Poverty Medicine: a thread for those comitted to medicine for the underserved

[simpler2]

I'm creating this thread as a space to post resources and/or ideas to enhance training in the area of Poverty Medicine. This term, discussed most extensively by David Hilfiker, MD, describes medical practice focused on indigent populations.
THIS SHOULD NOT be a space for debating the merits of such practice. There are many other threads for that purpose, please post there if this is your intent.
This space is for posting opportunities, advice, questions, readings, and other resources that may be helpful to those aspiring to become effective physicians of Poverty Medicine.

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[simpler2]

What I've found so far:
-Developing a proficiency in Spanish is essential and possible to do during med school
-There are numerous scholarships and loan repayment options for working with underserved populations
-Many schools offer combined MD,DO/MPH options, which could aid in future work towards advocacy/policy
-Thorough training is essential as many of these patients cannot afford specialist referral

My question now:
-I'm primarily looking into UNM family medicine residency but am having trouble coming up with some alternatives. There is the US news top rural medicine program list. I'm wondering if anyone has knowledge of other family medicine programs MD or DO with focus on the underserved (not that are simply located in an underserved location).

 

[dseattle]

have you looked at Community Health Centers?

http://www.nachc.com/

 

[simpler2]

have you looked at Community Health Centers?

http://www.nachc.com/

I am a NHSC scholar so I will likely end up at a Community Health Center. As of now though I'm still just looking into Residency options. I know I could receive adequate training for working in such setting at many FM Residencies but I would prefer one that has a focus on underserved/indigent populations.

 

[simpler2]

Guess there's not too many people on this path

 

[devilpup]

Guess there's not too many people on this path

There are a number of us lurking around. We should visit the URM forum more often, though.

Out here in CA there are several new programs at the UC's aimed at training med students who are interested in pursuing this path. Hopefully the trend continues. As the issues of quality, care, and cost worsen, the underserved population will experience the worst impact.

 

[EMDocV]

What I've found so far:
-Developing a proficiency in Spanish is essential and possible to do during med school
-There are numerous scholarships and loan repayment options for working with underserved populations
-Many schools offer combined MD,DO/MPH options, which could aid in future work towards advocacy/policy
-Thorough training is essential as many of these patients cannot afford specialist referral

My question now:
-I'm primarily looking into UNM family medicine residency but am having trouble coming up with some alternatives. There is the US news top rural medicine program list. I'm wondering if anyone has knowledge of other family medicine programs MD or DO with focus on the underserved (not that are simply located in an underserved location).

Morehouse School of Medicine

 

[Dr Lyss]

Travelers Summer Research Fellowship at Weill Cornell is great for any undergrads interested in working with underserved populations. I learned a lot and got to do some cool research too

 

[HungryDoc]

This isn't *directly* related to the topic of poverty medicine (and this is my first post ever) so please redirect me to the right place if this is the wrong thread.

Anyway, this conversation regarding resources for doctors going into poverty medicine resonates with an observation I've made as I've been selecting medical schools to apply to. There appears to be an inverse relationship between a school's prestige and their stated dedication to addressing the healthcare needs of the poor. I find this curious because if I was in charge of our nation's medical education apparatus I'd put a stronger emphasis on addressing the current healthcare crisis (47M uninsured, millions of under-insured, and skyrocketing costs) rather than improving the state of the art in medical interventions. To be clear, I'm not saying that we shouldn't pursue medical research, rather I think that too little emphasis is put on addressing our current healthcare crisis and that a reallocation of resources is needed.

Do folks here agree, or am I underestimating the contributions that say, Harvard, is making to addressing the medical needs of the poor?

 

[MsKrispyKreme]

^Your post was great. IMO, prestige in medicine is directly related to providing treatments for rich White people so to expect Ivy League med schools and their grads to focus on the underserved is ludicrous. I don't expect it and see no evidence for it.

 

[simpler2]

This isn't *directly* related to the topic of poverty medicine (and this is my first post ever) so please redirect me to the right place if this is the wrong thread.

Anyway, this conversation regarding resources for doctors going into poverty medicine resonates with an observation I've made as I've been selecting medical schools to apply to. There appears to be an inverse relationship between a school's prestige and their stated dedication to addressing the healthcare needs of the poor. I find this curious because if I was in charge of our nation's medical education apparatus I'd put a stronger emphasis on addressing the current healthcare crisis (47M uninsured, millions of under-insured, and skyrocketing costs) rather than improving the state of the art in medical interventions. To be clear, I'm not saying that we shouldn't pursue medical research, rather I think that too little emphasis is put on addressing our current healthcare crisis and that a reallocation of resources is needed.

