The aim of the Residency Program in Social Medicine is to train residents for clinical excellence in primary care. In order to achieve that aim we offer several unique training experiences and opportunities:
A Commitment to Healthcare for All
At the RPSM we take the slogan “Health Care for All” very seriously. The Department of Family and Social Medicine is affiliated with two community health centers and sees its responsibility to care for patients regardless of ability to pay. This also moves us beyond the walls of our clinical practices out into the community – into soup kitchens, homeless shelters, schools, workplaces, nursinghomes and single room occupancy hotels. Many of our residents and faculty also work in international settings.
An integrated, longitudinal Behavioral Science Curriculum
Fundamental to the RPSM training is the application of an integrated biopsychosocial approach to healthcare that recognizes the importance of understanding medical problems from an individual, familial and community perspective. Unique to our curriculum, is the attention given to the patient’s family and social context when addressing problems at the clinical encounter. We promote a family systems model, understood as the best way to apply a biopsychosocial perspective to clinical practice. The psychosocial curriculum at RPSM is integrated throughout the 3-years of training through the following major components.
- Psychosocial Precepting
Trained psychologists and a psychiatrist, working as psychosocial preceptors, are in clinic during most resident clinic sessions in order to assist residents to better identify and address patients’ psychosocial issues as they arise. Behavioral preceptors work collaboratively with medical preceptors and offer expertise in patient assessment, doctor-patient relationship issues as well as intervention planning. In addition, preceptors are available to conduct on-going counseling with particularly complex patients in conjunction with the primary care resident.
- Observation of Medical Encounters
Throughout the 3 years of residency, residents are observed by the behavioral faculty by sitting in during encounters with patients or by videotaping, and later reviewing, the patient encounters. These conjoint video review sessions provide residents with an essential training in conducting effective, efficient and culturally sensitive patient interviews.
- Psychosocial Seminar
Several times a month during Tuesday afternoon teaching, residents present a particularly challenging or poignant clinical case in collaboration with the psychosocial faculty focusing on a related theme particularly relevant to primary care practice. The aim of the seminar is to teach the integration of the psychosocial, biomedical and social medicine approaches to the medical encounter as well as to provide a forum in which the residents can share and reflect on their clinical experiences. In addition, residents learn how to assess and manage common clinical problems presented in primary care practice.
- Psychosocial Courses
Three didactic courses are offered yearly to residents during their residency training. During the Orientation month, a course on Interviewing is offered to incoming residents. Second year residents are given a three session course, focused on Assessment which takes place in the Fall. Following a similar format, a course on Intervention is provided to third year residents in the Winter.
- Psychosocial Elective
This elective, under the supervision of a behavioral faculty, offers an opportunity to PGY-II and PGY-III residents to further develop their skills and knowledge in the psychosocial area. An overview of basic concepts applicable to primary care practice is provided with a special focus on how to formulate problems and plan interventions within a family systems framework. The elective is tailored to the particular needs and interests of the residents.
A 3 Month Curriculum in Social Medicine
One month of each year of residency is devoted to teaching social medicine. During these months residents are released from all hospital responsibilities.
- Interns Social Medicine Orientation Month
During the month of October interns participate in an intensive orientation to the theory and practice of social medicine. Interns work directly with faculty and one another to explore various topics, including application of the biopsychosocial model in clinical practice, fundamentals of physician-patient relations, advocating for patient rights, among others. An introduction to the colorful history of the Bronx and the many cultural communities that make up its fabric are also emphasized. Residents frequently draw on the skills acquired during this month throughout their training.
- Information Mastery for Social Medicine
Residents again come together as a group in September of their second year to review fundamental principles of epidemiology, biostatistics and evidence based medicine as they apply to community oriented primary care.
- Health Systems and Health Teams
In May of the residents 3rd year, they take part in formal teaching seminars that delineate the complexities of the current health care system. Emphasis is placed on patient advocacy, navigation of health systems, rules and roles of health care teams and health economics from national and international perspectives.
Social Medicine Rounds
Twice monthly, lectures, workshops, or seminars addressing the larger context of medicine and health are given. These rounds address issues of public health, international medicine, political activism, cultural competence, and more. They are led by experts available in the New York metropolitan area, or those of national renown.
Please visit www.socialmedicine.org/ for more up-to-date information about social medicine rounds and other social medicine related activities in our department.
Social Medicine Projects
All residents are required to plan and execute a project drawing upon the skills obtained during their training. The projects can be conducted alone or in groups, and are expected to span across the three years of residency. Projects can be designed in education, research clinical care, advocacy or community partnership. Projects are presented at the close of the PGY-3 year to RPSM faculty and residents. Frequently residents go on to publish and more present their work in regional and national forums. The subject and scope of projects is limited only by residents’ imagination, and many projects have spawned programs and collaborations that continue after the residents' graduation.
Examples of Social Medicine Projects
Credit Towards Master's Degree in Public Health
The rigor of the curriculum offered by the RPSM’s social medicine curriculum has been recognized by other institutions in New York City, including Columbia University School of Public Health, Hunter College-CUNY, and the New School for Social Research. Completion of the social medicine curriculum affords Montefiore graduates approximately 15 credits towards a Master’s degree in public health from any of these institutions. Many RPSM graduates choose to seek this degree later in their careers.
Resident Partnership System
Incoming residents are partnered with a member of their class. These relationships allow residents to share ambulatory, inpatient, and program related responsibilities. In addition, partners can assume clinic tasks for one another to maintain patients’ continuity of care. Frequently these partnerships develop into long lasting friendships.