Care of Marginalized Populations

Faculty Co-Chairs:

Amanda Provencio, MD
Iván de la Rosa, PhD
Donna Winslow, PhD

ACGME Program Requirements (see IV.C.)

Goals

At the end of CMP rotation, the resident will be able to:

1. define marginalized populations and identify the characteristics of those populations that are undertreated, vulnerable, and underrepresented,
2. identify and manage with a Team-Based approach, the unique or different medical care considerations for lifelong access to high-quality, effective, affordable, and compassionate care in the treatment of psycho-social and medical conditions,
3. demonstrate an awareness of and responsiveness to the larger context and system of health care and call effectively on other resources in the system to provide optimal health care,
4. evaluate self-practice and engage in lifelong learning.

General Information

Marginalized and vulnerable populations are groups and communities that experience discrimination and exclusion (social, political, and economic) because of unequal power relationships across economic, political, social, and cultural dimensions. This rotation aims to expose residents to what entails the care of marginalized populations and develop knowledge, attitudes, and skills in providing care. Below are the Goals and Expectations of this rotation.

Expectations for Residents and Faculty (if beyond those outlined in the resident manual):

Resident Expectations & Deliverables 

1. The resident is responsible for completing all assigned readings and modules.
2. The resident is responsible for choosing a specific population to focus on during the rotation.
3. Residents will be present at their rotation site on time and will present with the direct supervisor, expected to manage her/him/themselves with respect and address the clients/patients and personnel of the rotation site with respect.
4. It is expected the resident learn about addressing not only medical needs but also the inclusion of social determinants of health of this group.
5. By the end of the rotation, the resident is expected to complete a guided essay and give a presentation on the marginalized populations they worked with.

Roles of Faculty members/Healthcare professionals and community members

Care of marginalized population faculty will provide a structured learning opportunity to explore the special needs of marginalized populations through the lens of faculty members of different disciplines including social medicine, behavioral medicine, and family medicine.

Social medicine faculty‘s role is to provide education and awareness of the person-in-environment that leads to the marginalization of vulnerable individuals.

Family medicine physician faculty‘s role is to assist with the merging of education and knowledge of marginalized and vulnerable individuals into healthcare practice.

Behavioral science faculty‘s role is to provide education and knowledge of the behavioral and psychological needs of marginalized and vulnerable individuals and integrate them into healthcare practice.

Community members and other healthcare professionals will provide exposure, education, and awareness of the needs of the identified marginalized group.

Level of Supervision

Residents are supervised by residency faculty and community preceptors through direct observation and review of written reports and presentations. Structured supervision includes initial, mid, and final check-ins with CMP faculty.

Deliverables

1. The resident is responsible for completing an online module on the care of marginalized and vulnerable populations.
2. The resident is responsible for completing a written reflection on factors that contribute to marginalization specific to one marginalized population and submitting this to a member of the CMP faculty by the end of the rotation.

Objective (competencies)	Educational Strategies	Assessments
By the end of the CMP rotation, residents will be able to work in interprofessional teams to enhance patient safety and improve patient care quality. (Goal 2) (PC, SBC, ICS, Prof, PBLI)	Residents will have exposure to different professionals at their assigned site.   Residents will learn the specific roles and skills of other healthcare professionals in the care of the marginalized group.  Residents will carry out responsibilities specific to the discipline’s specific role on a team.  Residents will participate actively in team meetings	Evaluated by site coordinator or representative
By the end of the CMP rotation, the resident will be able to ensure that patient/family preferences/goals are considered when developing the team’s care plan (Goals 2 & 3). (PC, SBC, ICS)	Residents will include/consider patient social needs and preferences in treatment planning. Residents will work alongside social and other health care professionals to learn about social and environmental factors that impact vulnerable populations. Residents will deliver and participate in didactic discussions with faculty about the care of marginalized and vulnerable populations.	Written reflection. Staff and preceptor observation
By the end of the CMP rotation, residents will be able to demonstrate knowledge of unique or different medical care considerations that may need to be applied to marginalized populations. (Goals 1, 3 & 4) (MK, PC, SBC, PBLI)	Residents will participate in structured education surrounding a specific marginalized group    Residents will be exposed to/spend time with a specific marginalized group and participate in rounds, consultations, and time with members of this group.     Residents will shadow social, health care professionals, and community members to learn specific needs and resources related to care.	Written reflection   Completed modules

Resources

1. Resident is expected to complete the following module during this rotation focused on structural competency. Please enroll to complete the module: Introduction to Structural Competency – College of Arts and Sciences (nmsu.edu)
2. Aprendamos: Contact Erin O’Donnell  eodonnell@aitkids.com; 575-526-6682, www.aitkids.com 301 Perkins Dr., Las Cruces NM
3. Families and Youth Inc.: Lisa Chavez, lchave@fyinm.org (575) 522-4004 1302 S. Solano Dr., Las Cruces NM 88005