Underserved Populations AOC
University of Pittsburgh School of Medicine

Upon completion of the Service Learning AOC in underserved populations, students will:

Define a problem list for a special needs patient that incorporates both acute conditions and underlying issues associated with the patient's current situation

• Prioritize the presenting primary and secondary problems of a clinic patient
• Understand and be able to incorporate the concepts of directed brief interventions and twelve-step recovery into clinical practice
• Identify potential cultural, ethnic, and socio-economic barriers to conventional treatment regimens and primary and preventive care
• Recognize the role of substance abuse in patients' clinical presentations and the rehabilitation process
• Recognize, diagnose, and manage patients with common mental health disorders and know when to refer and ways to collaborate with a mental health specialist
• Recognize common conditions related to exposure that afflict the homeless and other disadvantaged/distressed populations, their causes, and ways to treat and prevent them
• Be familiar with health care maintenance and disease prevention interventions applicable to these populations
• Recognize the problem of interpersonal violence in our society and develop skills and knowledge to support these victims utilizing community resources
• Understand the sexual and reproductive health of high-risk under-resourced women and the efforts in the community to ameliorate these problems
• Appreciate the role of poverty in the lives of elderly persons, support services and outreach efforts in the community
• Understand the psycho-socio-economic factors contributing to run-away and throw-away youth and ways to meet their needs
• Understand how state and federal public entitlement systems operate and how persons access services within Medicaid, managed care, fee-for-service programs, and through free care
• Be able to describe community-identified needs and appreciate how they may be different from those of a health provider or public health agency
• Understand principles of community needs assessment and instruments and methodologies used
• Appreciate the benefits of an interdisciplinary approach and self-empowerment to sustain measures of improvement within a community-in-need
• Identify the opportunities as a health professional to make a difference in a community

Each student will be assigned a faculty and a community mentor based on their needs and interests.

Each student is also encouraged to maintain a service learning portfolio documenting all their activities and accomplishments in the 4 years of medical school training. Successful completion of the Service Learning AOC will result in the receipt of a Certificate of Excellence in Community-Based Service Learning and a letter to the Dean of the School of Medicine.

Summary of program components:

Year	1	2	3	4
Service Learning Hours - 200 total (1)	X	X	X	X
Meetings and workshop (2)	X	X	X	X
Scholarly project (3)		X	X	X
Core curriculum (4)	X	X	X	X

1. HOEP, Operation Safety Net/OSAL, PALS, Shuman Center, STATS, CHAT, Pittsburgh Refugee Center, the Women’s Clinic. Service learning activities from participation in Bridging the Gaps and Schweitzer Fellowship Program may be counted toward your total requirement for the first 2 years. Service learning hours in 3^rd and 4^th years may be accomplished via clinical activities in Birmingham Clinic, Detox clinic, emergency medicine clerkship with focus on vulnerable populations, the Women’s Clinic, outpatient’s geriatric clinic, nursing home or home visits, psychiatry electives, and/or outreach sites affiliated with Magee-Womens Hospital. Other community sites will need approval from AOC coordinators and directors.
2. Beginning in the first year, students are encouraged to attend bimonthly journal club meetings sponsored by our Program. These lunch time sessions are designed to introduce basic knowledge as well as critical reviews of recent research and studies related to the underserved. Two reviews and presentations of current journal articles are required in the second and fourth year. Students may also participate in other journal clubs sponsored by Geriatric Medicine, Women’s Health, International Health, and Community Psychiatry.   Students are also encouraged to attend our quarterly research methodology seminars in how to design surveys, conduct focus groups, submit IRB applications, and given an overview of the ethics of participatory action research, and qualitative research methods.
3. Summer projects include Bridging the Gaps, other institutional sponsored summer research programs, the AMSA sponsored Health Promotion and Disease prevention project. Students who wish to design and pursue their own summer project should discuss with the AOC directors and coordinators at the end of the first year. Summer participation with the Schweitzer Fellowship Program is also accepted.  Scholarly projects include the design, conduct and evaluation a community project under the supervision and support of your faculty and community mentors. Students may use their summer projects to satisfy this requirement by conducting follow-up study and evaluation. Presentations at local and national conferences and symposium will be expected.
4. Two or more senior electives in Community Health Eletive, international electives, Acting Internship in Child and Adolescent Psychiatry, Psychiatric Emergency Services, Management of Psychiatric Illness in the Primary Care Setting,  Geriatric medicine, OR women’s health electives. Core curriculum from year 1 (Patient/Doctor Relationship and Ambulatory Course 1); year 2 (CE3); year 3 (CAMC). The senior electives will satisfy the core curriculum requirement for the 4th year.

Additional activities:

• Membership in professional organizations (ACU, HCH Clinician’s Network, SNMA, AMSA, etc.)
• Attending board meetings of local community agencies.

Interested students should complete the application form and submit a personal statement about why they would like to participate in the program. Application is due in the fall of the second year of medical school.

STUDENT EVALUATIONS

Completion of service learning hours as specified above. 

Strength of research endeavors

Both the summer and the senior projects will be judged by 1. background investigation prior to project proposal 2. question/hypothesis 3. methods of study 4. results and outcome 5. discussion/evaluation which should include research limitations and drawbacks 7. community implications 8. annotated bibliography and 9. community and faculty mentors' response.

Quality of written and oral presentations of the above projects will be evaluated by an independent faculty (may be more than one) from the School of Medicine. The student is encouraged to invite a faculty of his/her choice to attend any conference or symposium where the presentation would be given. Evaluation will be given on the strength of research endeavors, clarity and flow of presentation, and ability to respond to the audience's question and input.

PROGRAM AND FACULTY EVALUATIONS

Written evaluations of community and faculty mentors

Oral critiques of the program during regularly scheduled meetings of students, mentors and faculty

Regular meetings with AOC director

Written surveys