Primary Care Training and Enhancement -- Residency Training in Street Medicine - The University of Nevada, Reno (UNR) School of Medicine ASGME accredited Department of Family Medicine Residency Program has developed an evidence-based education and training program to equip medical residents with the skills to address social determinants of health while providing primary medical and behavioral healthcare to individuals experiencing homelessness. Through the UNR Street Medicine health professional curricula and remote clinical experience, UNR aims to expand and strengthen the Family Medicine Residency Program to meet the underserved medical needs of this vulnerable population while also providing training to health professionals, interdisciplinary teams, and residents across the continuum. The project works to address the lack of health care professionals providing services to the unhoused population and to ensure residents have the skills to provide services to at-risk and vulnerable populations. Curriculum will be expanded to deliver training in non-traditional settings such as shelters, encampments, and temporary housing. Expanding the program to include specialized clinical rotations and targeted educational content will better prepare residents to manage complex health conditions prevalent in the unhoused population. The program will establish clinical rotations, address the lack of robust didactic training content on the unhoused population, provide experiential learning and interdisciplinary training to address the gaps in existing education, training, and to meet the unmet need of primary care providers in the community, including increasing the number of providers with experience treating the unhoused. This program will also provide education on how to reduce the stigma and provide cultural competence in serving the unhoused for youth, adolescents, and adults in the targeted communities of Washoe County (urban) and Lyon County (rural), which are contiguous and designated as Health Professional Shortage Areas by the HRSA due to severe shortages in primary health care and mental health services. Targeting these areas with community organizations that serve the unhoused population, UNR will utilize a phased approach to expand and enhance the medical training curriculum and clinical experience specific to the care of individuals experiencing homelessness. UNR will also provide street medicine as an elective for other ACGME programs who have demonstrated an interest, including the UNR Department of Psychiatry who will work collaboratively to support education on behavioral health, serve as a referral source for psychiatry, as well as identify street medicine as an elective for Psychiatry residents and the Fellows enrolled in the new Addiction Fellowship program. These efforts will be done through community partnerships with organizations serving the homeless population. The outcome goals include increased trust between medical teams and unhoused individuals; improved patient adherence to treatment plans through culturally relevant care; reduction in healthcare disparities among homeless populations; enhanced medical resident confidence in providing equitable person-centered care; and increased number of family care trained residents in street medicine with the ability to bring care to individuals outside of traditional settings.
