A few years ago, in his president's address to the Association of American Medical Colleges, Dr. Jordan J. Cohen shared his vision of the future of academic medicine. Among the points he stressed were the importance of establishing true partnerships between medical schools and the communities they serve, elevating prevention and health maintenance to an equal platform with diagnosis and treatment, and addressing pressing social problems, such as drug abuse, teenage pregnancy and domestic violence.1
McCurdy and colleagues2 go a step further, suggesting that medical schools have a “social contract” with society and thus have an obligation to help improve the overall health of the public. As young health professionals, we have the responsibility to hold our own academic institutions accountable for fulfilling that social contract. If our institutions do not provide a clear avenue for us to fulfill our commitment to contribute to society, we must create our own opportunities.
The Alliance of Health Professional Students (AHPS) was founded in December 1997, as Ryung Suh, a Corporation for National Service fellow, called on student government leaders from various health professional programs to come together to develop a strategic initiative to address various public health issues in the District of Columbia. AHPS comprises students from a consortium of 12 health professional programs of multiple disciplines at Catholic, Georgetown, George Washington and Howard Universities and the Uniformed Services University of the Health Sciences.
Bringing together students of multiple disciplines to include schools of medicine, nursing, dentistry, public health, physician assistant and pharmacy is not a new concept. However, AHPS is unique in that it is the first multi-institutional student collaborative in a city submerged in a public health paradox. Current estimates indicate that Washington, D.C., is among the richest of cities in health care resources, with the number of physicians, nurses and physician assistants per capita at more than double the national average.3 Yet, the District's health indexes for infant mortality, cancer, substance use and heart disease are among the worst in the nation, while surveillance findings indicate that many areas suffer from a shortage of primary care providers.4
Five years ago, the D.C. Primary Care Association (DCPCA) was formed to develop new strategies to help bridge this disparity. Represented by the major players in the District's health care arena, the DCPCA has assumed the lead in health care reform in the city.5 AHPS enables health professional students to unite and join this citywide coalition to help improve the overall state of health of its underserved populations.
The current strategy of AHPS involves a parallel, two-pronged approach. First, AHPS functions as a “clearinghouse” of student volunteers who are matched with a network of service agencies that seek volunteers. The AHPS project director, a first-year faculty member at Georgetown University School of Medicine, along with the Health Promotion and Preventive Services Committee, works to seek out these volunteer opportunities and add the agencies to the network.
Last summer, the alliance experienced some initial success while functioning in this capacity. A myriad of student volunteers participated in a number of events in which they performed free blood pressure screenings, school physical examinations, Papanicolaou smears and prostate examinations. They participated in a citywide immunization fair and assisted with the District's March for Cancer and AIDS Walk. In the near future, AHPS plans to devise a centralized system through which any community organization could tap into this potentially huge source of student volunteers.
In addition to this “clearinghouse” model, the alliance advocates for the implementation of service learning in the schools across the city. The concept of service learning has become a well-known entity in the health professions arena over the past few years. In 1995, the Health Professions Schools in Service to the Nation (HPSISN) program, with support from The Pew Charitable Trusts and the Corporation for National Service, launched a national demonstration project of service learning in 20 different sites across the country. The HPSISN program defines service learning as “a structured learning experience, [in which] students . . . are expected not only to provide direct community service but also to learn about the context in which the service is provided . . . and their roles as citizens.”6
Incorporating service learning into health professional education curricula would not only help address many of the public health issues in the District, but would also help produce a community-competent health care work force. The Pew Health Professions Commission recently identified a set of core competencies required by all current health professionals. These competencies include having interest in the care of the community's health, the ability to participate in a racially and culturally diverse society, being clinically competent, having the foresight to promote healthy lifestyles and practice prevention, and ensuring cost-effective appropriate care.7 Service learning can help students develop all of these community competencies while giving them a way to serve within the constraints of their academic and clinical workload.
AHPS continues to grow and has recently become recognized as a legitimate organization in the District of Columbia's complex primary health care arena. We hope that AHPS can serve as a model for health professional students at other schools across the nation. The organization's approach to helping the community through service learning can also be adopted at the level of postgraduate training and even beyond. As health professionals at any stage of our careers, we must strive toward fulfilling our social contract with the communities in which we live.