Montefiore Residency Program in Social Medicine

The Montefiore Residency Program in Social Medicine (RPSM) is one of the oldest primary care training programs in the United States. It is located in Bronx, New York which contains some of the poorest urban districts in the United States. It is managed by the Montefiore Department of Family and Social Medicine and offers training in 3 primary care specialities: internal medicine, family medicine and pediatrics. It has trained over 700 physicians in primary care with a focus on medically underserved populations.

History

The program was founded in 1970 by Drs. Harold Wise and David Kindig. In 1973 family practice was added as a third track. Residents worked in partnerships and maintained their continuity practices at the Dr. Martin Luther King, Jr. Health Center (MLK), which Dr. Wise had begun in 1968. The RSPM was their response to the difficulty of recruiting physicians to MLK who could work effectively with the community and other members of the health care team. At the time MLK was the flagship of the neighborhood health center movement of the Office of Economic Opportunity, the main federal agency coordinating Lyndon Johnson's War on Poverty.

In 1973 Dr. Jo Ivey Boufford, one of the RPSM’s first pediatric graduates, became the director of the RPSM and began developing the social medicine curriculum which all three disciplines shared. This included health systems skills, such as medical care organization and economics; community and organizational skills, such as medical anthropology, Spanish and community-based projects; research and evaluation skills, such as epidemiology, biostatistics, and health services research; and educational and teaching skills, including patient education and curriculum development.

In 1977 the family practice track moved its continuity practice from MLK to North Central Bronx Hospital and in 1980 the Montefiore Family Health Center (FHC) was opened and became the primary site for residency training and faculty practice in family medicine. Because of MLK’s fiscal problems, the pediatrics and internal medicine tracks moved to St. Barnabas Hospital in 1986. In 1990 several independent community health centers affiliated with MMC were organized into the Montefiore Ambulatory Care Network (MACN) under Dr. Robery Massad. In 1991 pediatrics and internal medicine moved to MACN, now divided between the Comprehensive Health Care Center (CHCC) in the South Bronx and the Comprehensive Family Care Center (CFCC) in the East Bronx. In 1997, when CHCC moved into a newly constructed facility, the social internal medicine and pediatrics tracks were again consolidated there. CHCC, CFCC, and FHC are all federally qualified health centers.

In 1992 the Department of Family Medicine at Montefiore, which administers the RPSM, became a full academic department at Albert Einstein College of Medicine with a Division of Research, a required third year clerkship for medical students, and its first geographic inpatient ward on Rosenthal D. Dr. Massad became the first Unified Chairman of Family Medicine at AECOM with affiliated residencies at Bronx-Lebanon Hospital Center. In 1993 Dr. Massad received national recognition awards from both the National Association of Community Health Centers and the Society of Teachers of Family Medicine. In 1995 the RPSM itself became the first organization to receive the National Primary Care Achievement Award in Education from the Pew Charitable Trust. In 1996 MACN was merged with the older Montefiore Medical Group and a former RPSM graduate, Dr. Kathryn Anastos, was recruited as its first Medical Director. Family practice residents began work at Castle Hill and Valentine Lane Family Practices, where medical students had been rotating since 1993. In 1998 Dr. Massad was succeeded by another RPSM graduate, Dr. Peter Selwyn, as Chair of the Department of Family Medicine and Community Health. Dr. Selwyn extended the Research Division and initiated a Palliative Care Service, including in-patient hospice beds.

In 2000 the Valentine Lane Family Practice was transferred to the St. John’s Riverside Hospital System in Yonkers, and half of the family practice residency moved to the Williamsbridge Family Practice. In 2001 member of the department established the first Hispanic Center of Excellence in New York State at the medical school. In 2003 the department established the Bronx Center to Reduce and Eliminate Ethnic and Racial Health Disparities, the first and only such NIH Center of Excellence in a department of family medicine. After the AECOM Department of Epidemiology and Social Medicine became the Department of Epidemiology and Population Health in 2004, the residency program was housed under the Department of Family and Social Medicine in 2005.

Notable alumni

• Jo Ivey Boufford - One of the first directors of the RPSM and currently president of the New York Academy of Medicine
• David Kindig - Emeritus Professor of Population Health Sciences and Emeritus Vice-Chancellor for Health Sciences at the University of Wisconsin-Madison, School of Medicine and Public Health
• Denise Rodgers - Vice chancellor for inter-professional programs at Rutgers University
• Camara Jones - Family physician and epidemiologist who works on the impact of racism on the health
• Steven Sayfer - CEO of the Montefiore Health System

References

• Brief History of the Residency Program in Social Medicine and the DFSM
• The residency program in social medicine of Montefiore Medical Center: 37 years of mission-driven, interdisciplinary training in primary care, population health, and social medicine. Strelnick AH, Swiderski D, Fornari A, Gorski V, Korin E, Ozuah P, Townsend JM, Selwyn PA. Acad Med. 2008 Apr;83(4):378-89

External links

• Montefiore Primary Care & Social Internal Medicine Residency Program
• Montefiore Family Medicine Residency Program
• Montefiore Social Pediatric Residency Program