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The Medical School:
Day-to-Day Survival
Residents and faculty teach medical students the value of treating the homeless

Medicine at Michigan(From left) Medical students Matthew Wixson, Joanna Lins and Ilinca Vladescu help staff the Delonis Center medical clinic for the homeless.

Monday night at the Delonis Center medical clinic for the homeless involves taking vital signs, patient histories and discussing health symptoms. It’s a growth opportunity for both doctor and patient as University of Michigan Medical School students, under the guidance of residents and faculty, obtain hands-on training in providing medical care to patients who might otherwise be neglected as they focus on day-to-day survival.

“With this population you see disease that’s left untreated,” says Sahar Aminipour, a second-year medical student. “Problems like diabetic foot care are often overlooked.”

“We all come into this wanting to help people,” she adds. “But you can lose touch with that during the first years of mostly classroom study. Here I can see the tangible effect of my training on patients and I’m re-energized.”

Homeless people are particular victims of diseases such as mental illness, but for the most part, they have all the same health problems as people with homes—just at rates three to six times greater. Without a home, there is no place to recuperate from an illness or treat an injury.

Jane Lee, a second-year medical student, has learned not to take anything for granted with patients. “You can’t assume they can buy even a discounted $4 prescription,” she says. The Delonis Center’s solution: a small on-site “pharmacy” of sample drugs.

Continuing EducationFive years ago, the new Delonis Center facility opened in downtown Ann Arbor and consolidated its shelter, day program and medical clinic under one roof. As many as 10 patients are seen at the weekly Monday night clinic staffed by volunteer U-M physicians, residents and medical students. During weekdays the clinic is staffed by nurse practitioners in collaboration with U-M.

“In a resource-poor environment you have to think more about the need for every test because there’s a cost—economically and logistically—for the patient,” says Brent Williams, M.D., associate professor of Internal Medicine and medical director at the Delonis Center.

The experience is part of the Medical School’s Poverty and Health curriculum in which students rotate to safety net facilities. The experience is expected to improve students’ communication, decision-making and medical skills, and help build respect for patients. The second-year students act as clinic coordinators.

“They’re a good example to us that even if you have your own practice,” Lee says of the local volunteer physicians, “you can take time out on a regular basis for this.” - SK

Find out more about the Delonis Center www.annarborshelter.org/myths.cfm

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