1. A Path Into Family Medicine: Empirical Evidence from M2 Summer Assistantship Joyce Afran, MD & J. Anna Looney, PhD RWJMS Dept of Family Medicine & Community Health New Brunswick, NJ
Program Description:
Launched in 1998 based on the Community Oriented Primary Care model, as an 8-week fulltime, interdisciplinary, community-based assistantship;
Students (medical, physician assistant & social work) selected through a competitive application process;
Community projects were conducted by students singly or in pairs, addressing a health issue in an underserved population;
Students performed needs assessment, developed/implemented an intervention, & evaluated the results;
Program offered intensive training & orientation, as well as weekly didactic sessions & field trips;
Program ended each summer with a poster session & celebratory event featuring key note speaker.
The program grew from 3 medical students in 1998 to 34 interdisciplinary participants in 2010.
Program Goals for Students:
To increase knowledge of challenges faced by specific underserved communities
To identify & address unmet healthcare needs in partnership with the community
To experience teamwork with peers from different disciplines, site staff & clients
To work closely with dedicated community mentors & faculty
To provide a forum for in-depth reflection & discussion of social justice
To give of oneself in community service to the underserved.
Program Administration:
Funded through HRSA - Predoctoral Training in Primary Care & SEARCH (Student/Resident Experiences & Rotations in Community Health) Program. Community partners & students receive stipends for participation.
Jointly directed by:
UMDNJ-Robert Wood Johnson Medical School Department of Family Medicine & Community
Health
UMDNJ-School of Health Related Professions Physician Assistant Program
NJ Primary Care Association (SEARCH grantee)
RESULTS
Of 48 RWJMS graduates who completed the COPC Assistantship, 56% chose
Primary Care residencies.
“I think most of us enter the healthcare field with the desire to help the underserved. The COPC experience made their hardships ‘more real’ in my eyes and reinforces my desire to work with them in my future career.”
“I think it made my desire to work with the underserved even stronger.”
19% entered Family Medicine
12% entered Pediatrics
25% entered Medicine
Discussion & Recommendations
Examples of Sites & Recent Projects:
Approximately 8% all RWJMS graduates entered Family Medicine over this same period
ARC OF MONMOUTH: “Healthy Life, Happy Life” – a nutrition & health program for clients with intellectual disabilities
ERIC B. CHANDLER HEALTH CENTER (FQHC): “Chandler Survival Guide” - resources for referrals, pharmacy discounts, social services, & patient handouts
ISLES YOUTHBUILD INSTITUTE (Inner-city Alternative High School): “Bridging the Health Knowledge Gap” – health literacy curriculum
SOUTH BRUNSWICK SENIOR CENTER: “Diabetes Patient Navigator “ –educational materials & counseling geared towards Southeast Asian clients
ELIJAH’S PROMISE SOUP KITCHEN:“Men’s Advocacy Group” – conducted informational sessions on housing, employment, legal issues, safe sex
PLAINFIELD HEALTH CENTER (FQHC): “Evaluating Barriers to Adolescent Asthma Primary Care” – addressed barriers to care in the community
DAMON HOUSE RESIDENTIAL REHAB – “Alumni Support Program” – created an infrastructure for monthly meetings for former addicts
Students with an interest in community service & the underserved self-select into this program.
Primary care careers offer the greatest opportunity for working with underserved communities. Studies have shown, however, that the majority of students who enter medical school with an interest in primary care, do not enter primary care on graduation.
The residency match results for program participants suggest that this COPC program confirms & boosts students’ early interest in and long-term commitment to primary care and working with the underserved.
Contact Information:
Joyce Afran, MD:
J. Anna Looney, PhD:
Office:
References: “Changes in U.S. Medical Students’ Specialty Interests over the Course of Medical School,” (J Gen Intern Med July (7):1095–2100)
“What influences Medical Student and Resident Choices” March 2009 report by the Robert Graham Center and the Macy Foundation