What I didn't learn in medical school: Bridging the gap between the clinic and the community

Background: Traditionally, medical students have received very little formal education on community assessment or how an appreciation of a patient's community can augment the development of more informed diagnoses and enhance the practice of medicine. Through the South Texas Environmental Education and Research (STEER) rotation, the MD/MPH dual degree program at UTHSCSA allows medical students the opportunity to receive shared credit for both the MPH practicum and a 4th year MD elective, while emphasizing community service and its implications on future practice.

Methods: STEER utilizes both classroom and community-based activities to educate students on issues surrounding the Texas-Mexico Border, health disparities, and the connection between the environment, public health, and medicine. It provides for the direct application of classroom knowledge in the service of local communities.

Results: After participation in STEER, students leave with an increased appreciation of not only the needs and complexities of the community, but with an appreciation of how circumstantial hardships have direct impacts on a population's health and lives. This provides students a new outlook on the impact that the environment plays on health as well as the etiology of disease. We left the experience with a new perspective on patients as more than a disparate sum of signs and symptoms, but rather as individuals, part of and influenced by a community.

Conclusion: STEER offers a unique learning opportunity that teaches students the importance of understanding the community that their patients come from. If possible, similar programs should be embedded into medical school curricula.