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November 2007 Issue
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Initiative on Poverty, Justice and Health leaders a recent discussion (top row, left to right): Brian Volck, MD, Ben Lamphere, MD, Chuck Schubert, MD, and Stephen Wilson, MD. (Bottom row, left to right): Melissa Keene, MD, Tiffiny Diers, MD, Doug Smucker, MD, and Katrina Willie, MD. Not pictured are Susan Montauk, MD, and Joe Kiesler, MD.
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Hands-On Initiative Prepares Medical Students, Residents for Treating Diverse Patient Populations

By Katie Pence
Published November 2007

Health care is very complicated in our society.

It has become even more complex recently as doctors struggle with the cultural, linguistic and socioeconomic barriers their patients bring to the examining room every day.

But UC is working to change all of that.

For the past three years, faculty members from the departments of family medicine, internal medicine and pediatrics have joined together to form the Initiative on Poverty, Justice and Health (IPJH), which helps prepare medical students and residents for these challenges.

IPJH first developed around the desire of these faculty members to teach others about caring for underserved patients.

“The skills needed to provide high-quality care to underserved patients are similar, whether it occurs in Cincinnati or abroad in developing countries,” says Tiffiny Diers, MD, an assistant professor of medicine and pediatrics and codirector of IPJH.

“Health providers must communicate effectively with patients from many different backgrounds and provide the best possible medical care given the limited resources available,” Diers adds.

With the goal of developing these skills among medical students and residents, the department of family medicine was awarded a $600,000 grant from the Health Resources and Services Administration in 2005 to fund IPJH’s activities.
 
IPJH now runs both medical student- and resident-level programs aimed at caring for the underserved.

A four-year Medical Student Scholars Program, focusing on international health initiatives and care for the underserved, now has 26 students participating. These students engage in clinical work with faculty at underserved sites and attend learning sessions on a variety of topics related to care of the underserved.

According to Doug Smucker, MD, an associate professor of family medicine and codirector of the IPJH effort, the scholars program helps to strengthen and expand the interests of students who want to work with underserved populations.

In addition, a resident rotation is open to residents from family medicine, internal medicine, pediatrics and pediatric medicine as an elective.

Residents have the opportunity to participate in learning sessions focused on the impact of poverty in health, cross-cultural communication, health literacy and Latino health care. Field trips to the local Medicaid enrollment office, community agencies and homeless shelters are also part of the rotation.

Diers says these programs were developed to further encourage students who may become disillusioned by their experiences.

 “Our goal with IPJH is to create educational programs that support medical students and residents in their desire to provide excellent care to these patients and to continue to do so once they are in practice,” she says.

IPJH has provided a forum for faculty to develop their own expertise in teaching and caring for the underserved. The faculty group as a whole has worked on curriculum development and teaching skills, but each faculty member has individually worked on a focus area to contribute to the group.

For Diers, that area is Latino health.

“The Latino community is growing rapidly in Cincinnati and is comprised primarily of people who have been in this country for less than 10 years,” Diers says.

“Coming from a variety of countries in Latin America, the population is very diverse. With such a diverse and newly immigrated population locally, we are working hard to identify the needs of the patient population, to educate our trainees and adapt our health care system to better serve them.”

Diers is the chair of the newly formed Latino Health Collabor-ative of Greater Cincinnati, in which UC faculty members are partnering with Latino service organizations and community members to improve the health status of the local Latino community.
 
The organization recently received $20,000 from the UC Faculty Development Council to support these efforts.

“The national need for improving care of underserved populations is increasing,” Diers says. “The IPJH faculty group is taking steps to strengthen underserved care by training and encouraging UC students and residents to find ways to make a positive difference in their communities.” 


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