Community health training for internal medicine residents working with community partners

Abstract

Graduate and undergraduate medical training are incorporating public health curricula into their programs to enable future physicians to participate in public health activities and improve the health of the communities. This paper highlights two approaches to a community health curriculum implemented at the Cambridge Health Alliance Internal Medicine Training Program from 2008-2010. Between 2008 and 2009, the residency program incorporated a longitudinal curriculum for first-year residents. The goal of the curriculum was to expose residents to basic community health research models while giving them time to participate in a 1-year practicum with the Cambridge Public Health Department. Strengths included increasing resident knowledge about the local public health department and providing residents with an opportunity to work with staff and patients in that setting. Limitations of such a design included staff time constraints for coordinating with community partners as well as resident dissatisfaction with being involved in only select portions of an evolving project. This curriculum was therefore revised into a 1-month ambulatory block consisting of didactics and a practicum with the local YWCA in September 2010. Residents felt that this design yielded more time in didactics than in the practicum. Both designs offer important learning points in terms of practically incorporating public health activities in a tightly scheduled residency-training program. The current paper highlights the importance of partnering with a community organization such as a public health department or the YWCA. Emphasis is placed on the contributions that residents can make to these organizations while they learn how to integrate clinical and community health activities.