Honors Program for Rural and Urban Underserved Medicine Program Guide

Honors Program in Rural and Urban Underserved Primary Care

UAMS College of Medicine

Program Director:

Leslie Stone, MD, MPH

Assistant Professor, Department of Family and Preventive Medicine

Director of Family Medicine Clerkship and Family Medicine Acting Internship

Administrative Director and Associate Program Director:

Joshua Baxter, JD, MBA

Education Coordinator, REP Grants Management and Research

Objectives:

Provide students a cutting-edge longitudinal educational and extracurricular experience in comprehensive medical care for underserved populations in both rural and urban underserved settings
Inspire student interest in a career practicing primary care in such communities in Arkansas
Foster a robust community of physicians, administrators, and students who are passionate about primary care in rural and urban underserved areas in Arkansas
Understand and master the HRSA Core Topic Areas (see Addendum, below)

Student Selection & Success:

This track will take a maximum of 20 students for each incoming class. Student applications, submitted via the Regional Programs website (see https://regionalcampuses.uams.edu/students/rural-and-underserved-honors-program/), will be due by the spring of students’ M1 year.

Entrance into this Honors Program will require a high level of student commitment and engagement, as well as faculty confidence in students’ likely success in completing the program. While in the program, each student will meet with a mentor three times per year, beginning the summer after their M1 year. Mentors will nurture student interest in a career in primary care and will serve as a personal and professional resource.

Overview of Schedule

The Honors Program in Underserved Rural and Urban Primary Care has both a standard and an accelerated track in order to accommodate those pursuing the three-year MD at UAMS’s Northwest Campus. Both tracks are diagramed on the following pages.

Standard Track

	Fall	Spring		Summer
M1	Apply for Program	Identify Longitudinal Project (LP)
		Continuity Clinic		Summer Preceptorship
		Identify Mentor		Meet with Mentor (1x)
				Read Core Texts
M2	Begin LP Literature Review			Complete LP Literature Review
	Extracurricular Activity	Extracurricular Activity
	Meet with Mentor (3x)
	Core Text Discussions (attend 2 of 3)
M3	Continue LP
	Join AHEC Scholars	Extracurricular Activity		Junior Clerkship in Family Medicine at a UAMS Regional Health Center/FQHC
	Meet with Mentor (3x)
M4	Complete LP		Present LP at IPE Student Research Day
	Extracurricular Activity		Extracurricular Activity
	Senior Elective
	Meet with Mentor (2x)

Accelerated Track

	Fall	Spring	Summer
Year 1	Apply for Program	Identify LP
		Continuity Clinic	Summer Preceptorship
		Identify Mentor	Meet with Mentor (1x)
			Read Core Texts
Year 2	Begin LP Literature Review		Complete LP Literature Review
	Join AHEC Scholars	Extracurricular Activity	Junior Clerkship in Family Medicine at a UAMS Regional Health Center/FQHC
	Meet with Mentor (3x)
	Core Text Discussions (attend 2 of 3)
Year 3	Complete LP	Present LP at IPE Student Research Day
	Extracurricular Activity	Extracurricular Activity
	Senior Elective
	Meet with Mentor (2x)

