Scholarly Concentration in Caring for Underserved Communities

Scholarly Concentration in Caring for Underserved Communities 

Concentration Directors

Fadya El Rayess, MD, MPH

Department of Family Medicine, Alpert Medical School
Email: [email protected]
111 Brewster St
Pawtucket, RI 02860
Ph: (401)523-2439

Joseph Diaz, MD, MPH, FAC
Department of General Internal Medicine, Alpert Medical School
Email: [email protected]
111 Brewster St
Pawtucket, RI 02860
Ph: (401) 729-2761

Overview

The concentration in Caring for Underserved Communities focuses on the impact of social determinants of health, culture, language and poverty on health status and health disparities.  Our goal is to give students an early positive clinical experience with organizations providing primary care for vulnerable populations from their first year of medical school through graduation. We have developed partnerships with such community health centers as East Bay, Thundermist, Crossroads, SSTAR, Clinica Esperanza and the RI Free Clinic, the VA’s homeless clinic and the Department of Corrections, with the goal of having students engage with the same community health setting throughout their 4 years of med school. Students choose a site that reflects their own interests and goals.

Beginning in the spring of theirs first year, interested applicants meet with concentration directors to identify mentors and a research focus for their scholarly project which they complete in the summer of their first year.  A dynamic second year seminar led by concentration directors helps concentrators develop the knowledge and skills needed to provide care, leadership and advocacy for underserved communities.

Concentrators have the opportunity to continue/complete their scholarly project during a scholarly elective in their 3rd or 4th year. By the end of the concentration, concentrators will have completed a capstone project and have had a longitudinal experience in a community health center or site serving an underserved community.

Curriculum


Learning Objectives

Learners will:

  • have a longitudinal experience with a specific community based health organization, mentor and the patients and community they serve
  • design, implement, evaluate and present at least one scholarly project in response to an identified community need; 
  • be able to recognize and discuss the impact of health disparities, access, culture, language and poverty on health status;

Timeline of Activities

Year I

  • Students choose a mentor and develop a proposal for a summer project in the fall/early spring. Concentration directors facilitate a series of meetings between the student and his/her community site mentor to develop a summer project proposal by the February deadline for concentration proposals. Possible projects include quality improvement, needs assessment and program development in response to a community/clinical need identified by the student and/or mentor. See list of past projects.

Summer between Years I & II:

  • The summer project will serve as foundation for scholarly product. The student will receive support and mentoring from the concentration directors to develop the skills needed to complete this summer project. 

Year II

  • During the second year concentrators continue to implement their projects building on their summer experience.
  • Concentrators attend monthly concentration seminars covering such topics as: impact of social stressors including poverty, racism, environment and sexism on health outcomes; the health care ‘safety net’: community medical and mental health centers, public housing, programs for the homeless, free clinics, correctional system and Department of Children & Friends.  Joint seminars will be held with the scholarly concentration on Advocacy and Activism and Women’s Reproductive Health.
  • They lead one of the seminar discussion on a topic of their choice and complete reflective writing assignments to be shared during the monthly meetings.
  • They also present a poster of  their project in November

Year III and IV:

  • Third and fourth-year students meet/correspond every 6 months with concentration directors to ensure that they are making progress towards meeting their scholarly goals.
  • Concentrators have the opportunity to continue/complete their scholarly project during a independent study elective in their 3rd or 4th year.
  • All members of the concentration are invited to participate in the seminar discussion and other concentration-related meetings/events.
  • The majority of the work on the scholarly product is completed by the end of the 2nd year. Analysis and write up are often completed during a 3rd or 4th year elective.
  • Concentrators are also expected to submit an abstract to a state, regional or national conference and/or journal manuscript for publication in the fall of their 4th year.

