UB Receives Two State Grants to Train Medical, Dental Students in Clinics for Refugees, Underserved Children

BUFFALO, N.Y. -- The University at Buffalo has received two grants totaling nearly $629,000 from New York State to provide culturally appropriate training for its medical and dental students and residents through school- and community-based clinics.

One grant supports a program for medical students and residents who will provide care to immigrant groups; the other funds a project involving medical and dental students working with underserved schoolchildren.

The goal of the grants is to improve access to health care for these groups while sharpening students' clinical skills and cultural competency. UB is the only university among nine awardees to receive two grants.

Three departments in the UB School of Medicine and Biomedical Sciences, along with the UB School of Dental Medicine, are developing the programs.

The larger of the two grants, funded for $393,933, will support the Refugee Cultural Competency Training Program sponsored by the medical school's Department of Family Medicine. Kimberly Griswold, M.D., M.P.H., assistant professor of family medicine, will direct the project.

The Northwest Buffalo Community Health Care Center and Jericho Road Family Practice on Buffalo's West Side, operated by Myron Glick, M.D., will be joint sponsors. The International Institute of Buffalo and Journey's End Resettlement Services also will be involved.

"Our strategy is to offer a concentrated cultural-immersion experience to students and residents at evening clinical sessions that serve only refugee patients," said Griswold. "The students will be working with people from Rwanda, Sudan, Somalia, Ethiopia, Congo, Kosovo, Bosnia and Cuba."

The program builds on a pilot project developed over the past two years by Griswold, UB medical students and volunteers, in which medical students conducted health screening of refugees during monthly "health nights" at one of the participating clinics.

The current project formally incorporates refugee care into the medical-school curriculum as an option for interested students, who can use the experience as part of their existing clinical-practice training and receive academic credit or as an extracurricular activity and receive "extra" credit.

Clinics will take place evenings from 5-10 p.m. and will begin with an hour-long orientation presented by immigrant resettlement staff, a medical anthropologist, physician and social worker. Students then will spend 3 1/2 hours in clinic doing initial health evaluations with refugees, followed by a debriefing focus session. Students must commit to two sessions in order to qualify for the program.

The trainees will work with an interdisciplinary team consisting of a physician, physician's assistant, nurse, translators and social workers. They also will be involved with public-health education through a lay-mentor program to assist pregnant refugee women.

Within two years of the three-year funding period, Griswold aims to have 60 students per year, or approximately one-third of each class, involved in the program.

"Based on our work to date, integrating medical students and staff into the care of culturally diverse populations has enriched both providers and recipients of care," Griswold said. "We hope to build on the enthusiasm and professionalism of students, as we work together to improve cultural competency and continue to learn from the patients themselves."

The second project -- "School Based Health Centers: Training Medical Students and Residents in a Community Setting" -- is a collaboration involving the UB medical school's departments of Pediatrics and Psychiatry and UB's dental school. Dennis Nadler, M.D., the medical school's associate dean for academic and curricular affairs, will be primary investigator, and Richard Sarkin, M.D., associate professor of clinical pediatrics, will be project director. The project is funded at $235,285 for three years.

"The idea is to use school health sites to train medical students and residents in the continuity of health care, and expand their horizons from care giving to providing education," Nadler said.

UB's Department of Pediatrics, under the aegis of Kaleida Health, currently operates 11 school-based health centers, which function as primary-care clinics for students. Pediatric residents provide much of the care.

These schools are located in low-income neighborhoods, where 90-100 percent of the children qualify for free or reduced-price lunches and where most of the children are enrolled in the school's health center, Nadler said. Several of these centers will serve as project sites.

"Medical students and psychiatry residents will become involved in issues such as preventive mental health care, self-esteem, bullying, school failure and classroom issues, in addition to delivering primary care in a setting students have come to depend on for their health care," Nadler said. "Dental students and residents will be involved in providing care and dental education."

First-year students may be assigned to the school-based health clinics for their required course in clinical practice of medicine, he said, and some third-year medical students will complete part of their required pediatric internship in project schools. Fourth-year students may choose the project schools for their adolescent medicine elective.

The project's overall goals are to sharpen trainees' clinical skills in working with children and adolescents and to enhance their cultural competency and professionalism, he said.

"This is an extraordinary opportunity for both service and education for all concerned," Nadler said. "We are delighted the New York State Health Department has recognized the importance of this project and has agreed to provide support."