The Social Medicine Portal

Social Pediatrics at Montefiore

The Residency Program in Social Pediatrics began at Montefiore in 1970. Our program is designed to train pediatricians who are interested in practicing medicine within underserved, disadvantaged communities. Since its inception the residency program has trained over 150 pediatricians, many who have gone on to leadership positions as advocates for impoverished children and families. Our residents are trained alongside residents in Montefiore’s categorical residency program¹. Inpatient training takes place within the Children’s Hospital at Montefiore. In addition to traditional didactics, residents in Social Pediatrics receive extensive training in the biopsychosocial aspects of medical care. They are exposed to a multi-disciplinary core curriculum, which includes training in:

• Family Dynamics and Intervention
• Advocacy & Community Organizing
• Clinical Research & Evidence Based Medicine
• Social Epidemiology
• Community Based Participatory Research
• Medical-Legal Advocacy
• Health Systems & Policy

Ambulatory education and clinical experience occurs at the Montefiore Comprehensive Health Care Center (CHCC) a federally-funded community health center located on 161^st street in the South Bronx, just a few blocks away from the world-famous, Yankee Stadium. CHCC is located in the 16^th congressional district–the poorest congressional district in the United States. The clinic serves more than 12,000 patients who make more than 71,000 visits annually and offers a variety of medical and ancillary services, such as medical, OB-GYN, dental, nutrition, health education, social work and WIC. Social Pediatrics is a three-year training program leading to board eligibility in pediatrics.

Intern Year

The main focus of the first year of social pediatrics training is the development of a strong general pediatric knowledge base and the advancement of inpatient skills. The intern year bears a a close resemblance to the first year of training in the categorical pediatrics program. For example, like the categorical residents, you spend one afternoon session a week in your ambulatory clinic at CHCC. However, there are important differences. One is that in the fall notable exception is:

Each social pediatrics intern attends a month-long intensive orientation to social medicine with the interns from Family Medicine and Social Internal Medicine. During this call-free month, you will be exposed to basic principles in social medicine, connect with the Bronx community, and begin to explore important issues that impact the health of this community. In addition, throughout the year interns attend the weekly social pediatrics rounds, schedule permitting, as described below.

Second and Third Years

In addition to the refinement of inpatient skills, the second and third year of the social pediatrics residency continues with an increased focus on ambulatory and community pediatrics. In the second and third years of training, At the beginning of the second year each social pediatric resident is paired with another social pediatric resident from the same year. The partners share a continuity panel and inpatient responsibilities. This allows residents to spend more time in the ambulatory setting, and continue quality inpatient training. Each pair divides call responsibility between themselves. Residents also participate in a school health rotation during the second and third years. During this rotation residents provide primary care services in a school- based health care center, interact with a community health team, learn to advocate for children in a school-based setting and learn the legal and political issues involving school-based health centers.

The social pediatrics’ schedule differs from the categorical schedule as it includes 3.5 blocks of full time clinic each year. There is also one call free elective during both second and third year.

In addition to clinical responsibilities, social pediatrics interns and residents are required to participate in community-related research, education, and advocacy activities.

Specific Program Components:

In addition to clinical responsibilities, social pediatrics interns and residents participate in a comprehensive core curriculum designed to provide instruction in the fundamentals of community-centered research, advocacy and epidemiology.

Social Pediatrics Rounds: This core conference is held weekly providing residents with on going exposure to important social pediatric-related topics such as foster care, cultural competency, homelessness, community organizing, domestic violence and health literacy.

Social Pediatrics Curriculum: During second and third year residents are given the opportunity to participate in varied curricular activities including research methods and design, social epidemiology, medical legal advocacy, medical Spanish, journal club, policy rounds and board review.

Social Pediatrics Project: Residents are required to complete a social medicine project during their three years in residency. These projects will provide practical hands-on community pediatrics experience.

