The University of Connecticut Internal Medicine Program’s Community Health Alliance Track (CHAT) is a three-year longitudinal curriculum integrated within the main residency curriculum designed specifically for residents who envision partnering with our community, and who see value in learning about health concerns directly from our community and contributing to addressing them. By the end of this track, residents will receive the training necessary to recognize concerns impacting health and well-being in our neighborhoods and promote healthcare access and healthy outcomes across their careers. We engage through listening and service events, roundtable discussions, legislative advocacy, scholarship, research, teaching, and volunteerism.

Community Health Alliance: Track Mission

The mission of our track is to train and prepare the next generation of clinicians committed to caring for everyone, including disadvantaged populations, and to promoting healthcare access, well-being, and a healthy environment. We focus on developing the knowledge, attitudes, and skill sets to improve health and longevity, and place strong emphasis on being informed by the communities we serve. We aim to forge a sense of belonging in the healthcare setting for our patients and training physicians alike.

Goals

By the end of this track, residents will be leaders within our Internal Medicine Program in promoting care consistent with Society of General Internal Medicine Task Force recommendations, and be able to:

• Assess health, well-being and longevity gaps in the communities we serve, working with community members to promote positive paths forward.
• Identify biases, attitudes and behaviors that detract from a sense of belonging in the health care setting, and develop effective responses to mitigate these, including providing trauma-informed care.
• Assess barriers to accessing available health resources, and construct plans to address these.
• Forge partnerships with community stakeholders and local organizations critical to health and well-being.
• Promote a healthy environment.
• Engage in the community through alliances - listening sessions, roundtable conversations, legislative advocacy, scholarship, research, teaching and volunteerism.

Curriculum

The Community Health Alliance curriculum centers on community engagement, listening events and service to assess and tackle longevity gaps, community health concerns, as well as other factors impacting local well-being and the environment, accomplished via the categories below:

Meet

Our monthly meetings are track-member facilitated. Meetings include member-led discussion and presentations on topics of interest, in conjunction with our surrounding community.

Serve

Track residents have the opportunity to care for under-served local populations at high risk for poor health and well-being outcomes.

Charter Oak Street Medicine: Our track members are pioneering a street medicine outreach service in collaboration with Charter Oak, a federally qualified health center. For two mornings during Y Blocks, track members have the option to join Charter Oak’s mobile medicine van team, serving Hartford’s uninsured and/or unhoused population at various neighborhood and shelter stops. Track members experience longitudinal care delivery on the streets of Harford with an experienced community team, and assess social and environmental determinants of health for persons seeking care. There is an option to complete the Quality Improvement Internal Medicine requirement with the Charter Oak team. This longitudinal experience will be substituted for other clinical/QI time in Y blocks, and at this time is only open to track members.

Care Under the Bridge: We are pioneering a partnership with Hands on Hartford, a local non-profit whose outreach van makes stops throughout Hartford, serving unhoused persons most Monday evenings, including under bridges and at encampments. This will be open to 1-3 track residents; residents will go out with the van, where they see clients and may supervise medical students. This longitudinal experience will be substituted for other clinical/QI time in Y blocks, and at this time is only open to track members. There is an option to complete the Quality Improvement Internal Medicine requirement with this team.

Listening, Round Table, and Engagement Events

Community Health Alliance track members host and join community events, held approximately every 1-2 months. Track members propose, develop, and lead these. All track members contribute at least one outreach project each year with a community health lens, on a topic of their own choice, for the benefit of our local communities; these may include community listening/roundtable events, service events, community resource dissemination for the wider residency program, or scholarship/publication.

