University of Washington School of Medicine Underserved Pathway Frederick M. Chen, M.D., M.P.H. Amanda Keerbs, M.D., M.S.H.S. Sharon Dobie, M.D., M.C.P. Department of Family Medicine

Workshop Outline Description of UW Underserved Pathway Progress to Date Implementation and Lessons Learned Issues/Challenges

Goals/Purpose The Underserved Pathway supports medical students and residents interested in working with underserved populations –Mentorship –Academic activities –Service Learning

UP Components 1.Mentorship 2.Web-based Core Curriculum 3.Service Learning 4.Preclinical and Clinical Courses 5.Independent Investigative Inquiry (III)

UP Diagram Pre-Clinical Electives, Selectives, RUOP, Preceptorships in underserved sites Clinical Block Rotations, Core Clerkships, Electives in underserved sites Web Module Service Learning – CHAP, SITC, Volunteer activities Mentorship – Quarterly contacts with mentors, faculty/staff support Web Module Independent Investigative Inquiry

Learning Plan Self-directed pathway Plan designed with student’s mentor and Underserved Pathway advisor.

Mentorship Establish a long-term mentoring relationship with a healthcare provider working in an underserved setting meet a minimum of once per quarter career and educational counseling introduce students to the issues of working in an underserved setting

Core Curriculum (web-based) Unique fund of knowledge in underserved medicine Eight web-based modules with interactive elements Pathway students complete two modules per year.

Core Curriculum (web-based) Who are the Underserved? Patients with HIV/AIDS Substance Abuse Chronic Poverty/Homelessness Intimate Partner and Domestic Violence Medicare 101 Race, Ethnicity, and Healthcare People with Disabilities

Web site

Service Learning Complete an average of 2 hours of community service activities per quarter over four years. Exposure to Community Engagement process

Other course requirements Preclinical: * Rural/Underserved Opportunities Program and/or a preclinical preceptorship with a practitioner working in an underserved community. * 2 credits from a list of approved non-clinical selectives. Clinical: * At least 12 credits from an approved list of Underserved Pathway core and elective rotations.

Independent Investigative Inquiry Underserved Pathway students must complete a III project with a focus on care for the underserved and/or underserved populations. Literature review Research project Community project

Unique aspects Longitudinal mentorship Mentors working in underserved medicine Service learning requirement 5 state WWAMI region Multi-disciplinary pathway

Pathway Development

Pathway Implementation Integration into Medical School –Coordination with existing pathways –Acceptance by Curriculum Committee Launching the Pathway –Recruiting Mentors –Recruiting Students

Pathway Outcomes Current Statistics –44 students –42 mentors –7 web learning modules Pathway Maintenance –Check-in’s with mentors and students –Ongoing mentor recruitment –Continuing contact with other pathways

Pathway Evaluation Periodic Evaluation End-of-Year Evaluation Long-term Tracking Plans

Issues and Challenges: The Program Recruiting and managing students Mentor recruitment and support Sustainability What happens when the grant ends? Title VII instability Where is it best housed? Dean’s office? a department?

Issues and Challenges: Family Medicine Mission Who are we targeting? Great interest, but will it draw to careers with the underserved? Declining interest in Family Medicine. Will this draw students to family medicine? Scale, scope and the cost of the program

Issues and Challenges: The School School’s continued interest and support RUGD track planning Involving other specialties and departments