COMMUNITY BASED MEDICAL EDUCATION
I. Pediatric Links with the Community (PLC) is an innovative partnership between the Department of Pediatrics and community based agencies that serve children and their families. By training pediatricians to care and advocate for under-served and high-risk youth and families, we believe we are taking a critical first step in ameliorating health effects of poverty on children. Founded in 1996 by two pediatricians who were recent graduates of the Rochester training program, PLC is now a formal part of the Pediatric and Medicine-Pediatric residency experience. It has been honored with numerous awards, including the 2000 Ambulatory Pediatric Association Outstanding Teaching Award for the best educational program in the country, the highest teaching award given to members of this national organization, and in 2001, received the American Academy of Pediatrics' prestigious Professional Education Award, the highest honor for education in pediatrics. PLC has been so successful that it is being replicated throughout the U.S., most recently serving as a model for similar programs at Children's Hospital of Philadelphia and Denver Children's Hospital.
Pediatric and Medicine-Pediatric residents participate in a two-week PLC rotation, typically working with at least 15 community organizations. For instance, some provide medical care for homeless and uninsured children at a community health clinic; others offer health education at the Boys and Girls Club of Rochester; and some lead discussions on children's health issues for parents at an inner city church. Senior residents have the opportunity to form longer-term relationships with community organizations. By June 2004, over 200 pediatric residents and over 200 medical students will have participated in PLC program activities in collaboration with over 40 different community organizations in Rochester and the surrounding area.
The success of PLC has led to numerous grants and awards. In 2000, PLC and Children's Hospital at Strong were one of six pediatric residency programs nationwide awarded a multi-million dollar grant from the Dyson Foundation to promote pediatric training in the community. Under the Dyson Initiative, a unique Child Advocacy Resident Education (CARE) track and electives for second and third year residents were implemented to further develop partnerships with community-based organizations in projects that teach residents and benefit children.
II. The Community Health Improvement Clerkship (CHIC), facilitated by the Department of Community and Preventive Medicine, underscores the School of Medicine and Dentistry's commitment to graduating students who not only excel in the academic side of medicine, but are well versed in how socioeconomics influences health, and how to best provide care for marginalized patients. Students are eligible to receive a distinction in community service on their M.D. diploma if they complete 40 hours of community service each year, in addition to completing the requirements of CHIC.
The only required fourth-year clerkship of its kind in the country, CHIC provides medical students with a community-based educational experience, while increasing access to health care by underserved populations. The program also serves to educate the community about health promotion and disease prevention practices, and monitors health indicators in targeted communities.
Students are encouraged to develop or participate in projects that benefit the Jay/Orchard neighborhood, or replicate projects conducted in this community in other Rochester neighborhoods to compare findings and learnings. Examples of programs include:
- Conflict Resolution Workshop: At the request of the school principal, medical students created and delivered a workshop to 15 children between the ages of 5 and 12 in the Jay/Orchard street area. The workshop included acting out recent conflicts at school or home (such as someone stealing someone's tennis shoes), and then "re-enacting" the conflict with alternative, non-violent, constructive behaviors. Parents and teachers said that workshops of this nature are greatly needed in the community.
- Hoops for Health: CHIC has agreed to conduct weekly after school sessions on nutrition and exercise for 50 fifth and sixth graders. Through a partnership with Quad A, a non- profit organization dedicated to foster positive after school programs and the Rochester Police Department, medical students have helped to design a life skills program that aims to keep kids off the street and in a safe learning environment. Health education is incorporated into a physical activity program, along with discussions on substance abuse, consequences and anger aversion.
III. Leadership Education in Adolescent Health (LEAH) is an interdisciplinary training program that provides a broad range of educational experiences to prepare physicians for leadership roles related to innovative adolescent health care services. Directed by our Division of Adolescent Medicine in the Department of Pediatrics, we are one of only six program sites funded by the federal government's Health Resources and Services Administration and Maternal and Child Health Bureau. A variety of academic, clinical and research oriented interactions between LEAH trainees and faculty ensures that trainees acquire the requisite competencies for future leadership roles, while faculty advance their existing leadership roles by integrating adolescent health services into local, state, regional and national systems of care, and conducting cutting edge research.
Two major classes of services are provided through LEAH: direct clinical services to adolescents and their families, and consultation and technical assistance to programs or agencies with MCHB-related services. Examples of programs include Doc on Board, a partnership between LEAH and the Center for Youth, an organization that provides counseling and support services to runaway and homeless youth and teens. LEAH trainees obtained a grant to provide medical services to homeless youth on the Center's outreach van, which every week cruises the inner city streets known to be frequented by homeless and runaway youth. When the fellows are onboard, a magnetic sign is attached to the van that says "Doc on Board." Area youth have come to recognize the van and seek out services.
IV. Students for Rochester Outreach (SRO) volunteer program is a testament to the Medical Center's commitment to community service, and serves as a reminder to our students that even though they leave the school and become licensed professionals, there will always be a need for continued volunteerism and advocacy on behalf of children and underserved individuals with the greatest needs. Rochester is one of the few medical schools in the nation with an official infrastructure to coordinate, support and monitor volunteer work of our students, and we successfully recruit about one-third of our students to participate in the 30+ volunteer programs we run annually.
Students work in community programs that are either established, or that they create from models based elsewhere in the country. A mainstay of SRO is The Mentoring Initiative, which addresses the needs of at-risk and underserved children and teens in our community. Medical, graduate biomedical science students and graduate nursing students are matched one-to-one with Rochester City School District students to help them develop skills and knowledge in core academic subjects including math, science, and English. While the children and teens gain academically, the positive role model and interaction with the medical students pays off as well.
The Saturday School Program is an initiative researched and created by medical students, and funded through an AAMC grant. The program helps more than 100 students at risk of failing at an inner city school. Medical students provide two hours of one-on-one tutoring in core subjects such as math, science and reading every Saturday morning. The hope is that these intense educational sessions will provide the at-risk children the boost they need to succeed in their education and become active, healthy members of their community. Once a month, health risk screenings and education are also offered to parents of Saturday School students.
These programs and many more are evidence of the true partnerships we have developed with the community, and serve to bring community health to the forefront of the Medical Center's research efforts and education of medical students and residents. We believe that addressing health issues for the community, especially high-risk children and families, is perhaps one of our most important economic and social obligations, and this belief reflects our long standing commitment to improving the health of our community. We will continue to work in partnership with the Rochester community to bridge the gap between the health care system, public health and the educational system as we continue on our journey to deliver on George Eastman's vision of making Rochester the healthiest community in the nation.
