Transforming Education and Community Health (TEACH) Program | Department of Internal Medicine | UC Davis Health

Since 2005, we have offered a separate third year program called Transforming Education and Community Health (TEACH). This highly successful training program is geared for residents interested in caring for the medically underserved, developing advocacy skills and becoming leaders in academic general internal medicine. The goal of the TEACH Program is to improve access to high quality health services by training residents to provide well-coordinated, evidence-based, culturally humble primary care to underserved adults.

This community-based collaborative, in partnership with the County of Sacramento Department of Health and Human Services, aims to reduce health disparities and increase the number of primary care physicians in medically underserved communities. We accomplish this by caring for our most vulnerable patients on a separate inpatient medicine team and following up with them at the Sacramento County Health Center clinic. Its endeavors and accomplishments have been featured in an article for the Sacramento Bee.  Many of our TEACH graduates have gone on to primary care careers.

Our TEACH program philosophy was expanded to our UC Davis Medical School.  The school recruits medical students who share this aim to join the TEACH-Medical Student Program for their medical school training. These students work closely with our TEACH residents.

Our Patients

Sacramento is one of the most racially and ethnically integrated major cities in the United States, providing a unique setting for teaching culturally humble care. The TEACH Program is centered in Oak Park, a vibrant, historic community just steps from UC Davis.  Our clinic patients reflect the diversity of Sacramento.  Many of our patients are Latino, which includes undocumented residents of Sacramento County.  As a one of the biggest refugee resettlement areas, we also have a large population of patients from the Middle East.  One in eight patients requires an interpreter. The languages spoken include: English, Spanish, Farsi, Pashto, Vietnamese, Hmong, Russian, Mien, and various Chinese dialects.

The Sacramento County Health Center is a 100,000 sq ft comprehensive ambulatory facility that provides outpatient services to medically underserved patients. Most of our patients have Medicaid or Medicare.

Curriculum

The TEACH program is a yearlong experience that replaces the traditional third year of residency. It follows the 4+4 blocks. Residents rotate in two week blocks on the TEACH inpatient service, where they care for primarily uninsured or Medicaid patients admitted to UC Davis Medical Center. The 3rd year resident leads the team of an attending and two third-year medical students.

When not inpatient, TEACH residents spend three afternoons per week in their county-based continuity clinic at the Sacramento County Health Center. They also rotate through UC Davis specialty and sub-specialty clinics as well as county-based clinics including the Nephrology, Musculoskeletal Medicine, Rheumatology and Complex Care Management.

A typical TEACH resident annual schedule includes (subject to changes):

• 18-20 weeks on Ambulatory Care
• 6 weeks on UC Wards
• 10 weeks on TEACH Wards
• 2 weeks on MICU
• 2 weeks on CCU
• 6 weeks of elective
• 2 weeks of ER
• 4 weeks of vacation

Whenever possible, hospitalized patients on the TEACH service are followed up by their resident physician in the clinic. This experience allows the resident physician to care for patients during their acute illness, during their recovery, and in follow-up care. It also helps us to care for the underserved patients that live in our surrounding neighborhood.

The TEACH residents often will complete scholarly projects that stem from work in the QI track or Primary Care Program. Prior examples include enhancing culturally sensitive care to our refugee patients, improving clinic workflows for treating helicobacter pylori gastritis, and reviewing preventative care for HIV patients. 

The TEACH residents also participate in advocacy work. Through faculty mentorship and partnerships with community-based organizations, our residents use their patient stories to advocate for vulnerable patients. Previous experiences have included writing exercises on alternatives to calling 9-1-1 for mental health crises, leading social media campaigns in Spanish on COVID virus and vaccine, and submitting op-eds related to COVID vaccinations in low-income communities to the Sacramento Bee.  

Check out one of our former TEACH residents on the news: CNN or KCRA (Spanish)

Applying to the TEACH Program

The TEACH Program is for third year residents. We have residents apply for one of the six TEACH resident positions during their second year of residency. Both categorical and primary care residents who are passionate about underserved medicine and primary care are welcome to apply.

TEACH Graduates

Our TEACH graduates go onto a variety of careers, including primary care, hospitalist, and subspecialty fellowships. Visit our 'Life After Residency' page to see where some of our recent TEACH graduates have gone.  

Reference

Fancher TL, Keenan C, Meltvedt C, Stocker T, Harris T, Morfín J, McCarron R, Kulkarni-Date M, Henderson MC. An academic-community partnership to improve care for the underserved. Acad Med. 2011 Feb;86(2):252-8.