Uic's urban medicine program's longitudinal community rotation: Preparing physicians to practice in urban underserved communities

In 2005 the UIC College of Medicine launched the Urban Medicine (UMed) program as an innovative approach to expose medical students to social determinants of health and develop their skills in community-based research approaches that address health disparities. UMed aims to “prepare physician-leaders for underserved urban communities.” We have defined four potential roles for UMed graduates: practitioner, advocate, researcher and policy maker. The curriculum is based on four iterative themes: (1) community diversity/intercultural communication, (2) disparities in healthcare access and outcomes, (3) community-based participatory research, and (4) advocacy and policy. To engage students in communities, we developed a Longitudinal Community Rotation (LCR) which spans all years in medical school and involves small student teams working with community agencies in Chicago's underserved neighborhoods to develop and evaluate health promotion/disease prevention activities. We have evaluated the initial impact of the LCR on students, community partners, and community residents. From 2009-2012, 122 students developed projects with 24 community agencies; they reported increased knowledge and skills in program planning and evaluation (p < 0.02) as well as self-efficacy to develop public health models that address community healthcare issues and barriers (p < 0.001). Community partners reported that UMed students increased opportunities for leadership in their community, provided information in a culturally appropriate manner, and improved the emotional and mental well being of participants. Three-fourths of partners interviewed were confident that UMed student projects would continue even after students leave the agency, although staff and time constraints were identified as potential barriers to sustainability.