Do folks here agree, or am I underestimating the contributions that say, Harvard, is making to addressing the medical needs of the poor?

Hungrydoc, I think you bring up some interesting points in your observation. However, from what I have seen, many of the prestigious medical colleges DO have at least some focus on the plight of the uninsured/underinsured. It is also my perception that this focus is usually at least in part to boost a school's image. My school (NSU, not really "prestigious") has a large rural/underserved component during clinicals but I can't think of many classmates that value this or want to focus on indigent care in the future. I think its difficult to teach solutions to the health care crisis though. Addressing the social component of disease is much less concrete than the science aspect, maybe this is why you see so much focus on the later.

 

[HungryDoc]

It's nice to hear that there's an emphasis on these issues at NSU (and presumably Harvard et al.) It's disappointing to think that many of the students don't value the exposure to the underserved. Perhaps therein lies a clue to what makes a school like Howard, Meharry, or Morehouse special. I like to imagine (since I'm not a student and don't know whether this is true or not) that there is a "culture of service" in these institutions that shapes the way that students and faculty value certain opportunities. I wonder how much of it is due to their selection criteria and how much is due to way that the medical education is delivered.

Do you think that there are any schools that do a decent job of addressing the social components of disease? This isn't something I've been considering when choosing programs to apply to.

 

[EMDocV]

As with all medical specialities there are common pros & cons associated with specific practices. For some time I have become very interested in working with the socioeconomically disadvantaged & underserved. I have found a true desire to pursue OB/GYN. As an african american male I have really in a selfless manner set my self up for several oportunities for discrimination. There are still some instances where patients prefer physicians of other genders & racial backgrounds. I am fully cognizant of that and hope you are as well. However I am so excited about community outreach, preventive medicine, & especially obstetrics. Being a primary care physician in my opinion seems very rewarding. I anticipated going into private practice, specifically in Georgia with someone who has my same visions & goals. Serve those that are less fortunate, the most vulnerable, & have the need for quality healthcare. I am also into education or rather educating for healthy lifestyles, safe & normal pregnancies. Nevertheless I was wondering if there were any other prospective OB/GYN's or Med students considering OB/GYN, that might have that same outlook. Regardless of the preferance for females in some cases, or the malpractice insurance. Are there any of you all in the healthcare field that tailor thier vocation around serving minority populations? Minority populations in OB/GYN? like myself...

 

[RySerr21]

^Your post was great. IMO, prestige in medicine is directly related to providing treatments for rich White people so to expect Ivy League med schools and their grads to focus on the underserved is ludicrous. I don't expect it and see no evidence for it.

Dartmouth does a pretty amazing job at setting up rotations and offering medical mission trips all around the world serving those in poverty and those that are drastically underserved.

One of my goals is to practice in medicine in Africa, possibly working with the aids/hiv epidemic. Dartmouth has a rotation set up in Tanzania for this very purpose and allows students to do resaerch as well as get clinical exposure in a rural, underserved population. THey aslo have several mission trips set up which you can participate in throughout the summer.

I encourage any one intersted in pracitcing this kind of medicine to consider applying to DMS.

 

[samisab786]

I don't know what I want to do right now since I'm still an undergrad in college, but if I were to do something in healthcare, I would love to do it in an underserved area mostly because I am only opting for healthcare since it is one of those careers in which you can provide an incredible amount of service. It's terrible how many people who are in America do not have access to the simple things many take for granted. In addition, whatever I plan to do, I want to help motivate the kids in underrepresented areas to follow their dreams career-wise.

 

[scarterinscrubs]

Does anyone have a suggestion on how detailed I should be on my Secondaries when asked about why I want to practiced in an underserved area?

 

[simpler2]

Does anyone have a suggestion on how detailed I should be on my Secondaries when asked about why I want to practiced in an underserved area?

I would be honest and highlight the practical reasons (i.e. you want to practice full spectrum care, you like the challenges, you came from this population...stuff like this). Many of us have more emotional, religious or ethical reasons but I wouldn't focus entirely or too heavily on these as the person reviewing your app. may be of differing opinion or view.