Care of the Underserved Track

Rationale for the Development of a Track on Underserved Care

There is a need for competent physicians who are able to offer compassionate and culturally sensitive care to the diverse and growing population of patients in underserved settings.¹ In 2005, it is estimated that 46.6 million Americans lacked health insurance with a resultant poor access to health care.² In Houston alone, it is estimated that over 800,000 people lack health insurance and face difficulty in accessing needed health care.³In caring for this population, it is important for physicians to have a particular set of knowledge, skills and attitudes since one study found that inner-city patients had more chronic medical conditions, more emotional issues, a greater number of problems evaluated per visit, higher rates of health habit counseling and longer, more frequent office visits.⁴ In addition, other studies have revealed that uninsured patients have poorer clinical outcomes for a variety of chronic illnesses such as diabetes, cardiovascular disease and mental illness and receive standard preventive services (immunizations, cancer screening) less often.⁵

The four-year Care of the Underserved Track coordinates current offerings on underserved care and present them to students in a more formal and organized fashion across the four years. This track provides them with the specific knowledge, skills and attitudes they need to provide care to underserved patients in the future, recognize them for their accomplishments while here at Baylor and encourage them to seek future residency and practice positions that will enable them to continue caring for underserved patients. In addition, the faculty involved in this track strive to supplement the curriculum by serving as positive role models of physicians providing care to underserved patients.

Competencies Expected of Track Graduates:

Please see list of competencies that are expected of Care of the Underserved Track graduates. (Also see Requirements for completing the track and recognition of students section below.)

Overall Goals of the Care of the Underserved Track are to:

Provide students with high quality, hands-on clinical and service-based learning experiences at a variety of underserved sites, both ambulatory and in-patient
Encourage students to develop a scholarly interest in underserved care by conducting a research project
Encourage students to obtain residency training in a program which emphasizes care of the underserved
Encourage students to care for underserved patients in their future practice

Available Educational Experiences

(Note: All courses and electives in the Baylor curriculum that allows students to learn different aspects of underserved care are listed in this section. However, due to the large number of available courses and electives, Care of the Underserved Track students will not be required to complete all of these courses and electives. Requirements for completing the track and recognition of students section. Also, all courses and electives are open to all Baylor students and are not limited to those completing Care of the Underserved track requirements

Required Courses

Preclinical

Patient, Physician and Society (PPS) -I, -II (if assigned to a preceptor site in an underserved setting)
Patient, Physician and Society (PPS) –III (if assigned to a preceptor site in an underserved setting)

Clinical

Family and Community Medicine Core Clerkship (if assigned to a preceptor site in an underserved setting)
Longitudinal Ambulatory Care Experience
- HOMES pathway
- Underserved Care and Rural Health pathway

Electives

Preclinical

740-530 Underserved Care Clinics (Volunteering) (Blocks 1-8)
210-409 Cultural Diversity and Sensitivity in Health Care (Block 5)
450-593 Beyond the Exam Room: Physician as Advocate (Block 6)
740-408A Medical Spanish I (Block 7)
740-408B Medical Spanish II (Block 8)

Clinical

Inpatient

740-515 Required Sub-internship in Family Medicine - (BTGH)
740-503 Required Sub-internship in General Medicine Medicine - (BTGH)
740-521 Required Sub-internship in Clinical Pediatrics - (BTGH)

Outpatient

740-511 Care of the Underserved (Northwest Clinic)
740-512 Immigrant Medicine
450-581 Principals and Practice of Ambulatory Medicine
450-579 General Medicine - Care of the Indigent Elder (Ben Taub General Hospital)
450-587 Medicine/Pediatrics Primary Care

Research

740-528 Community Based Research Project in Urban Underserved Care. Students may choose to do a research project in one of the following areas:

Health Care Issues
Access Issues
Disparity Issues

Extracurricular activities

Workshops will be held on one evening per month for students in the track for all four years and any other interested students. Activities for those workshops will include:

Discussion of current community projects being conducted by either students or faculty
Discussion of pertinent underserved care topics
Presentation by a physician who practices underserved care on what he/she actually does
Reflection on what they are learning from their underserved care experiences
Students will also be encouraged to volunteer in the community in activities such as the HOMES clinic

Requirements for completing the track and recognition of students"

Available Educational Experiences section, the steering committee has set the following requirements for students wishing to be recognized as track completers.)

For students entering their first year at Baylor College of Medicine in July 2007 or later, complete 2 credits of preclinical electives from the above list.

For all students, complete either the LACE HOMES pathway OR the LACE Underserved Care and Rural Health pathway during the third-year

For all students, complete 8 weeks of advanced electives
1. The 8 week Community-Based Research project in Urban Underserved Care elective (740-528)
OR
2.Two of the following 4-week advanced clinical electives

a. Inpatient
1) 740-515 Required Sub-Internship in Family Medicine - (BTGH)
2) 450-503 Required Sub-Internship in General Medicine - Ben Taub General Hospital
3) 520-521 Required Sub-Internship in Clinical Pediatrics (BTGH)

b. Outpatient
1) 740-511 Care of the Underserved (Northwest Clinic)
2) 740-512 Immigrant Medicine
3) 450-581 Principals and Practice of Ambulatory Medicine
4) 450-579 General Medicine - Care of the Indigent Elder (Ben Taub General Hospital)
5) 450-587 Medicine/Pediatrics Primary Care

Students who complete the above requirements will receive a certificate documenting their accomplishment and will recognized at the time of their graduation.
Care of the Underserved Track Steering Committee – A steering committee of interested faculty and students oversees the track. William Y. Huang, MD of the Department of Family and Community Medicine is the Chair of the steering committee. A list of current faculty and students on the committee is available on request.

View or Print the Summary of the Available Courses and Electives on Underserved Care

For more information or to express interest in participating in this track, please contact William Y. Huang, M.D. of the Department of Family and Community Medicine by phone at 713-798-6271 or by e-mail.
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1 Fernandez E, Foss F, Mouton C, South-Paul J. Introduction to the dedicated issue on minority health. Family Medicine 1998;30:158-159.
2 Denavas-Walt, Carmen, Proctor, Bernadette D. and Lee, Cheryl Hill, U.S. Census Bureau, Current Population Reports, P60-231, Income, Poverty and Health Insurance Coverage in the United States: 2005, U. S. Government Printing Office, Washington, DC, 2006.
3 Gateway to Care web site. http://www.gatewaytocare.org/. Accessed on April 1, 2004.
4 Blankfield RP, Goodwin M, Jaen CR, Stange KC. Addressing the unique challenges of inner-city practice: a direct observation study of inner-city, rural, and suburban family practices. Journal of Urban Health: Bulletin of the New York Academy of Medicine 2002;79:173-185.
5 Institute of Medicine, Committee on the Consequences of Uninsurance. Care without coverage: too little, too late. Washington, DC: National Academy Press; 2002.
(Note: From the list of course and elective options described in the

Please see the track requirements in the

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