Montefiore Receives AMA Grant for Residency Training

The American Medical Association’s new Reimagining Residency initiative has selected Montefiore Health System’s (MHS) residency programs in family medicine, internal medicine, pediatrics, and obstetrics &gynecology and women’s health to receive a grant totaling $1.8 million over five years.

The AMA grant will support residency training in family medicine, internal medicine, obstetrics & gynecology and women’s health, and pediatrics

The AMA chose 11 projects to support from among more than 250 proposals submitted by institutions and organizations across the United States., Grant recipients included Montefiore, Partners HealthCare, Johns Hopkins, Stanford, University of North Carolina, Vanderbilt, University of California at Davis/Oregon Health & Science University, New York University, Penn State, Association of Professors of Gynecology and Obstetrics, and Maine Medical Center.

During the five-year grant period, through its winning initiative — “Residency Training to Effectively Address Social Determinants of Health: Applying a Curricular Framework Across Four Primary Care Specialties”— Montefiore will develop, implement, and evaluate the multi-pronged curriculum.

“At Montefiore, our training programs are highly focused on social determinants of health,” noted Dr. Anna Flattau, the primary grant writer. “This is our lifeblood and has been for many decades.”

What are social determinants of health? “They are the economic and social barriers that come between people and good healthcare,” explained Dr. Catherine Skae, principal investigator of the grant and vice president for graduate medical education. “Here in the Bronx, when we ask people about their issues, at the top of the list are things like housing, transportation, and food insecurity.”

Reaching a Broad Range of Physicians

Among the 10 largest medical and surgical training programs in the country, Montefiore provides postgraduate clinical training to more than 1,400 residents across 106 accredited residency and fellowship programs.

“By instituting a curriculum over these four areas of residency, we’ll reach hundreds of doctors in a short period of time,” said Dr. Skae, who also is associate professor of pediatrics.

Awareness of social determinants of health will grow not only in the residents—approximately 15 percent of whom are Einstein graduates—but to Einstein students in clerkships at Montefiore as they rotate through the specialties. “Everyone needs these skills,” said Dr. Flattau, also an associate professor and vice chair for clinical services in the department of family and social medicine.

Next steps include training faculty members to deliver the message to residents and medical students, and developing a way to measure their effects. “We’ll look at well-being tools, performance indicators, and people’s wellness over time,” noted Dr. Skae.

Ultimately, “within five years the AMA wants to disseminate our findings across the country. Training residents to consider and act upon social determinants of health will shape the future of resident training here and elsewhere.”

The AMA also put Drs. Skae, Flattau, and Gorski in touch with a physician who wants to create ICD (international classification of diseases) codes for social determinants of health so they can become a part of billing and coding.

Pursuing the grant was a group effort, with involvement across institutions and programs and support for data-driven aspects provided by Montefiore’s office of community and population health. “It’s a characteristic of Montefiore and Einstein that we form strong partnerships, and it’s important to honor the collaboration that led to the grant,” said Dr. Flattau.

Dr. Todd Cassese, assistant dean for clinical sciences education, praised Dr. Victoria Gorski, assistant professor of family and social medicine, who also was an author of the grant. “She has championed social determinants of health education, and education more broadly at Einstein and beyond.”

The collaboration will continue as the program’s steering committee invites community members to join and contribute feedback over the five years.

The AMA Reimagining Residency initiative builds on the work of the AMA Accelerating Change in Medical Education initiative, launched in 2013 to create the medical schools of the future. Their effort addresses the growing gap between how physicians are trained and the skills they will need to practice in modern health systems.

The association aims to drive the future of medicine by reimagining medical education, training, and lifelong learning to assure that physicians will be ready to provide care in the rapidly evolving healthcare environment. To view the complete list of innovation projects that received AMA Reimagining Residency grants, visit www.changeresed.org.

Posted on: Tuesday, February 18, 2020

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