Primary Care Training and Enhancement -- Residency Training in Street Medicine - Methodist Hospital in Sacramento proposes to implement the Primary Care Training Enhancement in Street Medicine (Methodist PCTE-SM) project within its ACGME accredited and award-winning Family Medicine Residency Program (FMRP) in Sacramento. The population of chronically homeless people in Sacramento is the third largest in the nation - trailing only behind Los Angeles, California and New York City. The Methodist PCTE-SM project proposes to enhance resident training in providing comprehensive, trauma-informed care to individuals experiencing homelessness, including those with histories of interpersonal violence and human trafficking. This project addresses the critical need for primary care physicians equipped to meet the complex medical, behavioral health, and social needs of this vulnerable population. Methodist PCTE-SM will expand an existing partnership between the FMRP, Community Against Sexual Harm (CASH), City of Refuge, and the Family Justice Center (FJC) to create an integrated care model that combines didactic, workshop, and experiential learning in street medicine. Residents will participate in a longitudinal curriculum and dedicated rotations, working alongside interprofessional teams to provide primary care, address social determinants of health (SDoH), and connect individuals with essential resources in community settings. Learning objectives include developing proficiency in building rapport with marginalized populations, performing physical exams in challenging environments, navigating complex social service systems, advocating for patients' needs, and understanding the social determinants of health that contribute to homelessness and health disparities. The curriculum will emphasize chronic disease management, mental health and substance use disorder treatment (including medication-assisted treatment), trauma-informed care, and cultural competency and will train 8 new residents annually. Specific outcomes include: (1) enhanced resident knowledge, skills, and confidence in providing street medicine; (2) stronger partnerships with community organizations; (3) increased resident awareness of the impact of chronic conditions, mental illness, substance use, and SDoH on the unhoused; (4) integration of a sustainable street medicine program within the FMRP; and (5) improved access to primary care services for unhoused individuals in Sacramento. Methodist PCTE-SM will disseminate findings through conference presentations, publications, and online sharing of curriculum materials and, if successful, will seek to sustain this program for the long term and to replicate the curriculum and the model at Medical Safe Haven clinics throughout the state - in Redding, Santa Maria, and Northridge - and a new site in Gilbert, Arizona. Methodist Hospital's Graduate Medical Education Program qualifies for funding preference based on its placement rates for graduates in practice settings that primarily focus on serving residents of Medically Underserved Communities (MUCs).
