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 (see Footnote 1). In 2005, it is estimated that 46.6 million Americans lacked health insurance with a resultant poor access to health care (see Footnote 2). In Houston alone, it is estimated that over 800,000 people lack health insurance and face difficulty in accessing needed health care (see Footnote 3). In 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 (see Footnote 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 (see Footnote 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
- 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
Requirements for Completing the Track and Recognition of Students
The steering committee has set the following requirements for students wishing to be recognized as track completers.
Foundational Sciences Electives
Complete one Foundational Sciences elective from the following list:
- MEFAM-530 Underserved Care Clinics (Volunteering) (Blocks 1-8)
- MEPED-565 Hiding in Plain Sight: Identify/Understand Vict. of Violence (Blocks 2, 8)
- MEOSA-409 Cultural Diversity and Sensitivity in Health Care (Block 5)
- MEPED-562 It Takes a Village: Foundations of Pediatric Advocacy (Block 5)
- MEMED-593 Beyond the Exam Room: Physician as Advocate (Block 6)
- MEFAM-408A Medical Spanish I (Block 7)
- MEFAM-408B Medical Spanish II (Block 8)
Community Project Electives
Complete one of the following:
- MEFAM-535 Community Project in Underserved Care
- MEFAM-536 Community Project in Homeless Care
Complete 8 weeks of advanced electives (two of the following 4-week advanced clinical electives)
- MEFAM-515: Family Medicine Sub-Internship (Ben Taub Hospital)
- MEMED-503 General Medicine Sub-Internship (Ben Taub Hospital)
- MEPED-547: Pediatric Sub-Internship (Texas Children’s Hospital) – please ask to be placed on the PHM service
- MENEU 503 Neurology Sub-Internship (Ben Taub Hospital)
- MEOBG 503 Obstetrics and Gynecology Sub-Internship - please ask to be assigned to Ben Taub Hospital
- MEFAM-511 Care of the Underserved (Northwest Health Center)
- MEFAM-512 Immigrant Medicine
- MEMED-587 Medicine/Pediatrics Primary Care
- MEPED 560: Serving Disadvantaged Pediatric Patients in Houston's Communities
- MEPSY547: Outpatient Community Clinic Psychiatry & Psychotherapy
Recognition of the completion of the above requirements will appear on the student's official transcript and will also be noted in the commencement program.
End of Track Reflection Paper
Students entering Baylor College of Medicine in July 2013 or afterwards will be required to submit an end of track reflection paper in April prior to their graduation from Baylor College of Medicine. In this paper, students are asked to describe key experiences that have contributed to their learning about underserved care in medical school. Students are asked to explain how these key experiences have contributed to their learning in at least three of the following competency areas:
- Medical Knowledge
- Patient Care
- Interpersonal communication
- Systems-based practice
- Practice-based learning
For more specific information on the meaning of these competency areas, please read the Core Competency Graduation Goals for all BCM students. It is anticipated that the end of track reflection paper will be 5-10 pages in length.
In addition to the above curriculum, extracurricular workshops will be held periodically 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
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 at firstname.lastname@example.org.
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.