Social Medicine and Advocacy Residency Training = SMART



The ability to skillfully address patients’ medical and social needs is critical to improving health outcomes. The goals of establishing this specific track with a focus on the social determinants of health is to support family medicine physicians to excel as community health leaders through commitment to social justice and community service.



“The AAFP supports the assertion that physicians need to know how to identify and address social determinants of health in order to be successful in promoting good health outcomes for individuals and populations…Physicians in training must develop awareness of the potential obstacles patients confront when following treatment plans.”


Residents in this training track learn how to screen for challenging social issues that impact health and healthcare access.Trainees work closely with experienced social services personnel to learn about resources in the community to help address these problems once they are identified.



Medical Students

A start-up goal of SMART is to graduate two residents annually through the program starting in 2019. To reach that midstream goal, we will be enrolling two second-year residents in 2017 and continue to bring in two dedicated residents each year. This requires an upstream conduit of medical students with an interest in social medicine and in serving vulnerable populations and will include local University of Kansas medical students.

The JayDoc Free Clinic is a medical student run free clinic operating out of the Family Health Care site three evenings each week. Student interest in social medicine at the University of Kansas is high. Eighty to ninety percent of the medical student body volunteer their evenings at JayDoc. Almost every year for the past thirteen years, the three executive directors have not only chosen a primary care specialty, but have chosen placements in residencies with a focus on social medicine. (There are only a handful in the country.) Four (about 1/10th) have returned to the Kansas City area, but about half of residents who attend a residency with an emphasis in social medicine go on to work in charity health care and about half of residents stay to work in the area near their residency training site. The downstream goal is to develop providers with a strong interest in continuing service to the vulnerable populations in our community.


Family Medicine Green Team

Family Medicine Orange Team

Dr. Tina Garcia

Dr. Turner Fishpaw 

Dr. Sofia Ligard

Dr. Rommel Asagwara 



Schedule of weekly topics, faculty-

 Wednesday post-CORE 4:00-4:30 PM 




Social Medicine and Advocacy Residency Training Program

This clinic site will develop into a training program that will include educational, clinical, and research activities added to regular Family Medicine curriculum. The goals of establishing this future program with a focus on the social determinants of health is to support family medicine physicians to excel as community health leaders through commitment to social justice and community service and to:

  • Develop an abiding interest in the identification and analysis of social and environmental factors that influence health in the communities served.

  • Formulate plans to mitigate the effects of social determinants of health through utilization and development of community resources.

  • Employ strategies to act through advocacy as well as direct services to improve the health of the families and communities served.

  • Initiate and support change of policies, regulations, legislation and other assessed barriers to improve the health of the public.

  • Apply innovative and evidence-based practices in the service of the health of the community.

    Educational Component

  • A weekly didactic/discussion session for SMART residents focuses on pertinent topics.

  • Participation in regular educational activities includes weekly Wednesday afternoon required family medicine residency Core didactic and interactive workshops. (SMART residents present topics on social determinants of health at CORE twice annually.)

Clinical Component

  • Clinical experience includes 4 clinic sessions weekly in the community care clinic (Family Health Care) by the third year.

  • Clinical experience includes work with medical students in the JayDoc Free Clinic, a medical student run clinic which operates three nights a week at Family Health Care’s clinic site.

Research Component

  • A clinical or community research project is completed by the SMART group and presented at the Research Forum at the end of the second year. Faculty mentors assist residents with hypothesis generation, literature searches, project design, the iterative Human Subjects Committee approval process, and project implementation (including survey design, data collection and analysis, etc.).

Special Curriculum Topics:

  • Social vulnerability index determination.

  • Understanding social determinants of health and impact on the health of individuals and of the community:

    • employment and poverty

    • food insecurity

    • substance abuse

    • homelessness and unhealthy housing and environment

    • domestic and community violence

    • literacy, education and school expulsions

    • homosexual and transgender

    • race, ethnicity and language

    • transportation.

  • Overview of Public Health systems.

  •   Health care payment systems including Medicare and Medicaid and 2010 health care reform.

  •   Behavioral health needs.


Public Health Block

Experiential training includes work at food kitchens, homeless shelters, homeless encampments, school-based clinics, the public health department and other community resources sites.


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