Incorporating Community-Academic Partnerships into Graduate Medical Education
Progress in Community Health Partnerships Research Education and Action
O ur nation's health is challenged by the persistence of heath disparities, lack of universal health insurance, and increasing poverty rates. There is an unprecedented contrast between the sophisticated technology used to treat strictly "medical" conditions and the tools needed to treat problems such as obesity, substance abuse, and domestic violence, which are deeply rooted in social conditions. 1 Even when the knowledge base exists regarding how to treat these conditions, a gap exists in how
... gap exists in how these services are translated to the individual patient and communities as a whole. This gap is being addressed in a number of ways. Accrediting bodies at the undergraduate and graduate levels now require that community health and cultural competency be incorporated into training. Recently, the Liaison Committee on Medical Education recommended that "medical schools should make available sufficient opportunities for medical students to participate in service-learning activities." 2 In support of such training initiatives, federal agencies and private foundations have been promoting translational research, service learning, community-based participatory research (CBPR), and community-engaged scholarship in the health care professions. Despite these efforts, training still occurs mostly within hospital walls. Furthermore, many academic institutions remain resistant to viewing community-based education, research, and service as a credible and valid way to address the issues at hand. Community-academic partnerships, for the most part, stem from either individual, passionate leaders or the political need of a particular institution rather than being universally held as an integral part of the mission of an academic medical center. In this issue of the Progress in Community Health Partnerships, we can learn from two successful initiatives geared toward creating a health care work force that can effectively combine knowledge with action to achieve social change to improve health outcomes and eliminate health disparities. 3 Doctor Earnestine Willis and her colleagues describe a successful, sustainable, integrated program for pediatric residents where the community has active participation in the design, implementation, and evaluation of the pediatric training program. 4 The tension between creating community projects that meet the self-identified needs of the community and the outside perceived needs of the academic institution seems to be resolved. Both community and university members learn from each other's culture; the learning is reciprocal.