DEVELOPING AN AREA OF CONCETRATION IN COMMUNITY HEALTH AND ADVOCACY

Proposal to the Academy of Medical Educators
Sharad Jain, MD

Background:
As the School of Medicine restructures its fourth-year curriculum to include the Area of Concentrations program, one of the areas envisioned by its developers is that of Community Health and Advocacy. While substantial opportunities currently exist for students in these areas, there has been little coordination of these efforts. In addition, while other medical schools (including Albert Einstein and NYU) have well-developed curricula in advocacy, similar coursework is not currently available at the University of California, San Francisco (UCSF). Although most students who enter UCSF have an expressed interest in working to improve the health of their communities, many report having difficulty in identifying mentors on the faculty who can support and develop these interests throughout their training. The purpose of this proposal is to create an area of concentration in community health and advocacy that provides new and exciting opportunities for medical students and to design the framework (including preparation, experience, and legacy) for this program.

Goals:
The goals for this project involve developing an interdisciplinary Area of Concentration in Community and Health and Advocacy. This will involve the following steps:

· Coordinate current offerings within the School of Medicine that fit under this area. This process will include reviewing electives offered within many departments with the goal of establishing a simple method for students to access this information. In addition, coursework offerings in other Schools at the University would also be reviewed to develop collaboration across Schools in order to create a multidisciplinary program
· Explore development of new curricula to support student interest in these areas. This coursework would likely include offerings in the preclinical years to expose students to this area of concentration, as well as material for the fourth-year to provide a framework for students in preparation for experiential learning; curricular offerings at other medical schools may be instructive in fulfilling this goal.
· Create a listing of potential mentors across departments who have experience and expertise in the areas of community health and advocacy. The School of Medicine is currently working on updating the faculty database and is interested in including this area in the survey that is sent to faculty. Faculty will also be asked to describe projects on which they are currently working so students can learn about the various opportunities for participation in these projects.
· Establish a website that provides a central listing, with links, to the various parts of this area of concentration, including preparation, experience, and legacy. Included in this listing would be courses available for students (both in the preclinical and the fourth years), mentors who can provide both career and project advice, and project opportunities for experiential learning.
· Coordinate with the Advisory Colleges faculty to provide advising and mentoring to students with interests in these areas. Dr. Lee Jones has agreed to help facilitate linkages between this area of concentration and that group.
· Coordinate with other areas of concentration currently being developed to ensure consistency of offerings and requirements. In addition, curricular materials and opportunities that overlap different areas of concentration should be shared to the extent feasible.
· Explore possibilities for integration of some of the curricular material for this area of concentration into the core curriculum, so that all UCSF medical students are exposed to portions of the objectives of this area.
· Contact other schools with similar curricula to learn from their programs. Initial contact has already been established with faculty at NYU and Albert Einstein medical schools; in addition, the organization Public Citizen supports advocacy programs by providing some administrative and financial support for curricular innovations of this sort.

Plans for measurement of efficacy:
An ad hoc committee composed of members already identified by the Areas of Concentration meta-group will meet regularly to review the curricular offerings and to discuss ideas for new coursework that is appropriate for students interested in this area. In addition, the committee will review proposed projects to ensure that students who enroll in this area are performing work of the highest caliber with appropriate faculty support. It is expected that that this area of concentration will learn from other areas who are further along in the development process and that there will be some consistency in evaluation across the different areas. Finally, we plan to develop an evaluation instrument that will be distributed to all students enrolled in this area of concentration to solicit feedback from them in an ongoing manner.

Plan for continuation at end of funding cycle:
It is unclear at present how this project will be continued beyond the current year. The Areas of Concentration meta-group has discussed ways to obtain funding directly from the School of Medicine to maintain this program once it is created; further funding may be requested from the Academy, especially for the development of new programs within this area of concentration

For further information, please contact:
Sharad Jain, MD at Sharad.Jain@ucsf.edu