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Cited by 10Innovations in Medical EducationHealth and Medical EducationCommunity Health and Development

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

Open access
Oldfield, Benjamin J., Clark, Bennett W., Mix, Monica C., Shaw, Katherine C., Serwint, Janet R., Desai, Sanjay V., Kruzan, Rachel M., Stewart, Rosalyn W. +2 more·2018·Journal of General Internal Medicine
DOI 10.1007/s11606-017-4272-yPMC PMC6258596
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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.

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Crossref · 10.1007/s11606-017-4272-y

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  • Multiple articles cautioned that advocacy activities involving patients and communities should adapt to their evolving needs, engage nonclinical and community stakeholders, minimize burden for community partners, and demonstrate community impact.

    “Multiple articles cautioned that advocacy activities involving patients and communities should adapt to their evolving needs12–16, engage nonclinical and community stakeholders28,31,42, minimize burden for community partners42, and demonstrate community impact18.”

    From Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022 (2023) · cites this paper as [31]

    The Program Description (page unavailable) describes rotations with community organizations, curricula designed with site staff, and opportunities for residents to invite community partners, supporting engagement of nonclinical and community stakeholders. It does not say that advocacy activities should minimize the burden on community partners; the searched passages on burden and partners do not establish that caution. The other clauses in the citing sentence are attached to different citations. (LLM, conf=0.86)

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  • Lack of formal, explicit, and consistent training leads to inadequate preparation of trainees.

    “Lack of formal7, 8,11,19,21, explicit9,31, and consistent11,16,32 training leads to inadequate preparation13,28,33 of trainees and negatively impacts patient care13.”

    From Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022 (2023) · cites this paper as [31]

    The Abstract says few residency curricula explicitly incorporate community organizations’ strengths and priorities, supporting the point about a lack of explicit training. It does not say that training is generally inconsistent or establish that this lack leads to inadequate preparation of trainees. (LLM, conf=0.80)

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  • Articles described ways to make curricula adaptable to evolving learner needs, including soliciting feedback, supporting trainee autonomy and ownership, and providing options.

    “Articles also described ways to make curricula adaptable to evolving learner needs14,21,31. Soliciting feedback from learners and then incorporating reported interests into curricular elements (e.g., selecting guest speakers—legislators, community activists, journalists, etc.—using trainee input)15,21, supporting trainee autonomy and ownership of advocacy work, and providing options (e.g., option”

    From Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022 (2023) · cites this paper as [31]

  • Scholarly opportunities were shown to be of importance to trainees, and articles described ways to ensure trainees saw academic benefit from their advocacy education.

    “Scholarly opportunities were shown to be of importance to trainees21,27,29,31, and articles described ways to ensure trainees saw academic benefit from their advocacy education (e.g., residents interested in pursuing fellowship could combine advocacy efforts with research interests to produce scholarly work)7.”

    From Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022 (2023) · cites this paper as [31]

    The Program Description describes an Academic Half Day and resident-led quality-improvement projects, but does not say these activities produced scholarly work or academic benefit from advocacy education. A search of our copy for fellowship, research interests, and scholarly work found no account of residents combining advocacy with research for fellowship applications. The earlier clause about the importance of scholarly opportunities has other citations; this source is cited for the later example. (LLM, conf=0.72)

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Cites

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Research works printed but not linked: 1

  1. Institute of Medicine. Primary care and public health: exploring integra- tion to improve population health. Washington, DC: National Academies Press; 2012.

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Authors
Oldfield, B. J., Clark, B. W., Mix, M. C., Shaw, K. C., Serwint, J. R., Desai, S. V., Kruzan, R. M., Stewart, R. W., Ruhs, S., & Feldman, L. S.
Affiliations
  • Yale University (US)
  • Johns Hopkins University (US)
  • Chase Brexton Health Care (US)
Corresponding author
Oldfield, Benjamin J.
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2018-01-03
Volume
33
Issue
12
Pages
2250-2255
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/s11606-017-4272-y
PMC
PMC6258596
OpenAlex
W2782439565
Cited by
10
References
50
Citations by year
2025: 2 · 2023: 3 · 2021: 2 · 2019: 2 · 2012: 1
FWCI
0.95
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Yale University
  • Josiah Macy Jr. Foundation
  • Raymond and Beverly Sackler Institute for Biological, Physical and Engineering Sciences, Yale University
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Health Sciences › Health Professions › General Health Professions › Health and Medical Education
  • Health Sciences › Health Professions › General Health Professions › Community Health and Development
Keywords
urban health, primary care residency, residency curriculum, structural vulnerability, community organizations, community health centers, internal medicine residents, stakeholder engagement, primary care providers, graduate employment outcomes, collective efficacy
MeSH terms
Community Health Services, Humans, Internship and Residency, Primary Health Care, Urban Health Services, Vulnerable Populations

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