal medicine-pediatrics residents.

SETTING:

Academic hospital, community health center, and community-based organizations.

PARTICIPANTS:

Internal medicine and combined internal medicine-pediatrics residents.

PROGRAM DESCRIPTION:

The program integrates community-based experiences with a focus on stakeholder engagement into its curriculum. A significant portion of the training (28 weeks out of 3 years for internal medicine and 34 weeks out of 4 years for medicine-pediatrics) occurs outside the hospital and continuity clinic to support residents' understanding of structural vulnerabilities.

PROGRAM EVALUATION:

Sixteen internal medicine and 14 medicine-pediatrics residents have graduated from our programs. Fifty-six percent of internal medicine graduates and 79% of medicine-pediatrics graduates are seeking primary care careers, and eight overall (27%) have been placed in community organizations. Seven (23%) hold leadership positions.

DISCUSSION:

We implemented two novel residency tracks that successfully placed graduates in community-based primary care settings. Integrating primary care training with experiences in community organizations can create primary care leaders and may foster collective efficacy among medical centers and community organizations.

KEYWORDS:

community-based interventions; postgraduate medical education; primary care; socioeconomic factors

PMID:
29299817
DOI:
10.1007/s11606-017-4272-y
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