Grant sends residents out of hospital, into community

UCSF Benioff Children’s Hospital in Oakland can add one more item to its list of achievements: a $1.3 million Health Resources and Services Administration (HRSA) grant.

The grant, which the hospital was awarded in July by the U.S. Department of Health and Human Services, gives organizations the chance to build and enhance healthcare for underserved people and communities. Some of the key areas the program concentrates on are HIV/AIDS treatment, organ donation, continued training of healthcare workforce, and improving primary healthcare centers. At the Children’s Hospital Oakland, it will be used to expand its Community Advocacy Primary Care Expanded Pediatric Resident Training curriculum, or CAP Expert program.

The program, which supplements the education its residency program presents, is a curriculum that aims to produce better community-focused pediatricians. Though the program doesn’t directly serve children, as CAP Expert co–director Dr. Diane Halberg says, it does create a curriculum enabling pediatric residents to visit and learn about various agencies and organizations helping children (and their families) who are in need of more community support and who have complex medical issues. “One example,” said Halberg, “is children and families that live in poverty are often food insecure. We would send the pediatric residents to the Alameda Food Bank to [better] understand how this resource is managed.”

The enhanced curriculum will increase resident exposure to social determinants of health by maximizing time spent in the Oakland community. Through site visits to juvenile justice centers, food banks and group homes, residents will gain a better understanding of their importance as serving as a medical home for patients who must navigate through an increasingly complex medical system.

Dr. Pamela Simms-Mackey, a graduate medical education director, says the current 80 residents in the program finished medical school and are completing three years of pediatric residency training to become board-certified pediatricians. Once they’re done, residents choose to enter one of the numerous fields the world of pediatrics has to offer. Of the program graduates, Simms-Mackey said, about 40 percent head toward primary care. But one of the CAP Expert goals is to increase that number to 65 percent. Another hope is that many of them would practice in an underserved area—which makes up a large portion of who the Children’s Hospital Oakland’s training program and primary care clinics serves.

Those goals, said Dr. Gena Lewis, a CAP Expert co-director, were already a part of resident training at the hospital—the HRSA grant will simply help fund its expansion. “I think that the way that we are going to be teaching our residents will be much more hands-on,” said Lewis, “They will have more teaching face-to-face with us now than they used to, [opportunities] for reflection about the experiences that they’ve had in our curriculum, and [reviewing] what they know and how it can be applied to real-world medicine.”

Third-year general pediatric resident Celine Sparrow expanded on the details, saying, “The enhanced curriculum will increase resident exposure to social determinants of health by maximizing time spent in the Oakland community. Through site visits to juvenile justice centers, food banks, group homes, to name a few, residents will gain a better understanding of their importance as serving as a medical home for patients who must navigate through an increasingly complex medical system.”

One navigational method is the help organizations in communities can provide like, as Simms-Mackey cited, the Regional Center of the East Bay, which aids those with developmental disabilities. “When we work with organizations in the community that help partner with us to ensure the health and wellbeing of children, we ask them to share what they would like a pediatrician to know,” said Simms-Mackey. “These are young physicians in training and we want to equip them with the tools to be effective providers/clinicians in the communities they eventually end up practicing in.”

That will help pediatric residents like Sparrow, who just found out that she will be chief resident next year. “I already know that I probably will be doing something in primary care,” she said.