Concentration Related Electives

Pre-Clinical

Years 1 & 2 Electives

BIOL 6503: Poverty, Health, and Law
BIOL 6504: Healthcare in America
BIOL 6508: Gender and Sexuality in Healthcare: Caring for All Patients
BIOL 6525: Sex Ed by Brown Med
BIOL 6529: Addiction Medicine
BIOL 6530: Health and Housing: Outreach and Education
BIOL 6533: Sex- and Gender-based Medicine: An Overview
BIOL 6650: MOMS (Medical Students Outreach to MotherS-to-be)
BIOL 6653: Refugee Health and Advocacy
BIOL 6655: Health and Structures of Oppression
BIOL 6663: Integrated HIV/HCV Testing and Counseling Certification Course
BIOL 6678: Incarceration and Health
BIOL 6679: The San Miguel Project
BIOL 6693: Sexual Assault & Domestic Violence Advocate Training
BIOL 6687: A Trauma-Informed Approach to Patient-Centered Care
BIOL 6686: BE REAL About Health: Brown Enriching RITS Residents' Experiences in Adolescent Life
BIOL 6540: Medicine, Knowledge, and Social Justice: Theory and Practice
BIOL 6516: Race, Health, and Structural Inequality: Interdisciplinary Perspectives

Clinical

Family Medicine Clerkship - integrate scholarly concentration work into project requirements
Independent Study - Scholars can use this rotation to complete their project.
Advanced Clinical Mentorship (ACM) - it may be possible to design an ACM that also allows work towards the scholarly product.

Evaluation

  1. First year: students are evaluated on their summer project presentations.
  2. Second year: students are required to attend and actively participate in monthly seminars. They are evaluated on their participation, reflective writing and the seminar they lead.
  3. Fourth year: students submit a c.v. of concentration related activities and give a powerpoint presentation of their final product at the concentration graduation in May.

Maximum Number of Students

4-6 per class

List of Current and Past Concentrators

Class of 2020

  1.       Jenna Berger, E*Navigator: using mHealth to improve colorectal cancer screening health literacy in underserved communities. (Mentor Joseph Diaz, MD, MPH, site East Bay CHC)
  2.       Caroline Burks, Teams Work: Improving Team-Based Care in Urban Safety Net Systems.(Hali Hammer, MD, site San Francisco Health Network)
  3.      Danielle Castagneri, Assessing how activities conducted in home-based child care settings are associated with physical activity levels in ethnically diverse, 2-5 year old children. (Kim Gans, PhD, site Hasbro)
  4.       Julia Hadley, Outcomes of a non-occupational post-exposure prophylaxis program after sexual assault; five years of experience at an urban medical center. (Erica Hardey, MD, MMSE and Roxanne Vrees, MD, site: Women & Infants ER)
  5.       Rachel Hill, Incredible Years: Adaptation, Implementation, and Evaluation with Adolescent Mothers. (Patricia Flanigan, MD; site Hasbro and Nowell Leadership Academy)
  6.       Randall Li, Informing the Adaptation of a CHW Model to Facilitate Lung Cancer Screening for Chinese Taxi Drivers. (Jennifer Leng, MD and Joseph Diaz, MD ; site NYC)

Class of 2019

  1.       Katherine Ciocolello. Medical and Community Perspectives Regarding Disparities in Access to High Quality End of Life Care: Barriers and Potential Solutions. (Mentor Gowri Anandarajah, MD, site Hope Home & Hospice)
  2.       Julianne Edwards. Computerized Intervention to Improve Family Knowledge of Environmental Triggers for Children with Asthma. (Mentor Dr. Garrow, site Hasbro ED)
  3.       Denise Marte. Parenting Adolescent Empowerment Model: Employing an empowerment based group education approach to improve and assess changes in the emotional preparedness of pregnant adolescents in underserved communities in RI. (Mentor: Jordan White, MD, MPH, site Nowell Academy)
  4.       Shayla Medina. Assessing the health status and health care utilization of unaccompanied immigrant minors: a stakeholder analysis. (Mentor: Carol Lewis, MD, site Refugee Clinic Hasbro)
  5.       Amber Cardoos. Incarceration as a time of weight gain: developing a weight loss intervention for female inmates at the RI Adult Correctional Institution. (Mentor: Jennifer Clarke, MD, MPH, site ACI)

