Learning Social Medicine in the Bronx: An Orientation for Primary Care Residents

Fornari, Alice; Anderson, Matthew; Simon, Sherenne; Korin, Eliana; Swiderski, Debbie; Strelnick, A. Hal

doi:10.1080/10401334.2011.536898

Cited by 16 publications

(22 citation statements)

References 14 publications

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“…Our intervention adds to the growing number of residency programs testing experiential education strategies to increase appreciation of health disparities, including clinical simulations and community ''treasure hunts,'' 8 and more intensive community introductions, ranging from 2 days 9 to 1 month. 10 Our study illustrates the critical role of nonacademic partners in medical education. As the medical system faces increasing pressure to address population health at a reduced cost while improving health, the role of community leaders grows in importance.…”

Section: Discussionmentioning

confidence: 99%

The Impact of “See the City You Serve” Field Trip: An Educational Tool for Teaching Social Determinants of Health

Chang

Bass²,

Duwell

et al. 2017

Journal of Graduate Medical Education

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Section: Discussionmentioning

confidence: 99%

The Impact of “See the City You Serve” Field Trip: An Educational Tool for Teaching Social Determinants of Health

Chang

Bass²,

Duwell

et al. 2017

Journal of Graduate Medical Education

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Section: Settingsmentioning

confidence: 99%

“…A unique aspect of the department's residency curriculum addresses social justice and health disparities. 13 The clinics are managed in collaboration with the Bronx Community Health Network, a community advocacy and service organization.The clinics are located in different communities in the Bronx, but the demographic makeup of the 2 communities is largely similar. Seventy-eight percent of Williamsbridge Family Practice and 79% of Family Health Center community residents self-identify as black or Latino, 33% and 35% are foreign-born, and 55% and 64% have at most a high school education, respectively.…”

mentioning

confidence: 99%

Results of a Voter Registration Project at 2 Family Medicine Residency Clinics in the Bronx, New York

Liggett

Sharma

Nakamura

et al. 2014

The Annals of Family Medicine

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PURPOSE Federally qualified health centers provide care to medically underserved populations, the same individuals often underrepresented in the electoral process. These centers are unique venues to access patients for voter registration services. METHODSWe undertook a clinician-led, nonpartisan voter registration drive within 2 university-affiliated federally qualified health centers in the Bronx, New York. Patients were approached by voter registration volunteers in clinic waiting areas during a 12-week period.RESULTS Volunteers directly engaged with 304 patients. Of the 128 patients who were eligible and not currently registered, 114 (89%) registered to vote through this project. This number corresponded to 38% of all patients engaged. Sixtyfive percent of new registrants were aged younger than 40 years.CONCLUSIONS This project was successful in registering clinic patients to vote. Clinics are not only health centers, but also powerful vehicles for bringing a voice to civically disenfranchised communities. INTRODUCTIONI n the United States, voting is a fundamental right of citizenship and represents the power to influence societal conditions that affect health conditions. Despite this opportunity, only 42.5% (93 million) of the American electorate voted in the 2012 presidential election.1 Low voter turnout is even more of a challenge in local elections. In 2009, just 18.4% of voters cast a ballot in the New York City mayoral election, the lowest turnout since 1969.2 This phenomenon may lead to skewed health policy outcomes that favor more civically active citizens. 2,3The demographic composition of a community can predict low voter turnout. Whites vote at a rate 10% higher than blacks and 50% higher than Latinos and Asians nationally.3 Low household income, young age, and residential mobility are also major predictors.2,4-6 The Bronx community is particularly vulnerable. It is the poorest urban county in the United States, with 29% of its residents living at or below the poverty level. Additionally, Bronx residents experience high rates of residential mobility. 8 Twelve percent of residents change addresses within 1 year of moving to a new address.9 In many ways, social disparities mirror health disparities in that inequitable distribution of health resources and disproportionate adverse health outcomes affect these same groups. 10The magnitude of voter disparity is especially great among individuals who are likely to receive care at federally qualified health centers (FQHCs). These patients are most often Medicaid eligible, uninsured, and low income. Offering voter services in this setting allows increased access to potential voters, facilitates civic participation, and enables patients to get involved to improve community health. Additionally, the National Voter Registration Act of 1993 empowers FQHCs to provide voter ser- vices. Under the law, offices that provide public assistance, including Medicaid services, are considered voter registration agencies. 11The National Association of Community Hea...

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“…[1][2][3][4][5][6][7][8][9][10][11][12] Currently, most IM programs provide ambulatory training in hospitalbased continuity clinics, 13 and there are few studies exploring free clinics as potential community-based IM training settings or the outcomes of this type of community-based training. [14][15][16] Most published experiences thus far with community-based training have been in family medicine or with medical students. [16][17][18][19][20][21][22][23] Previous experiences have been positive, demonstrating improved culturally appropriate training in underserved populations, high resident satisfaction, and that trainees feel highly prepared for future practice.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16] Most published experiences thus far with community-based training have been in family medicine or with medical students. [16][17][18][19][20][21][22][23] Previous experiences have been positive, demonstrating improved culturally appropriate training in underserved populations, high resident satisfaction, and that trainees feel highly prepared for future practice. 14,15,20 Positive workforce implications have also been demonstrated with improved recruitment of high-quality residents and faculty to work in the health centers and graduates who are more likely to work in underserved settings.…”

Section: Introductionmentioning

confidence: 99%

Resident Education in Free Clinics: An Internal Medicine Continuity Clinic Experience

Pincavage¹,

Razi²,

Arora³

et al. 2013

Journal of Graduate Medical Education

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Background Most internal medicine (IM) residency programs provide ambulatory training in academic medical centers. Community-based ambulatory training has been suggested to improve ambulatory and primary care education. Free clinics offer another potential training setting, but there have been few reports about the experience of IM residents in free clinics. Objective We assessed the feasibility and acceptability of inclusion of an ambulatory rotation in a free clinic and IM residency curriculum and the advantages of the free clinic setting over the traditional ambulatory clinic model. Methods In 2010, the University of Chicago Internal Medicine Residency Program partnered with a free clinic in order to establish a community-based continuity clinic experience. To assess the feasibility of this innovation, 16 residents were surveyed 9 months after implementation of the clinic to determine satisfaction, perceived preparation to address common medical conditions, and attitudes toward the underserved care population. A subset of these responses was compared to responses from residents in the traditional clinic model. Results Residents in the free clinic rotation were more satisfied and perceived they were more prepared to work in low-resource settings and reported similar levels of preparation regarding common outpatient conditions than residents in a traditional continuity clinic format. They reported increased future likelihood of working in an underserved clinic. Conclusions Our exploratory study suggests free clinics may be an effective platform for community-based continuity clinic training.

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Learning Social Medicine in the Bronx: An Orientation for Primary Care Residents

Abstract: Orientation is a highly rated and valued part of our curriculum. Its success derives from ongoing curricular innovation and evolution, a departmental commitment to social medicine, and positive community response to our learners' interest and energy.

Cited by 16 publications

References 14 publications

The Impact of “See the City You Serve” Field Trip: An Educational Tool for Teaching Social Determinants of Health

The Impact of “See the City You Serve” Field Trip: An Educational Tool for Teaching Social Determinants of Health

Results of a Voter Registration Project at 2 Family Medicine Residency Clinics in the Bronx, New York

Resident Education in Free Clinics: An Internal Medicine Continuity Clinic Experience

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