Faculty

Peter Sherman, MD
Director, Residency Training Program in Social Pediatrics

David K. Appel, MD
Executive Director, School Health Program

Sandra Braganza, MD, MPH
Faculty, Residency Training Program in Social Pediatrics

Neal Hoffman, MD
Faculty, School Health Program

Natalie Langston-Davis, MD, MPH

Faculty, Residency Program in Social Pediatrics

Theresa Pinili-Ozuah, MD
Faculty, Residency Training Program in Social Pediatrics

Andrea Rich, MD
Medical Director, Comprehensive Health Care Center

Jennifer Rich, MD
Faculty, Residency Training Program in Social Pediatrics

Iman Sharif, MD, MPH
Associate Director, Residency Training Program in Social Pediatrics

Charles Strouthides, MD
Faculty, Residency Training Program in Social Pediatrics

Graduates

Many graduates of social pediatrics continue to fulfill their training mandate by practicing in inner city health centers, community hospitals and large, urban medical centers. Several of them serve as health policy makers, health administrators, and leaders in community medicine. Some help underserved children in rural health facilities. Others put their social pediatrics training to use in subspecialties, where there is often a need for a novel community-oriented approach.

Alumnae of the Residency Program in Social Pediatrics include:

Philip Ozuah, MD, PHD Chairman, Department of Pediatrics, Albert Einstein College of Medicine & Children’s Hospital at Montefiore

Jo Ivey Boufford, MD President, New York Academy of Medicine

David Appel, MD Director, Montefiore School Health Program

Andrew Goodman, MD Associate Commissioner, New York Department of Health

Steven Shevlov, MD Chairman, Pediatrics, Maimonides Medical Center

Sharon Joseph, MD Medical Director, New York Children’s Health Project-Children’s Health Fund

Research and Advocacy

Social Pediatrics residents and faculty have contributed significantly to scholarly dissemination and clinical research. Our department participates in several national and regional meetings each year including meetings of the American Academy of Pediatrics, the Association of American Medical Colleges, the Ambulatory Pediatric Association and the American Public Health Association. In addition, residents and faculty participate in local advocacy projects for the betterment of the community we directly serve.

Recent scholarly activities, research, presentations and publications of social pediatrics residents & faculty (resident names in bold):

Harris JC, Giddy J, Thomas M. QI: HIV Testing of the children of adult patients in an HIV treatment program. Presented at the Pediatric Academic Societies, Toronto, Canada, May 2007. Presented at the Eastern Society for Pediatric Research, Philadelphia, PA, March 2007.

Harris J, O’Connor K, Sharif I. Legal needs assessment of families accessing care at an inner-city community health center. Presented at the Pediatric Academic Societies, Toronto, Canada, May 2007. Presented at the Eastern Society for Pediatric Research, Philadelphia, PA, March 2007.

Langston-Davis N, Perez-Rivera B, Sarmiento A, Santana I. Impact of an electronic health record on the promotion of NIH asthma guidelines in the primary care setting. Presented at the American Public Health Association, Washington, DC, November 2007.

Scharbach K, Sharif I, Skae C. Resident knowledge and comfort with pediatric pain management. Presented at the Pediatric Academic Societies, Toronto, Canada, May 2007. Presented at the Eastern Society for Pediatric Research, Philadelphia, PA, March 2007.

Sharif I, Wills TA, Sargent JD. Does television viewing during middle-school lead to poorer school performance? Presented at the Pediatric Academic Societies, Toronto, Canada, May 2007. Presented at the Eastern Society for Pediatric Research, Philadelphia, PA, March 2007.

Tesher M, Siegel S, Sharif I, Campbell D. Resident knowledge and confidence about breastfeeding in a poor urban community. Presented at the Pediatric Academic Societies, Toronto, Canada, May 2007. Presented at the Eastern Society for Pediatric Research, Philadelphia, PA, March 2007.

Sherman PA, Rice A. Domestic violence and the family, In RA Hoekelman, ML Weitzman, HA Adam, NM Nelson, MH Wilson, eds. Primary Pediatric Care, 5th Edition. St. Louis: In Press.

Sherman PA, Pezzullo R. Homelessness and the family, In RA Hoekelman, ML Weitzman, HA Adam, NM Nelson, MH Wilson, eds. Primary Pediatric Care, 5th Edition. St. Louis: Mosby, In Press.

Sherman P, Cahill L. Sexual abuse in children in the context of domestic violence. Pediatrics in Review. American Academy of Pediatrics. 2006; 27: 339-345.

¹NOTE: Social Pediatrics is not listed separately in the Directory of Residency Training Programs, but it does have a separate matching number (listed under Montefiore programs match number 315332O