Primary Care Training and Enhancement -- Residency Training in Street Medicine - Project Abstract Charles R. Drew University of Medicine and Science (CDU) proposes the Street Medicine Advance Residency Training (SMART) program, which aims to expand its Family Medicine and Internal Medicine Residency Programs by integrating structured training in street-based medicine, preparing residents to provide high-quality, interdisciplinary care for people experiencing homelessness (PEH) in non-traditional healthcare settings. The SMART program aligns with HRSA’s Notice of Funding Opportunity (NOFO) goal of increasing the number of primary care physicians trained to provide healthcare outside of traditional clinical environments. It directly addresses the three NOFO program objectives: 1) Developing and enhancing training, clinical rotations, and didactic curricula to prepare residents in street medicine to provide comprehensive, sensitive care for PEH, including mental health and substance use disorder (SUD) treatment; 2) Increasing residents’ knowledge and skills to meet the unique needs of PEH, including navigating medical, behavioral health, legal, and social support systems; and strengthening residents’ ability to work in interprofessional teams, incorporating chronic disease management, mental health, substance use, and medical-legal collaboration to address the social determinants of health (SDoH) that impact patient care. Proposed program components: Family Medicine Residency Program The program will 1. Expand six clinical rotations for PGY1, PGY2, and PGY3 residents by increasing experiential learning hours through CDU’s Mobile Health Outreach Project (MoHOP) and the Department of Health Services (DHS) Street Medicine Team (SMT). 2. Develop and integrate a structured didactic curriculum, incorporating the AAFP Street Medicine Outreach Course and a longitudinal instructional series focused on patient-centered care, behavioral health management, harm reduction, and social determinants of health. 3. Establish a street medicine elective for Family Medicine and Internal Medicine PGY2 and PGY3 residents, providing hands-on training in mobile and street-based healthcare settings. 4. Create a Street and Academic Medicine Interest Track, equipping PGY2 and PGY3 residents with specialized expertise in interdisciplinary care, quality improvement projects, and scholarly activities. Internal Medicine Residency Program The Internal Medicine Residency Program will introduce a new elective for PGY2 and PGY3 residents, integrating both online coursework and on-the-ground training in street medicine. Residents will train directly in street medicine through: • The DHS Street Medicine Team (SMT), delivering care in encampments, shelters, and other non-traditional locations. • CDU’s Mobile Health Outreach Project (MoHOP), a mobile clinic providing primary care, wound care, chronic disease management, behavioral health support, and harm reduction services in Service Planning Areas (SPA) 4 and 6. Key Initiatives The SMART program is structured around three key initiatives: • Enhancing Family Medicine residency training by expanding experiential learning, implementing structured didactic coursework, and developing a street medicine elective. • Establishing a Street and Academic Medicine Interest Track for Family Medicine PGY2 and PGY3 residents to develop specialized expertise in caring for PEH. • Implementing a street medicine elective for Internal Medicine PGY2 and PGY3 residents, expanding their exposure to non-traditional care settings. CDU, founded to address the critical need for more medical professionals in physician-shortage areas, is a private, nonprofit medical and health sciences institution committed to strengthening the national healthcare workforce. CDU qualifies for funding preference, as documented evidence shows that over the last four graduating classes, 24 of the 36 graduates (66.7%) have entered practice settings primarily serving MUCs.
