This elective is likely to fill up quickly, so please register as far in advance as possible.

This elective will span across two main settings. The primary site will be an inpatient consult service within Loyola University Medical Center. Students will be responsible for answering consults sent through AMS to the Street Medicine Consult Service group. All consults will be addressed within 24hrs of being placed. Students will be responsible for creating a patient list, taking time to understand the patient's medical needs and social needs. All inpatient consults will be staffed with a supervising physician and documented within EPIC including recommendations and referrals to community resources. Students will be responsible for speaking with the consulting service and coordinating care interprofessionally with social workers, case managers, residents, and nursing staff. Students must round on patients for the duration of their inpatient stay. When appropriate, students may also work with Trinity’s community health workers if they take on a patient’s case that has been referred to them. In addition, students will also participate in CTA outreach at the CTA blue line station in Forest Park on Thursday evenings from 8pm to midnight.

Outside of these clinical responsibilities, students will engage with literature and podcasts on topics of social justice and medical care for people experiencing homelessness. Students will be responsible for helping collect and organize resources within the google drive in order to create a learning library to be housed on the street medicine website. At the end of the rotation students will be required to write a minimum 2-page reflection on their experiences within the clinical sites and from the recommended literature. Students will also participate in building a functional model of integrated and interdisciplinary care for individuals experiencing homelessness.

During this elective students will:

1. Address consults inpatient at LUMC regarding patient’s experiencing homelessness. Participate in care coordination, charting recommendations in EPIC and daily rounding for duration of patient’s inpatient stay.
2. Understand the resources available to those struggling with homelessness and referral opportunities for medical providers
3. Be presented with a list of ongoing projects that you may sign up for with goals to be completed by the end of the rotation
4. Be evaluated by the medical provider with whom the student staffs their patients with on shift. These evaluations will be submitted to the course director to provide formative and summative feedback regarding the student’s clinical work.
5. Participate in a training course for volunteers by the Night Ministry prior to the rotation.
6. Work alongside a medical provider on Thursday evenings at CTA outreach by assessing patients and coming up with plans for the patient.
7. Listen to podcasts or read research articles regarding some of the many issues faced by this population. For at least 5 of these podcasts or articles, record what you learned on the attached log. Recommended sources are found on the log as well. Students may also participate in recording a podcast episode with the Loyola Street Medicine Podcast Series.
8. Keep a log of the patients you see on the various sites and document the conditions you observe and reflect on how they are caused by or worsened by a lack of stable housing.
9. Reflect on their experiences both medically and socially through a final paper at the conclusion of your rotation.
10. Complete a final evaluation of the rotation to assist the clerkship director in further strengthening the elective rotation.

The course will be graded according to the following scale: Pass/Fail

Requirements

Students must complete all of the following to achieve a Passing grade for the elective:

a) Watch the core training video provided by The Night Ministry prior to the rotation: https://www.youtube.com/watch?v=0xaHSvP5LQI

b) Meet with the course director (virtually is acceptable) at the start of the elective to discuss the goals and expectations for this elective.

c) Attend orientation lecture on understanding and caring for the homeless population: Understanding and Caring for the Homeless Population - Oct 2022

d) Obtain evaluations from attendings on shift for summative and formative feedback. There will be a midpoint evaluation and a final formal evaluation.

e) Listen to or read a minimum of 5 podcasts or articles and document something you have learned from each and how you will incorporate this into your practice.

f) Document a record of patients seen and conditions observed.

g) Submit a personal reflection on the experiences of this rotation and how what you witnessed will shape your future career. Please include your response to the following questions in your final reflection:

1) As a result of this rotation, what additional insights have you gained into the homeless population and how will this impact your future practice as a physician?

2) What challenges did you and your team face when coordinating care and discharge planning for patients experiencing homelessness? Can you provide any examples of how you had to “think outside the box” to find a practical solution for a specific situation? (i.e., creating mittens out of socks for a patient with frostbite injury)

3) What are your thoughts on the concept of homelessness being a crime?

For additional reading on this: https://housingnothandcuffs.org/

Listen to criminalization of homelessness podcast: https://open.spotify.com/episode/6yetI7bu119JFLM8cXptdB

h) Provide course directors feedback through a final rotation evaluation to assist in further course development. Please include your response to the following questions in your feedback:

• What suggestions do you have for improving this elective in the future?

• What advice do you have for future students to help prepare for their clinical experience at this site?

Street Medicine Consult Service - Please submit this completed patient log by the end of your rotation