Description of Activities

Longitudinal Project
The Longitudinal Project (LP) is a core learning activity of our Honors Program. It serves as a shared curricular and extra-curricular foundation on which group discussion and undergraduate medical academic experience can be based. Each student is allowed to choose a topic of personal interest that pertains to underserved rural or urban primary care in Arkansas. Topic selected, they will undertake a literature review of this topic during their second year to contextualize and guide their individual research. The LP culminates in a presentation to their colleagues at IPE Student Research Day in the spring of their final year.
Mentors
Honors Program students will choose a physician mentor by the end of their first year of medical school. These mentors can, but do not have to be, employed with the UAMS system. The role of these mentors will be to provide personal feedback and professional guidance, nurturing students’ interest in a profession in primary care in underserved areas in our state.
Continuity Clinic
Beginning the spring of their first year, Honors Program students have the opportunity to shadow a community doctor in the Greater Metro Area (Standard)/Northwest Arkansas (Accelerated) for a half day per week, once a week. At an early period in their education, Honors Program students have a unique opportunity to observe and familiarize themselves with the actual, hands-on practice of primary care.
Summer Preceptorship
The Summer Preceptorship is a 2-4 week in-clinic experience that takes place the summer after students’ first year. The goal of this experience is to expose students early in their undergraduate medical career to underserved rural and/or urban healthcare. The student is encouraged to choose a clinic in any region throughout the state where they can shadow a physician and gain valuable experience observing the physician-patient relationship.
AHEC Scholars
Area Health Education Center (AHEC) Scholars is a national initiative engaging students from various health disciplines through clinical, didactic, and community-based activities. UAMS Regional Programs (also known as Arkansas AHEC) administers this program and facilitates student connections at the national AHEC level. As AHEC Scholars, Honors Program students will have the opportunity to attend the statewide Student Rural Health Summit, as well as national conferences such as the annual American Academy of Family Physicians Conference. Honors Program students will be walked through the process to join AHEC Scholars the first semester of their third (Standard)/second (Accelerated) year of medical school.
Extracurricular Activities
Beginning the second semester of their second year, Honors Program students will have the opportunity to participate in an extracurricular activity of their choice. Whether mentoring an undergraduate student in the HBCU SUPER Project; serving as a committee chair or club officer for student interest groups such as the Family Medicine Interest Group (FMIG) or Rural Medical Student Leadership Association (RMSLA); becoming a Student Ambassador and serving on one of the current workgroups or starting a new workgroup; or volunteering at a community clinic or not-for-profit, Honors Program students are encouraged to explore and refine their professional interests and passion for primary care.
Junior Clerkship
For their third-year Family Medicine rotations, Honors Program students will be given priority for placement over other College of Medicine students. They are encouraged to choose rotations in unique places throughout the state, leveraging our partnerships with Community Health Centers (CHCs) and Federally Qualified Health Centers (FQHCs).
Senior Elective
Every Honors Program student will be required to take one qualifying Senior Elective. Please see the Addendum, below, for a list of approved elective courses. Other related courses at the College of Medicine will also be considered and, if approved by the Program Director, will count toward the Senior Elective requirement.
Core Texts
During the summer between their first and second year of medical school, members of the Honors Program will be required to read two texts. The Program Director, Associate Program Director, and affiliated faculty view these as fundamental texts necessary for medical students and residents who aspire to live and work in historically underserved areas. For the Class of 2025, the two required texts are as follows:

Anne Fadiman, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (New York, NY: Farrar, Straus and Giroux), 2012.

Tracy Kidder, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World (New York, NY: Random House, Inc.), 2009.

During their second year of medical school, Honors Program students will be required to attend two of the three scheduled discussion sessions on these texts.

Estimated Time Requirements

Standard Track

M1 Year	Apply: 1 hr. Identify LP: 4 hrs. Continuity Clinic (8 weeks x 4 hrs per week): 32 hrs. Identify Mentor: 3 hours	40 hours
M1 Summer	Summer Preceptorship: 80 hrs. Meet with Mentor (1x): 0.5 hr. Read Core Texts*: 20 hrs.	100.5 hours
M2 Year	Begin LP Literature Review: 40 hrs. Extracurricular Activities: 20 hrs. Meet with Mentor (2x): 1 hrs. Core Text Discussions: 4 hrs.	65 hours
M2 Summer	Complete LP Literature Review: 40 hrs. Meet with Mentor (1x): 0.5 hr.	40.5 hours
M3 Year	Continue LP: 40 hrs. Join AHEC Scholars: 2 hrs. Extracurricular Activity: 10 hrs. Meet with Mentor (2x): 1 hr.	53 hours
M3 Summer	Continue LP: 40 hrs. Junior Clerkship in Family Medicine at a UAMS Regional Health Center/FQHC: 120^ hrs. Meet with Mentor (1x): 0.5 hr.	40.5^ hours
M4 Year^	Complete LP: 40 hrs. Present LP at IPE Research Day: 4 hrs. Extracurricular Activities: 20 hrs. Senior Elective: 120^ hrs. Meet with Mentor (2x): 1 hr.	65^ hours

*Hours to read the core texts were based on the reading rate of 30 pages per hour for texts, for a total of 600 pages of reading.

^It should be noted that the time requirements for both the Junior Clerkship in Family Medicine and the Senior Elective are shown in the individual activities section but are not calculated in the total since they are a required part of a student’s standard academic curriculum and counted within the required course credits for the third and fourth years of medical school.