Class of 2018

  1.       Nora Avalos. HIV Testing in Hidalgo County, Texas. (Mentor: Maria Colon-Gonzalez, MD)
  2.       Lorena Garcia. Measuring Prisoners' Voluntary Consent to Clinical Research for Opioid Dependence. (Mentor: Paul Christopher, MD; site Butler Hospital and ACI)
  3.       Gary Khammahavong.  Continuation of Care: Why Do Some Refugee Populations Stop Seeing Primary Care Physicians? (Mentor: Elizabeth Toll, MD; site: Med/Peds Clinic, Lifespan)
  4.       Tim Pian.  Design and evaluation of a series of pop-up farmers’ market days at a public housing development. (Mentor: Anna Filip, MD; site: Thundermist Health Centers)
  5.       Ellen Richardson.  Barriers to Care: Access to Physical Therapy for Children with Cerebral Palsy. (Mentor: Craig Eberson, MD; site: Neurodevelopment Center, Hasbro)
  6.      Joshua Rodriguez-Srednicki – Understanding Homeless Vet Pop, A Comparison of Health Outcomes Before and After Recent Recession  (Mentor: Thomas O’Toole – VA)

Class of 2017

  1.       Nell Baldwin- Prison as a time of weight gain greater than pregnancy: developing a weight loss/ weight maintenance intervention for incarcerated women.  (Mentor: Jennifer Clarke, MD, MPH)
  2.       Meeka Gandhi- Kaleidoscopic and Kinesthetic Classroom Care: Integrating Arts and Movement into Elementary Level Nutrition and Physical Activity Curriculum (Mentor Fadya El Rayess, MD, MPH, site Baldwin Elementary School)
  3.       Sarah Guevera- Barriers to Influenza Immunization: An exploration of reasons and beliefs Spanish-speaking Hispanic adults choose to vaccinate or not by using qualitative videotaped interviews (Mentor: Jennifer Clarke, MD, MPH)
  4.       Rian Yallamachili – Evaluation of Vida Sana Program at Clinica Esperanza (Mentor: Annie DeGroot, MD)
  5.       Amed Logrono – Attitude towards antibiotic self-medications in DR comparison of native vs. immigrants (Mentor:  Roberta Goldman, PhD & Joe Diaz, MD; clinical site: Internal Medicine Clinic, MHRI) 
  6.       Samantha DeAndrade –  Perspectives on Hypertension in the Cape Verdean Community Qualitative Study (Mentors: Roberta Goldman, PhD & Fadya El Rayess, MD, MPH; clinical site: Family Care Center, MHRI)

Class of 2016

  1.       Emma Anselin – Motivational Interviewing and Nutritional Education: Building Practitioners’ Confidence in Changing Patients’ Eating Habits. (Mentors: Linda Shalon, MD, MS & Patricia Risca, DrPH, RD ; clinical site: Rainbow Clinic Hasbro)

Class of 2015

  1.      Jon Thorndike- Positive Deviance-Based Video Intervention to Prevent Relapse to Smoking Among Prisoners.  (Mentor: Jennifer Clarke, MD, MPH)
  2.      Izzy Marshall- Applying Anthropology to Improve Smoking Cessation Tools (Mentor: Joe Rabatin, MD, clinical site: Pawtucket)

Faculty Mentors

  • Jennifer Clarke, MD, PhD (IM-MHRI, Prison Health)
  • Anne DeGroot, MD, (IM-ID, Director of Clinica Esperanza)
  • Sarah Fessler, MD, (FM, Director of East Bay Community Health Center)
  • Beata Nelkin, MD (Peds, Thundermist Health Center, Woonsocket)
  • Thomas O’Toole, MD, MPH (IM, Director of National Homeless Veterans PACT Program)
  • Joe Rabatin, MD (IM, MHRI, RI Free Clinic)
  • Sara Delaporta, MD (FM, Thundermist Health Center, West Warwick)

Funding Opportunities 

Students can apply for summer assistantship funding.