Implementation of a A Public Health-Focused Curriculum for Medical Students Designed to Improve Urban Health Care

An Institute of Medicine report (2003) emphasized that medical schools must teach public health in the context of community engagement and prevention. Community-based participatory action is, therefore, a critical shared goal reached through interprofessional collaboration between public health professionals and future physicians. In response to this call for action, the Urban Medicine Program (UMed) at the University of Illinois College of Medicine was started in 2005 as an innovative, four year curriculum intent on developing committed practitioners, advocates, researchers and policy makers. In order to achieve its mission, UMed pursues the following goals: 1. Provide students with an understanding of social, environmental, and economic issues that contribute to health disparities in urban settings such as Chicago; 2. Develop skills that address the needs of urban residents, including cultural competence teamwork and use of complementary/alternative medicine; 3. To develop and enhance cross-cultural clinical skills 4. Instill a commitment to serve as practicing urban physicians and leaders. Students are chosen based on previous academic achievement, commitment to serving the underserved, and cultural awareness. This select group of 24 students per class completes the same curriculum as regular medical students while also participating in public-health seminars and a 2.5 year longitudinal community-based rotation (LCR). Outcomes to date suggest successful attainment of the goals mentioned above. 67% of UMed second year students and 84% of first year students strongly agreed/agreed that classroom seminars inspired them to be involved with/advocate for urban, disadvantaged populations. Overall, over 80% of students felt seminar content would be useful in their career as a physician. UMed students have partnered with 16 local organizations to address health issues that include: maternal mortality, malnutrition/food access, science/public health curricula, diabetes, and homelessness. LCR progress reports reflect the successful integration of student projects into the work of community partners (80% by year 2). Annual surveys exploring students' comfort relating to diverse individuals revealed that 92% of UMed versus 80% of traditional medical students reported feeling very comfortable/comfortable. Early outcomes of UMed graduates (2009/2010 classes) show that UMed participants choose primary care more frequently than their counterparts (67% versus 50%), and are staying in Chicago for residency in greater proportions than their peers (70% versus 50%).The UIC College of Medicine UMed program may serve as a model for how public health education, evaluation tools (e.g. logic model), and CBPR strategies (e.g. community advisory board) can be successfully integrated into a traditional medical school curriculum.