I also want to put in a word for our student-run clinic, EHHOP (East Harlem Health Outreach Partnership). When Mount Sinai won the Community Service Award from AAMC in 2009, this clinic was at the centerpiece of it all. One of the most unique things about Mount Sinai is that we are located at the border of two NYC neighborhoods with diametrically opposite health outcomes. The Upper East Side with one of the best health indicators in the city, and East Harlem, which ranks last or in the bottom 10% for most health indicators (c.f.
http://www.nyc.gov/html/doh/html/data/data.shtml). As such, Mount Sinai kind of took East Harlem "under its wing" and opened our free clinic exclusively to East Harlem residents. There are basically only three requirements for enrollment - you have to live in East Harlem, you are an adult, and you do not have insurance. The patient then is ushered through a series of consultations, beginning from social work to the medical consultations and specialty referrals to the main hospital, if necessary - all done at EHHOP.
All of this is made possible by a diverse team of senior clinicians (3rd and 4th years), junior clinicians (1st and 2nd years), clinic managers, teaching seniors (the "leader" who kind of runs the clinical show and sees to it that the other seniors know what they're doing), attendings (who verify the findings of the seniors before they sign off on their medication orders), and development staff. Each week, the clinic unfolds in a carefully choreographed show - on Wednesday, the clinic managers divvy up the scheduled patients, making phone calls reminding patients that they have an appointment that week, making changes if necessary. On Thursday and Friday, the teaching senior goes over the patients, drafting a plan for each patient (just like what residents do before rounds). On Saturday, clinic happens - the clinic managers (CMs) arrive first at 7, followed by the teaching senior (TS), followed by the seniors and juniors, and finally followed by the attendings who arrive around 10 or 11. Patients arrive at 9, and there's a steady flow until 12. The last patients usually leave clinic by 2, and everyone leaves in the reverse order by 3 or 4. The clinic managers and the TS continue to monitor the EHHOP phone (it's a cell phone that we pass around between CMs) and follow-up on the concerns of patients until Wednesday, when everything gets passed on to the next clinic team.
When I first came to Sinai, I held a pretty skeptical view of EHHOP, as I thought, "Student free clinic?! Pfft every med school has one of those..." It was only until I started being heavily involved in it I saw how this clinic was different from a lot of the other ones that I had seen/heard about. The med students running the show are REALLY committed to these patients, and they are constantly trying (and actively) improving and building on the clinic. We have student-run QICs (Quality Improvement Councils) that use data-driven methods to improve delivery of care at the clinic by making policy modification suggestions, which is then voted on by the steering committee. I am also impressed at the sheer number of people that are involved in the clinic and the rotating schedule that runs almost entirely glitch-free week to week.
It is my opinion that if you want to do something, stick to it and do it really, really well. For me, I think Mount Sinai has really outdone itself with EHHOP, and it should be something that you ask around about on your interview day - the faculty and anyone involved in the clinic would love to talk about it.
. Let's do this!
