• Article
  • April 12, 2017

Community Health Spotlight: Starting Care in the Community

How one medical school is preparing future doctors for a focus in population health

Population health will be integral to the future of medicine. Physicians and educators at the University of South Carolina School of Medicine Greenville had that mindset as they prepared to launch a new medical school in 2012. 

In order to get students thinking about the community they’ll serve from day one, the first step for medical students at USC Greenville is to complete their certification as emergency medical technicians (EMT). They do this before ever stepping foot in the classroom. Once certified as an EMT students begin going out on call, with a requirement of serving 12 hours per month throughout their med school program. 

“It’s a very powerful experience for a variety of reasons,” says Desmond Kelly, MD vice chair for academics and community affairs at Greenville Health System Children’s Hospital. “The philosophy in designing the course was that you need to know where your patients are coming from and to appreciate some of the realities and hurdles facing their lives."

In addition, this program gives the students important opportunities to work as members of interprofessional health teams and learn how to respond under pressure, from the start. They also gain the practical skills needed to respond in an emergency situation, something Kelly said he definitely didn’t acquire that early in his own medical education. USC Greenville was the first medical school in the country to incorporate this into their curriculum. 

Community health and population health are embedded throughout the medical school curriculum in Greenville, with the EMT training just one part of it. Didactic sessions complement the practical EMT experience with discussions in the first year about how national policy can influence provider response to managing populations. As students learn the basic medical sciences and about disease processes and management they hear from panels of patients about their personal experience with illness and the impact on their family and community. In the second and third years they explore the implications of population health outcomes on financial payment models and discuss the challenges of managing a population panel in a complex socio-economic environment. In the fourth year the earlier material is used to inform delivery of “boot camp” - a two week, case-based and didactic experience with the entire class.

Kelly reports that the students are responding positively to the opportunity. 

“Getting to hear the wonder of the students who are going into homes that are filled with circumstances and risk factors, it’s very telling for them,” Kelly explains.  

One student shared that perspective in a post on the medical school blog, writing: 

"The sadness of the social situations pervaded the day more than the impacts of the illness…  In all these situations, I felt the need to pause and consider where all of these people came from and how their stories brought them to a need for medical attention.  I have not faced such suffering or known such desperation."

To learn more, visit USC Greenville School of Medicine.

This is the first in a new series of articles spotlighting aspects of member hospital’s work in community health. If you have a story you’d like to submit for consideration, contact Stacy Biddinger.