Institution Name: Dept. of Family & Community Medicine, University of Arizona Project Director: Ronald Pust MD, Professor and Predoctoral Program Director Address of Project Director: 1450 N. Cherry Ave. Tucson, Arizona 85719 Email, Telephone, and FAX of Project Director: rpust@u.arizona.edu 520 626-7822 Fax 520 626-6134 Disciplines Involved in the Proposal: Family Medicine The College of Medicine at the University of Arizona, based in Tucson, is expanding—along with Arizona’s population-- to welcome a new curriculum, new and diverse communities and an entirely new, Phoenix-based campus. Enrollment will increase from the present 464 medical students to 536 by the end of the project. Plans are to increase to 1040 students over the next 10 years. Arizona’s population, now growing faster than any other state, increased by over 60% from 1990 to 2006, to 6,166,318 [US Census Bureau]. Yet Arizona [at $20,275] remains below the USA average in per capita income--and above average in persons [14%] in poverty, in foreign-born [13%] and in household use of language other than English [26%]. Both rural and urban medically-underserved include many Arizonans in our two largest minorities, Hispanic [28%] and Native American [5%]. Arizona is also the state with the highest proportion (24%) without healthcare coverage. Our disabled persons [20%] often have difficulty accessing health care. Despite our Department’s innovative development of the College’s programs addressing underserved, [including the CUP program, commended in the LCME letter], Arizona’s burgeoning and diverse population presents us with challenges in meeting the goals of Health People 2010 and other Federal and State benchmarks and program initiatives. Our goal in this project is to leverage these changing opportunities into a prominent presence for primary care and family medicine: in the new ArizonaMed curriculum; in caring for new immigrant and underserved communities; and in primary care capacity-building leadership at the Phoenix campus. Each of our three objectives will build on our Department’s leadership in major and distinct areas of medical education aimed at reducing primary care physician shortages in Arizona, especially among its diverse underserved populations: Objective A is focused on the new and evolving required curriculum; Objective B on the elective curriculum, directed at 3 underserved, cross-cultural populations; Objective C is aimed at Arizona’s severe physician shortage by expanding physician output in primary care, especially from the new Phoenix campus. Objectives and Methodology: To accomplish this project goal, we have three interrelated objectives: Objective A: NEW CURRICULUM—ArizonaMed Building on our family medicine faculty’s prominent role in the clinical skill mentoring “Societies” and in the “Lifecycle” block in Years I and II of the College’s new ArizonaMed required curriculum, our faculty will: A-1 Design and present 9 one-hour monthly faculty-development seminars, aiming to strengthen the teaching of primary care / professionalism value “threads” in the Years I & II Societies curriculum. A-2: Develop and teach 12 didactic clerkship hours of “Clinical Prevention across the Lifecycle,” partnering with the Pediatrics clerkship. Collaborating with our Deans’ Offices and community agencies and building on our Department faculty’s cross- cultural diversity and community medicine experience, we will introduce a longitudinal service-learning elective program with 3 parallel tracks, each working with a “new community” in Arizona—and disseminate these program designs beyond Arizona. These communities and our pertinent faculty are: B-1: Refugees and Immigrant Communities: Directed by Dan Casto MD and Tracy Carroll MPH, PT. B-2: Native American and Border Communities: Directed by Carlos Gonzales MD and T. Carroll MPH. B-3: Global Community Medicine--Bringing skills home: Directed by Ron Pust MD and T. Carroll MPH. Each of these 3 parallel elective tracks will feature 8 noon-hour Year I cross-cultural and clinical orientation topics specific to these diverse populations, followed by selection of ~4 students for each track for a 4 week community externship in June after Year I and a clinical capstone Preceptorship in Year IV. Objective C: NEW CAMPUS IN PHOENIX—MORE PRIMARY CARE DOCTORS FOR A GROWING ARIZONA Family medicine faculty will select, develop and sustain new Year III and IV training sites in the Phoenix area, primarily among medically-underserved, in order to promote careers in such communities by an increasing proportion of the growing number of students at the Phoenix campus. We will: C-1: Select and develop 8 new family medicine clerkship sites in inner-city or minority communities. C-2: Design 6 Year IV sub-internship sites to attract students to family practice via ArizonaMed’s new sub- internship requirement. C-3: Develop 4 electives for Year IV students in Phoenix clinical settings on the topics of: Cross-Cultural Geriatrics, Primary Care of AIDS Patients, Applied Public Health, Socioeconomics and Health. Resolution of Challenges: While we can anticipate a few specific challenges, which we document in the narrative, our experienced faculty, long aligned with HRSA program goals, and in influential administrative and daily teaching roles in the new curriculum, foresees achievement of each of our 3 major objectives. Outcomes Measurement and Dissemination: Objectives A, B, and C each list additional evaluation methods specific to its activities. Project outcomes and “products” will be disseminated through national meeting presentations, manuscripts, and modules for other medical schools to download from our website www.fcm.arizona.edu. Because of our enduring record of innovative programs and our unique opportunities in a diverse Arizona to address several national medical education issues and needs, we look forward to collegially sharing the outcomes of this proposed project. Evaluation and Technical Support Capacity: In our College of Medicine—mainly in our FCM Department— we have a core group of faculty and staff that has been involved in evaluation, developed a 25 year student database, and produced a sustained record of published educational research [See reference section]. These evaluation activities have been sustained over years by an experienced faculty and staff team. The team is now supported by a recently upgraded Departmental in-house I.T. staff with new technical capabilities and a new emphasis on research. These new technical capabilities are at our service for educational creativity and quantitative evaluation as well.