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2018 Spencer Foreman Award for Outstanding Community Service

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University of Puerto Rico School of Medicine

San Juan, PR

Founded in 1950 and accredited by the LCME in 1954, the University of Puerto Rico School of Medicine (UPRSOM) was established to train physicians to meet the island’s needs. Because most UPRSOM-trained physicians stay to practice on the island, the school works to ensure that its faculty, staff, and trainees are resourceful and have strong relationships with the community. UPRSOM is the leading provider of Hispanic (bilingual) physicians in the nation.

UPRSOM is a trusted partner for many diverse communities, including elderly, working poor, and homeless people; environmental organizations; pharmacies; and government agencies. For more than three decades, students and faculty have worked in interdisciplinary teams with communities to yield dozens of sustainable resources addressing community-identified needs while building community partners’ capacity. Much of this work occurs through the school’s service learning framework.

One such collaboration resulted in a safer experience for intravenous drug users (IDUs). Working with the IDU community and Punto Fijo, a harm-reduction program of Iniciativa Comunitaria, medical students are invited to shooting galleries and needle-exchange rooms to collaborate on how to ensure safe drug use while also promoting the dignity of people with substance use disorders. This collaboration has yielded posters acknowledging the human rights of drug users and showing how to inject more safely and care for skin ulcers. The posters were developed through an iterative process, with IDUs providing feedback on drafts placed on white boards in shooting galleries. The community also helped students compile a glossary of street slang for physicians to ensure better communication and respectful treatment.

UPRSOM also works with neighbors and community-based organizations to help families in poverty. Collaboration with local childcare centers, for example, led to the co-development of activities and manuals and sustainable systems to track each child’s BMI. Caretakers can now measure progress in helping children achieve and maintain a healthy weight, and they can use the data to maintain the centers’ grant funding. Students have also worked with local residents and organizations such as ENLACE, a government-owned corporation, to implement community gardens and environmental public health programs, including mosquito-breeding prevention campaigns in densely populated neighborhoods near the flood-prone, highly polluted Martín Peña Channel.

To inspire youth in the neighboring Península de Cantera neighborhood to serve their community, UPRSOM students created Build Your Own Bike. Youth earn bike parts in exchange for work in the community gardens. This unique program helps meet needs in the community, including contributing to food security, reducing pollution, building skills in construction and horticulture, and promoting exercise.

Community-identified needs that are ideal for community-based participatory research are matched with faculty at UPRSOM and other schools on the UPR Medical Sciences Campus who help launch the research, often with support from the Endowed Health Services Research Center.

In the aftermath of Hurricane María, UPRSOM leveraged its existing relationships and resources to respond to the most immediate needs on the island. Medical students volunteered as translators for FEMA, managed first aid, and moved debris so patients could get to the hospital. As donations flooded in, students organized a supply command center and sorted themselves into interdisciplinary brigades to visit communities, assess needs, and distribute supplies to precisely where they were needed. Faculty and residents offered clinical support and guidance.

“Organization came naturally to these groups already familiar with many of the needs in underserved areas,” says former UPRSOM dean, Edgar Colón.

Of UPRSOM, Agustin Rodríguez, MD, interim dean, says: “We make the most of the least and the best of the worst.”

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