Accelerated Track

Year 1	Apply: 1 hr. Identify LP: 4 hrs. Continuity Clinic (8 weeks x 4 hrs per week): 32 hrs. Identify Mentor: 3 hours	40 hours
Year 1 Summer	Summer Preceptorship: 80 hrs. Meet with Mentor (1x): 0.5 hr. Read Core Texts*: 20 hrs.	100.5 hours
Year 2	Begin LP Literature Review: 40 hrs. Join AHEC Scholars: 2 hrs. Extracurricular Activity: 10 hrs. Meet with Mentor (2x): 1 hrs. Core Text Discussions: 4 hrs.	57 hours
Year 2 Summer	Complete LP Literature Review: 40 hrs. Continue LP: 40 hrs. Junior Clerkship in Family Medicine at AHEC Regional Center/FQHC: 120^ hrs. Meet with Mentor (1x): 0.5 hr.	80.5^ hours
Year 3^	Complete LP: 80 hrs. Present LP at IPE Research Day: 4 hrs. Extracurricular Activities: 20 hrs. Senior Elective: 120^ hrs. Meet with Mentor (2x): 1 hr.	105^ hours

*Hours to read the core texts were based on the reading rate of 30 pages per hour for non-academic texts, for a total of 600 pages of reading.

Addendum

Qualifying Senior Electives

COMC 8424: Culinary Medicine

COMC 8425: Culinary Medicine II

EMER 8412: Pediatric Emergency Medicine

EMER 8413: Intensive Emergency Medicine

FMED 8402: Rural Primary Care

FMED 8420: Family Medicine Elective

FMED 8440: Acting Internship – Family Medicine

FMED 8441: Private Family Practice

FMED 8447: Family Medicine Primary Care

FMED 8448: Intensive Acting Internship in Family Medicine

FMED 8449: AHEC Scholars Elective

INTM 8403: Internal Medicine

INTM 8421: Acting Internship – Internal Medicine

INTM 8425: Internal Medicine Primary Care

INTM 8426: Complementary and Alternative Medicine

OBGN 8404: Rural Obstetrics and Gynecology

OBGN 8423: Distant Health and Telemedicine

OBGN 8424: Acting Internship – Obstetrics

OBGN 8425: Intensive Acting Internship – Obstetrics

PEDI 8415: Pediatric Primary Care

Please note that this list is not exhaustive and, with approval of the Program Director, another course may be taken to fulfill the Senior Elective requirement.

HRSA Core Topic Areas

The Health Resources and Services Administration (HRSA) is the federal funding agency that sponsors and guides the national AHEC Scholars program, which is part of the Honors Program. Upon completion of the Honors Program in Underserved Rural and Urban Primary Care Medicine, students will be able to demonstrate enhanced skills and proficiency in the following HRSA Core Topic Areas:

Quadruple Aim
Population Health
Social Determinants of Health
Practice Transformation
Behavioral Health Integration
Interprofessional Education and Practice
Cultural Competency
Current and Emerging Health Topics

The HRSA core topic areas will be reviewed and thoroughly discussed during each year of the program. The following is a breakdown of these topic areas as addressed during each year of the Honors Program.

Year 1: Preceptorship in a Rural or Urban Underserved Clinic

Students will distinguish the responsibilities of rural and/or urban underserved clinicians and health care systems in optimizing health outcomes with available resources, as related to the Quadruple Aim for population health.
Students will identify population-level interventions designed to improve overall health and reduce costs of care.
Students will be able to define the core topics list in the Main Objectives.
Students will be able to define essential terms in the concept of rural, urban, and underserved.
Students will be able to distinguish between underserved populations in both rural and urban environments.
Students will be able to list the elements that define social determinants of health.

Year 2: Literature Review

Students will define key concepts of health care quality improvement and discuss common challenges that rural and/or urban underserved healthcare systems are currently facing.
Students will identify a health care quality improvement project, as an element of their Longitudinal Project.
Students will identify strategies for overcoming resistance to change and for working within an interprofessional team.

Year 3: Junior Clerkship in Family Medicine and Longitudinal Projects

Students will examine the unique conditions that affect the patient-provider relationship in rural and/or urban underserved environments.
Students will be able to identify four skills that are critical to improving clinical interactions with patients.
If applicable and available, students will review site-specific or network-wide data related to their longitudinal project and incorporate the findings into their final presentations.

Year 4: Senior Elective and Submission and Presentation of the Longitudinal Project

Students will identify examples of current and emerging health topics and how policies are formed or influenced by the public knowledge, attitudes, culture, and politics surrounding those current health topics.
Students will be able to explain how the HRSA Core Topic Areas informed and were informed by their Longitudinal Projects.
Students will be able to summarize their experience as an Honors Program student and explain how their participation in the program contributed to their understanding of the HRSA Core Topic Areas.