Vision

At the South Park Inn Medical Clinic (SPIMC), students gain early clinical exposure to the challenges of caring for the underserved in a no-pressure atmosphere where the students are not being evaluated. Students are exposed to multiple clinical approaches by rotating supervising physicians, who are unrushed during bedside teaching where there is an emphasis on clinical exam. First year students are given the necessary time to perform basic H+Ps, and complete at least one per night. Senior medical students can develop leadership skills by becoming clinic managers or by serving on the clinic’s board. Senior medical students supervise junior students and develop teaching skills by educating shelter residents on health topics each month. Fund-raising, particularly the annual road race, and collecting medications during the annual drug drive, are every student’s responsibility. Participation helps the student keep a clear perspective on what is truly important in life during the turmoil of medical school.

Shelter residents receive free, walk-up health care that allows sufficient time and attention to their concerns. Medications are provided at no cost and referrals for diagnostic testing or long term care for chronic disease are made. The Charter Oak Clinic, which provides free services to homeless patients that are referred to them, is the primary referral center of the SPIMC. The Brownstone, Burgdorf, and St. Francis clinics are also utilized if patients have a PCP there. Counseling for substance use and HIV is crucial for this high risk population and is addressed at every visit. Preventative screening is offered to all appropriate patients in the clinic or is available by referral. The health care of residents extends beyond the exam room through monthly screening and educational initiatives.

The Hartford Tuberculosis Task Force is a local governmental agency responsible for TB screening, identifying PPD converters, and ensuring follow-up and compliance with anti-tuberculous medication. SPIMC will work with this group and other shelters in Hartford to identify SPI residents who have not been screened in the past year.

The University of Connecticut School of Medicine is the sponsoring institution for the medical student group that is SPIMC. SPIMC is an organization under the Dean of Students and Student Activities office, and has a faculty advisor. The educational experience a student receives at the clinic helps attain the goals of a medical education at UConn. The school provides guidance, a pool of physicians, and malpractice coverage for volunteering physicians.

Ten Specific, Easily Attainable Goals (within a year):

1. Operations or New Referral position will investigate transportation vouchers to referring clinics.
2. Manager education will create a way for managers to remember to remind students to check on PPD status, preventative healthcare (breast/rectal/hemocult), and substance use. Need to refer for gyn services/colonoscopy.
3. Operations will create a single waiver form to be signed by all patients that gives permission to speak with referring agencies, receive follow-up from those agencies, and communicate with SPI staff if a patient needs to take medication or has a follow-up appointment.
4. Create a system whereby the social worker or staff at SPI know when a patient has a referral appointment in order to maximize the probability that he gets there. New Referral position in conjunction with Operations and Manager Education.
5. Operations will install glove dispensers on the walls.
6. New Referral position needs to investigate arrangements for colonoscopy, gyn services at the WAHS, COC, etc. and have either formal referral or hand out cards for pts to self-refer to these services.
7. Student scheduling will know who speaks decent Spanish and will attempt to schedule one Spanish speaker at each clinic night.
8. Physician volunteers will work with MDs to ensure more physical exam/clinical findings teaching occurs. Also an end of the night wrap up session expounding on an earlier teaching point or disease will occur.
9. Student Volunteers will coordinate a tour of SPI (not just the clinic) with SPI staff for all new student volunteers.
10. Resident Education to continue as present, but with more screening initiatives including FSBS, HTN, substance use, HIV-Hepatitis risk factors, etc.

Larger Projects/Longer Term:

1. New Referral Position to ensure that our pts are getting care they need at referral centers. Possibly a few of same MDs seeing our pts at COC? Feasibility?
2. More space. Currently space is limiting # patients we can see a night and hinders the ability to provide preventative screening/ substance counseling/ full H+Ps by 1st years. Privacy is an issue also. Informal conversations with SPI indicate we will not get more room from them as they are in a space crunch. Investigate ways to make space we have more efficient. Increase # nights to see pts or increase 3 hours a night? Search for alternate (very close to SPI) location?
3. Women’s health night? With Gyn capabilities, paps, STD screening. Needs space and support (financial and logistical) to have paps and GC/Chlam Cx or recombinant tests read.
4. Coordiante PPD placing with Hartford TB people and other shelters. Each night cross reference all residents in SPI with an area list of last known PPD and status. Investigate the possibility of having an on-line list (security/privacy?) or some type of frequently updated list to be shared between all shelters to improve TB screening and avoid reduplication of PPD placement.
5. Merge migrant farm workers clinic (MFWC) into SPIMC. Similar goals and patient populations (primarily adult males). Significant Overlap between students volunteering, physicians volunteering, pharmacy needs. MD/Stud Vols, drug drive could be combined with retention of the MFW summer positions as functioning in the MFW Operations capacity. Eliminate redundancy and schedule conflicts.
6. Increased medical research of the populations we serve. Computer database will be an asset in this as will referral follow-up.
7. Sox and shoes for diabetics. Books for kids. Tooth brushes. Gifts for kids and Christmas?
8. Language Line Capability? Economic Feasibility? Necessity?