Faculty Chair:
Leandrita Ortega, MD
Contacts:
Rotation Experiences:
- COPE
Longitudinal Experiences:
- NMSU Graduate Public Health Certificate
- Community service hours requirement
- Community/Population Needs Assessment during Rural rotation
- Participation in Community Engagement Project (Nuestra Vida)
Outcome Statements:
- By the end of the third year rural rotation the resident will demonstrate understanding of the process of conducting a community/population needs and strengths assessment by performing and writing a basic community needs assessment report. The needs assessment will be performed on the community in which they are working either during their community medicine OR rural rotation. It will be turned in to the resident’s Faculty Advisor or the rotation Faculty Chair and a passing grade will be given for a score of 25/30 based on the rubric provided.
- By the end of the third year of residency the resident will display an understanding of the role the physician has in service to the community by completing and logging 20 hours of community service. The resident may seek out their own opportunities as long as the activity is approved by the Faculty Advisor or they may sign up for opportunities sponsored by the program as they become available. All hours will be logged in New Innovations.
- By the end of the community medicine rotation the resident will display an understanding of how to facilitate patient use of community resources and services by submitting to the Faculty Chair an end of the rotation quiz and obtaining a score of 85%.
- By the end of the third year of residency the resident will demonstrate an understanding of Public and Population Health by successful completion of the Graduate Public Health Certificate program from NMSU.
- By the end of the second year of residency the resident will demonstrate an understanding of engagement of community resources for the education of the public by successful involvement in the Nuestra Vida or equivalent program.
Weekly Schedule PGY1:
(rotation not offered in PGY1)
Weekly Schedule PGY2 or 3:
Week 1
| Monday | Tuesday | Wednesday | Thursday | Friday | |
| AM | St Lukes | FP Clinic | La Pinon | School based HC | FP Clinic |
| PM | DOH | FP Clinic | Didactics | School based HC | ECHO |
Week 2
| Monday | Tuesday | Wednesday | Thursday | Friday | |
| AM | St Lukes | FP Clinic | Case management-clinic | School based HC | FP Clinic |
| PM | DOH | FP Clinic | Didactics | School based HC | ECHO |
Week 3
| Monday | Tuesday | Wednesday | Thursday | Friday | |
| AM | St Lukes | FP Clinic | Case management-hospital | School based HC | FP Clinic |
| PM | DOH | FP Clinic | Didactics | School based HC | ECHO |
Week 4
| Monday | Tuesday | Wednesday | Thursday | Friday | |
| AM | St Lukes | FP Clinic | Gospel rescue mission/community of hope | School based HC | FP Clinic |
| PM | DOH | FP Clinic | Didactics | School based HC | ECHO |
Requirements:
AOA
Community Medicine
The program must provide 50 hours or two weeks of documented training in community medicine. This shall include time spent in any of the following experiences:
- Occupational health.
- Mental health agencies.
- Community based screening programs.
- Public health agencies.
- Community health centers.
- Free clinics.
- Drug and alcohol treatment centers.
- School health programs.
- Homeless shelters.
ACGME
There must be a structured curriculum in which residents address population health, including the evaluation of health problems of the community.
Description of Educational Experience:
The Community Medicine rotation is designed to provide an intensive introduction to the diverse issues of population based medicine, community health resources for patient care, screening, and education, and patient subpopulations and healthcare disparities. A significant portion of our community health curriculum is also taught in a longitudinal fashion over the full three years of a resident’s experience.
Goals
The goal of the Community Medicine rotation is to provide learning opportunities that will enable residents to develop the knowledge, skills, and attitudes necessary to:
- Understand the implications of patient health problems in the greater context of a community.
- Understand the variety of community agencies and support groups available to support their therapeutic efforts.
- Improve communication and professional relationships with community agencies and support groups.
- Understand the fundamentals of occupational medicine, school health, prison medicine, and public health services.
- Assess community health needs and interpret public health reports.
- Understand the role of the Family Physician in the larger context of a modular, all hazards disaster response.
