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The Urban Health Project

By Peter C. Krause

Two years ago, three first-year Harvard medical students--all enrolled in the same course in community medicine--decided to apply their rapidly accumulating medical knowledge to the real world.

They approached their three professors with the idea and received encouraging advice. The next summer two of the students began to flesh out the program with the support of a grant from the Medical School. By the end of that fall those two students, Larry Ronan and Linda Shipley, had succeeded in setting something up--they had found places for 10 students in clinics and health centers around Boston. During that school-year, they found $24,000 in funds, enough to cover living expenses for 10 first-year students for one summer. The Urban Health Project was born.

The first group of students traveled across the Greater Boston area, preventing lead poisoning, manning homeless shelters and rehabilitation clinics, interviewing hispanic immigrants and senior citizens. The philosophy that guided many of the programs tried to bring the health care system to the members of the community. Many of the students worked door-to-door, and visited the homes of patients.

"The summer was a success in every way we could measure it," says second-year medical student Madeline Wilson '81, who coordinated the project that summer and worked with the Boston Childhood Lead-Poisoning Prevention Program.

The students worked in the community four and one-half days each week, but then on Wednesday afternoons they met with their mentor, one of the teachers of the course that inspired the Project--Dr. Robert Coles '50, professor of psychiatry and medical humanities.

Coles, Dr. John A Billings, assistant clinical professor of medicine, and Dr. John D. Stoekle, professor of medicine, taught "Plain Doctoring" in January, 1983, a course designed to introduce medical students to the practice of medicine within a broader context--one which included community, housing, and family. The one-month course had taken students into the homes of patients, and given them hands-on training.

"We just talked about what they felt and it was very poignant, and very instructive," Coles says. "A little more of the connection between the world of the homeless and the poor and the distinguished Harvard Medical School wouldn't be such a bad idea."

When the students met, they discussed their experiences, and talked to physicians from outside the University about issues of community medicine such as Medicare, Medicaid, alcoholism, and hunger.

"It was a very powerful experience for all of us," says Wilson, a freshman proctor in Canaday Hall. The students worked with a wide variety of patients from homeless alcoholics, to girls who were pregnant for the second time at 15.

Now the project is in its second year and going strong. The group has raised $36,000 so far, and will send 14 first-year students out into the Boston Community this summer.

"We'd like to be doing more and we're working on it," says Wilson. Coles agrees: "It would be nice if we could extend it into the school year. I'm hoping that the Urban Health Project will become an integral part of the medical school," he says.

"There is a certain tendency for the students to be somewhat isolated," he says. "This is an educational effort as well as a way to offer one's time and energy and whatever skills one might have."

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