Improving
access to health care for needy
State
grants to fund training for students in clinics for refugees, underserved
children
By LOIS
BAKER
Contributing Editor
The university
has received two grants totaling nearly $629,000 from New York State
to provide culturally appropriate training for its medical and dental
students and residents through school- and community-based clinics.
One grant
supports a program for medical students and residents who will provide
care to immigrant groups; the other funds a project involving medical
and dental students working with underserved schoolchildren.
The goal
of the grants is to improve access to health care for these groups while
sharpening students' clinical skills and cultural competency. UB is
the only university among nine awardees to receive two grants.
Three departments
in the School of Medicine and Biomedical Sciences, along with the School
of Dental Medicine, are developing the programs.
The larger
of the two grants, funded for $393,933, will support the Refugee Cultural
Competency Training Program sponsored by the medical school's Department
of Family Medicine. Kimberly Griswold, assistant professor of family
medicine, will direct the project.
The Northwest
Buffalo Community Health Care Center and Jericho Road Family Practice
on Buffalo's West Side, operated by Myron Glick, will be joint sponsors.
The International Institute of Buffalo and Journey's End Resettlement
Services also will be involved.
"Our strategy
is to offer a concentrated cultural-immersion experience to students
and residents at evening clinical sessions that serve only refugee patients,"
said Griswold. "The students will be working with people from Rwanda,
Sudan, Somalia, Ethiopia, Congo, Kosovo, Bosnia and Cuba."
The program
builds on a pilot project developed over the past two years by Griswold,
UB medical students and volunteers in which medical students conducted
health screening of refugees during monthly "health nights" at one of
the participating clinics.
The current
project formally incorporates refugee care into the medical-school curriculum
as an option for interested students, who can use the experience as
part of their existing clinical-practice training and receive academic
credit or as an extracurricular activity and receive "extra" credit.
Clinics
will take place evenings from 5-10 p.m. and will begin with an hour-long
orientation presented by immigrant resettlement staff, a medical anthropologist,
physician and social worker. Students then will spend 3 1/2 hours doing
initial health evaluations with refugees, followed by a debriefing focus
session.
The trainees
will work with an interdisciplinary team consisting of a physician,
physician's assistant, nurse, translators and social workers. They also
will be involved with public-health education through a lay-mentor program
to assist pregnant refugee women.
Within
two years, Griswold aims to have 60 students per year involved in the
program.
"Based
on our work to date, integrating medical students and staff into the
care of culturally diverse populations has enriched both providers and
recipients of care," Griswold said. "We hope to build on the enthusiasm
and professionalism of students as we work together to improve cultural
competency and continue to learn from the patients themselves."
The second
project"School Based Health Centers: Training Medical Students and
Residents in a Community Setting"is a collaboration involving the medical
school's departments of Pediatrics and Psychiatry and the dental school.
Dennis Nadler, the medical school's associate dean for academic and
curricular affairs, will be primary investigator and Richard Sarkin,
associate professor of clinical pediatrics, will be project director.
The project is funded at $235,285 for three years.
"The idea
is to use school health sites to train medical students and residents
in the continuity of health care, and expand their horizons from care
giving to providing education," Nadler said.
UB's Department
of Pediatrics, under the aegis of Kaleida Health, currently operates
11 school-based health centers that function as primary-care clinics
for students. Pediatric residents provide much of the care.
These schools
are located in low-income neighborhoods, where 90100 percent of the
children qualify for free or reduced-price lunches and where most of
the children are enrolled in the school's health center, Nadler said.
Several of these centers will serve as project sites.
"Medical
students and psychiatry residents will become involved in issues such
as preventive mental-health care, self-esteem, bullying, school failure
and classroom issues, in addition to delivering primary care in a setting
students have come to depend on for their health care," Nadler said.
"Dental students and residents will be involved in providing care and
dental education."
First-year
students may be assigned to the school-based health clinics for their
required course in the clinical practice of medicine, he said, and some
third-year medical students will complete part of their required pediatric
internship in project schools. Fourth-year students may choose the project
schools for their adolescent-medicine elective.
The project's
overall goals are to sharpen trainees' clinical skills in working with
children and adolescents, and to enhance their cultural competency and
professionalism, he said.