- Assess barriers to optimal health among different subpopulations within a given community including health care disparities
Expectations:
Residents:
Residents are expected to arrive to all assigned community medicine experiences and continuity clinics on time and to dress and act in a professional manner. They are expected to contact the preceptors’ office prior to their first day on the rotation in order arrange the initial meeting time and location on day one of the rotation. It is expected that while at the preceptors’ office the residents will be respectful of the office space and personnel.
- The resident is responsible for completing all assigned readings and completing the end of rotation quiz to be turned in to the faculty chair by the end of the 4 week rotation.
- The resident is responsible for completing a community needs assessment during their rural rotation or their community medicine rotation using guidelines described on the attached grading rubric and turn in written report to their faculty adviser or the faculty chair.
- The resident is responsible for completing and logging 20 hours of community service prior to graduation. (Prorated for the first two years. 6 hours for the class of 2015 and 12 hours for the class of 2016)
- The resident is required to participate in the Nuestra Vida project as assigned during PGY-2.
- The resident is required to complete the Graduate Public Health Certificate program from NMSU starting PGY-2 and completed prior to graduation.
Faculty:
The Faculty and Staff at the each of the Community Medicine rotational site will supervise the residents in each of their patient or client interactions. They are also responsible for completing an evaluation of the resident at the end of the rotation, grading and providing feedback on the end of rotation quiz, and grading and providing feedback on the Community Needs Assessment report. Faculty will also assist with providing opportunities for completion of the community service requirement and guidance during participation in Nuestra Vida program.
Call:
There is no call specific to this rotation.
Patient Care
Goal
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:
Competencies
- Identify the role of a patient the greater community environment including relevant sub-populations.
- Identify the support agencies and groups that are appropriate to aid a given patient’s care.
- Appropriately identify and treat patients with environmental, occupational, and public health problems.
Objectives
Upon completion of this rotation the resident will demonstrate the ability to:
- Identify patient sub-populations and access community based resources appropriate to their care.
- Identify and appropriately treat common environmental illnesses.
- Identify and manage within an interdisciplinary team major public health issues such as STDs, TB, Hepatitis, drug addiction.
- Demonstrate understanding of pre-placement and return to work exams, and the basic concepts of disability evaluations including the specific documentation requirements of each.
Medical Knowledge
Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:
Competencies
- Understand basic population statistics and their application to community health issues.
- Understand the role of preventative health screening in a population context.
- Understand the role of disease prevention education and prophylaxis in a population context.
- Understand the role of sub-population identification in assessing an individual patient’s health risk.
- Be able to assess patients and sub-populations for risk of abuse, neglect, and family or community violence.
- Understand cultural aspects of health perceptions in both the community as a whole and identified sub-populations.
Objectives
Upon completion of the rotation, residents will demonstrate:
- The application of basic population statistics to specific community health issues as measured by successful completion of the Public Health Certificate program and successful integration of population statistics into the community medicine needs assessment report.
- The assessment of patients and sub-populations for risk of abuse, neglect, and family or community violence as measured by time spent with La Pinon sexual assault services and an end of rotation evaluation.
- Understanding of cultural aspects of health perceptions in both the community as a whole and in at least one identified sub-population as measured by successful completion of the Public Health Certificate program and participation in the Nuestra Vida program.
Practice Based Learning and Improvement
Goal
Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to:
Competencies
- Systematically analyze their practice, using quality improvement methods, and implement changes with the goal of practice improvement in the area of population or sub-population risk.
- Participate in the education of patients, families, students, residents and other health professionals regarding sub-population health risks and risk reduction
Objectives
Upon completion of the rotation, residents will demonstrate:
- An example of preventative health screening in a population context.
- An understanding of community based education as measured by successful participation in the Nuestra Vida project.
- The application of subpopulation identification in assessing an individual patient’s health risk.
- The assessment of patients and subpopulations for risk of abuse, neglect, and family or community violence.
- Understanding of cultural aspects of health perceptions in both the community as a whole and in at least one identified subpopulation.
And will participate in:
- At least one disease prevention education or prophylaxis activity and explain its role in a population context.
System Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:
Competencies
- Work effectively in various health care delivery settings and systems relevant to Family Medicine
- Coordinate patient care within the health care system relevant to Family Medicine
- Advocate for quality patient care and optimal patient care systems
Objectives
The resident:
- Will understand the role of the various public health, school-based health centers, prison clinics, and charity clinics in providing services to patient subpopulations and demonstrate effective coordination of care with these entities.
- Will demonstrate understanding of the interrelationship of the various support agencies and services in providing comprehensive patient care and education by appropriate patient referral for supportive services.
- Will demonstrate understanding of the role of community health surveys, population surveys, and epidemiological studies in addressing community health issues through presentation of a community health assessment and plan for remediation to the appropriate agencies.
- Will demonstrate understanding of the Incident Command structure and All Hazards model of disaster response and explain their role in the hospital and residency disaster plan.
Professionalism
Goal
Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:
Competencies
- Compassion, integrity, and respect for others
- Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
Objectives
The resident:
- Will conduct himself/herself in a respectful manner and participate in collaborative efforts to improve patient/community health.
- Will demonstrate commitment to improving the health of the community overall and of the subpopulations identified within it.
- Will demonstrate sensitivity to the cultural needs of identified subpopulations.
- Will consistently perform his/her tasks in a punctual, reliable and collegial manner.
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:
Competencies
- Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds.
- Communicate effectively with physicians, other health professionals, and health related agencies.
Objectives
The resident:
- Will demonstrate appropriate awareness of, and sensitivity to, cultural subpopulations in his/her patient panel.
- Will demonstrate appropriate interactions with peer groups and referral agencies
- Will prepare both a written and verbal presentation of a community health assessment and remediation plan.
Teaching Methods
Teaching occurs through direct observation, directed reading, and didactic presentations both for and by the resident.
Assessment Method (Residents)
Assessment is through direct observation, patient chart review, presentation evaluation, review of written community health assessment, community preceptor evaluations.
Assessment Method (Program Evaluation)
Rotation evaluation is by resident and preceptor written evaluation forms.
Level of Supervision
Residents are supervised by residency faculty and community preceptors through direct observation and review of written reports.
Educational Resources
Readings
Week 1
Week 2
US-Mexico Border Commission Healthy Border 2020
Week 3
Week 4
AAFP Quality Care for Diverse Populations Video Series (2 days, about 45 minutes total)
Websites
1. American Academy of Family Physicians: http://www.aafp.org/home.html
2. Centers for Disease Control and Prevention, Public Health Information Network (phin): http://www.cdc.gov/phin/index.html
3. Border Health Commission: http://www.borderhealth.org
4. Border Health Foundation: http://www.borderhealthfoundation.org
5. New Mexico Department of Health: http://www.health.state.nm.us
6. New Mexico Office of Border Health: http://www.nmborderhealth.org
7. New Mexico Health Data: http://nmhealth.org/erd/healthdata/hdata.shtml
8. Dona County Health and Human Services: http://www.co.dona-ana.nm.us/health
9. US census Bureau: http://www.census.gov/
10. National Center for Health Statistics: http://www.cdc.gov/nchs/default.htm
11. Kaiser Family Foundation: http://www.kff.org/
12. Health People 2020: http://www.healthypeople.gov/
13. Pan American Health Organization: http://new.paho.org/fep/index.php?lang=en
14. University of Kansas Community Tool Box chapter on community needs assessment
15. New Mexico DOH 2014-2016 Strategic Plan
16. New Mexico DOH Community Needs Assessment Resources
17. NMDOH Community Health Assessment & Planning Guidebook.pdf
19. US-Mexico Border Commission Report on access to care 2014
20. US-Mexico Border Diabetes Prevention and Control Project Prevalence Report 2010
22. CDC Emergency Preparedness and Response
Videos
HBO: The Weight of the Nation , HBO documentary on American obesity epidemic. Collaboratively developed with the Institute of Medicine (IOM), in association with the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), and in partnership with the Michael & Susan Dell Foundation and Kaiser Permanente.
Escape Fire A documentary about the American health care system and how to save the health of a nation.
Other Resources
SNMFMRP Curriculum 