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The Urban Medicine Program: Developing Physician-Leaders to Serve Underserved Urban Communities
Jorge A Girotti1, Gary L Loy, Joanna L Michel
1J.A. Girotti is assistant professor, Department of Medical Education, and associate dean, Admissions and Special Curricular Programs, University of Illinois College of Medicine at Chicago, Chicago, Illinois. G.L. Loy is professor, Department of Obstetrics and Gynecology, Rush Medical College, Chicago, Illinois. J.L. Michel is adjunct assistant professor of medical education and associate director, Urban Medicine Program, University of Illinois College of Medicine at Chicago, Chicago, Illinois. V.A. Henderson is a doctoral student, Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois.
Purpose:
Medical school graduates are poorly prepared to address health care inequities found in urban, underserved communities. The University of Illinois College of Medicine developed the Urban Medicine Program (UMed) to prepare students for the roles of advocate, researcher, policy maker, and culturally competent practitioner through a four-year curriculum integrating principles of public health with direct interventions in local, underserved communities. This study assessed the program's effectiveness and evaluated early outcomes.
Method:
The authors analyzed data for UMed students (graduating classes 2009-2013) from pre- and postseminar assessments and longitudinal community project progress reports. They also compared UMed and non-UMed outcomes from the same classes, using graduation data and data from two surveys: Medical Students' Attitudes Toward the Underserved (MSATU) and the Intercultural/Professional Assessment.
Results:
UMed students were more likely than non-UMed students to endorse MSATU constructs ("Universal medical care is a right" [P = .01], "Access to basic medical care is a right" [P = .03], "Access is influenced by social determinants" [P = .03]); to be selected for the Gold Humanism Honor Society (P < .0001); to complete joint degrees (P < .0001); and to enter primary care residencies (P = .002).
Conclusions:
Early outcomes reveal that a longitudinal, experiential curriculum can provide students with competencies that may prepare them for leadership roles in advocacy, research, and policy making. Contact with diverse communities inculcates-in medical students with predispositions toward helping underserved populations-the self-efficacy and skills to positively influence underserved, urban communities.
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