Track members have completed outreach projects that involved scholarship, advocacy, volunteerism, or quality improvement. Past events have included:

• Leadership session with UConn Health’s Dr. Jeffrey Hines
• Breakfast discussion and meeting with advocates for Hartford’s homeless
• Footwear distribution and health screening events for the homeless
• Multi-community interfaith alliance conference on local issues
• Health data mapping via PolicyMap with Health Disparities Institute statistician
• Legislative advocacy session on Connecticut bill proposals on health topics
• Delivering grand rounds on responding to bias in the inpatient setting
• Health screening fair at the Hartford Convention Center
• Community listening event on adverse landfill impacts on health in Hartford
• Award-winning QI project on sleep apnea screening in a clinic serving socioeconomically vulnerable population
• Interview highlighting how Hartford’s mobile mammography team addresses improving access to breast cancer screening
• Facilitation of a community health stakeholder panel for first-year medical and dental students
• Clothing drive for Hartford job seekers’ professional closet, and for hospital clothing banks for patients

Projects are tailored to meet our community’s needs and our track members’ own professional interests, keeping a focus on health and well-being.

Teaching and Mentorship

Bi-weekly Community Health Curriculum contribution: Track members contribute three bi-weekly teaching topics each year for their residency peers, linked to ambulatory curriculum topics. These curriculum supplements benefit the entire Internal Medicine residency program and faculty.

Track residents serve as program mentors on how to assess and address community determinants of health and well-being. Wherever their clinical site, track members are asked to mentor students, fellow colleagues, and faculty in how to assess for, address, and code community factors impacting health and well-being, to optimize healthcare delivery for everyone. At fall and spring residency town hall meetings, track members summarize community events, service initiatives and research for the full residency program.

Advocate

Track members consider political determinants of health and may participate in legislative work around health topics impacting our communities. Over the winter and spring during Connecticut’s Legislative Season, track members have the option to review several health-related bill proposals, engage in letter-writing or testify for community health topics. Ambitious track members may research and propose a bill of their own or as a group to the CT legislature. Prior track members met with an area non-profit group who helped us identify and understand high-priority health-related bills. One of the bills our track members promoted in support for Community Health Workers - successfully passed in the 2023 legislative session.

Learn

The track curriculum is underpinned by the above listed goals. Track residents actively contribute to curriculum development, with input from community members.

Time Commitment

Track monthly meetings are one evening a month which include community listening and service events, at mutually agreeable times with our community partners – generally one Tuesday every month. As noted above, all track members complete three community determinants of health-focused emails each year and one outreach project each year.

In Y blocks, one morning each of the 2 weeks is dedicated track time. This time may be spent with the mobile care van (Street Medicine program with Charter Oak or Care Under the Bridge), developing community health-related outreach projects, such as preparing to host a listening event or roundtable discussion, and scholarly work around the topic of community health for dissemination.

Track Certification

Each resident is asked to meet with the track director to ensure they are progressing within their program goals.

In summary, for certification of successful completion across three years, track members:

• Join the majority of monthly track meetings.
• Host/lead one community health-focused event annually, for the benefit of our surrounding communities. These may include roundtables, listening events, research, health and service events, or projects connecting community resources or with our wider residency program.
• Support and attend track colleagues’ community events.
• Contribute three teaching pieces annually to complement the ambulatory curriculum.

Members interested in pursuing certification at the Honors level in the track successfully complete all of the required pieces above each year, demonstrating at least 70% attendance, engagement, leadership, and mentorship within the track.

Members interested in pursuing certification at the Honors with Highest Distinction level in the track successfully complete all of the above required pieces, demonstrating consistent engagement, leadership, and mentorship within the track, PLUS:

Join the longitudinal Charter Oak Street Medicine program, or regularly complete Care Under the Bridge shifts with Hands on Hartford, or,

Ally with a community partner consistently over the course of three years on a sustained community health-focused project complementing that organization’s mission, or,

Publish on health-related topic in conjunction with community partners, or,

Participate in community health-related policy and/or legislative advocacy.  (Other significant related accomplishments not listed here will also be considered).

Additional Information

For more information regarding the Community Health Alliance Track within UConn’s Internal Medicine Residency Program, please contact the Community Health Alliance Track Director, Kirsten Ek, M.D., at ek@uchc.edu, or Track Chief, Dr. Lara Melo, at melosoarespinhodecarv@uchc.edu.