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Medical students learn in community settings (7/17/97)

The family practice department at The University of Texas Health Science Center at San Antonio recently honored 31 physicians, nurse practitioners, physician assistants and social workers who volunteer to train medical students in community medicine clinics and other social service agencies.

The honorees provide guidance to students under a program called Introduction to Community Medicine. The program stresses preventive health care delivered outside the context of the traditional doctor- patient office visit.

Family practice requires a community medicine experience for residents as part of their third-year clerkship in family practice, and it also offers a senior selective in community medicine. But the introductory program allows still other medical students to get community medicine exposure, said Melissa Talamantes, instructor and program coordinator =66rom family practice. During the six-week clerkship, students are assigned regularly scheduled times each week to participate in outreach activities. In addition, each student is given a community-oriented service learning project to complete and share with other students.

At the completion of the experience, students are able to:

Discuss community agencies and resources and the role of these agencies in the delivery of care by non-physicians;

Describe how physicians can become involved in community agencies;

Work effectively as part of an interdisciplinary team;

Gain insight into specific community issues;

Learn how individual interests and community interests relate to one another.

Dr. Barry Weiss, department chairman, thanked the volunteers for helping students to understand patients' day-to-day obstacles--barriers that may impact health care. "When you come to a new place as a department chair [Dr. Weiss joined the Health Science Center in 1996], you look at the list of people on your faculty," he said. "Our list is huge--250 or more people who provide all kinds of community-based experiences for our students. We have a huge army of people training our students and residents."

Dr. Rafael Martinez, a former family practice resident at the Health Science Center who sees patients at Centro del Barrio on the South Side, said the students "bring a new point of view to the clinic. Their enthusiasm flows over to us." The assigned community projects give students a chance to get a distinct perspective on a particular problem in the community, such as teen pregnancy or HIV, he noted.

"There is so much to do in the community that we are overextended," he said. "The students extend our reach and the patients are the beneficiaries."

"We're thrilled to have the medical students with us," echoed Sister Bernadine Prendergast of Sisters Care of San Antonio, a non-profit organization providing care for the elderly at home. The agency is not funded by Medicare or Medicaid.

Dr. Luis Solis of the El Carmen Clinic, run by Daughters of Charity, said he wants students to recognize the barriers of the poverty- stricken. "If a person has no water, no car or no money, then health care is secondary on his priority list. That's hard. Then the person gets labeled as 'non-compliant,' but he doesn't have the resources to comply," Dr. Solis said. "Maybe he has no refrigerator or no electricity and can't keep medications. We assume a lot of things [about patients] but we can't do that."

The students return from home visits with heightened awareness of cultural issues "which are helpful to experience in more than just theory," he said.

Students get the "big picture" of barriers to health, agreed Omega Arteaga Gamboa of Santa Rosa Community Healthwatch. "We can't tell someone to get a service if the person can't pay for it. So we guide patients through the Medicare maze and managed care," she said. "We have the students meet the families we serve. We tell them, you're here to experience the life of a patient who will be like someone you'll see during your career, particularly if you work in a community health setting."

"We appreciate all the work you've done and it's all on a volunteer basis," Talamantes said to the assembled honorees. "We hope to continue our partnerships with you for years to come."

The 31 honorees include: Omega Arteaga Gamboa, Santa Rosa Community Healthwatch; Jay Sanchez and Roland Flores, Health Care for the Homeless/SAMM Shelter; Kathy Haas, Lanier Student Health Clinic; Dr. Rafael Martinez, Centro del Barrio; Lillie Tarrillion, Elder House; Olive Roen, School of Public Health; Dr. Leticia Aguilar, University Family Health Center, Basse; and Dr. J.J. Gaspard, University Family Health Center, Southwest.

Also: Dr. Priti Mody-Bailey, University Family Health Center, Southeast; Dr. Carlos Cortez, Daughters of Charity El Carmen Clinic; Mylinda Swierc, Family Services Association; Cindy Garcia-Martinez, Child Abuse Prevention Services; Bill Dunn and Lupe Paz Robles, Child Protective Services; Jamie Boyson and Guillermo Rodriguez, Texas Department of Adult Protective & Regulatory Services; and Dr. Robert Koogler, KAFB-Kelly Clinic.

Also: Dr. Bernard Schwartz, Audie L. Murphy Memorial Veterans Hospital; Dr. Scott Ross, Texas Medical Clinic; Irene Hernandez, Christian Senior Services/Grace Place Northwest; Marie Gurierri, Edgewood Adult Day Activity; Sylvia Loera, Morningside Home Health Care; Dr. Richard Fergueson, VNA & Hospice of South Texas; Sisters Ann Birmingham and Bernadine Prendergast, Sisters Care of San Antonio; Drs. Ernesto Parra and David Katerndahl, family practice department; and Dr. Luis Solis, Jose Lambaria and Sister Constance Hummel, Daughters of Charity El Carmen Clinic.

Contact: Will Sansom (210) 567-2570