As part of a shift towards greater emphasis on Social Accountability, the University of Ottawa, Faculty of Medicine Undergraduate Medical Education program has established a student run clinic focusing on Social determinants of Health. Our goals are broadly to improve health equity and enrich the educational experience of future professionals in multiple disciplines. Based loosely on the Health Leads program originating in Boston, the idea was that an interdisciplinary group of student volunteers would act as navigators for patients referred for social need from primarily health care settings (these could be varied, from primary care medical clinics to legal/dental/nurse practitioner run clinics).
NORTH has an executive that is made up of two representatives of each discipline involved. Currently there are three disciplines including Law, Medicine and Social Work. This committee has drafted its own Terms of Reference, establishing how the clinic is organized and run. Behind the executive, each discipline has a subcommittee with a Faculty Lead, allowing each discipline to clarify how the clinic initiative fits into their program’s curriculum (i.e. as an elective, community service learning project, course, etc.) and associated issues like evaluation or insurance. The students who comprise each of the discipline subcommittees are also mixed to form interdisciplinary working groups for marketing, research, and education.
We are working on a model that has us based within the Bruyere Family Health Team. They are offering space and computer support (EMR). They have a large clinical group of both students and residents that can offer a referral base, and are very welcoming and supportive of the initiative. We have developed a training program for our navigators (with both online modules and face to face components), vetting existing resource databases for navigation (e.g. 211, eMental health), and ensuring there is a system in place from the start to measure the effectiveness of the initiative from patient outcome and educational perspectives. We have a Research Advisor from the Bruyere Research Institute, and a Social Work lead from the Bruyere Family Health Team. To begin with, we will be focusing on the needs of the refugee population served at this center. Clinics will be supervised by community social workers. There is a definite need for navigator support and we are hoping to develop a busy clinic at this site.
This is an exciting initiative that will allow us to run a unique clinic in Canada. The other student-run clinics in Canada are clinical-based, focussing on medical diagnoses and treatment rather than entirely on the social determinants of health. In addition, the clinic will be interprofessional from the start with students from all disciplines involved taking on similar roles. We will also be evaluating the initiative using sound research methodologies that will allow us to document and publish our results.