CCHERS Program
History of the CCHERS Program
The Center for Community Health Education Research and Service (CCHERS) was founded in 1991 with a grant from the W.K. Kellogg Foundation. Its goal was to increase access to and improve the quality of health care for Boston’s multi-cultural and multi-lingual communities by developing partnerships between academia and Boston’s neighborhood health centers.
The partnership offered unique opportunities to pool resources, coordinate care, and advance the training and education of health care professionals and students interested in community-based care.
By encouraging cooperative educational initiatives, CCHERS helped develop community-based health care programs, initiate research and support public policy reforms designed to improve responsiveness to urban health and wellness needs. At the conclusion of the grant, Boston University School of Medicine took over support for the medical student education program that still thrives at a number of neighborhood health centers proximal to BUSM.
Community Based Health Professions Education
CCHERS sought to educate a broad array of health professions students for careers in primary care in community-based settings. It placed nursing, medical, and other students in “academic community health centers” and integrated community service with health professions education and community-derived and directed research.
The program continues to be a great way for BU medical students to learn about community health care as students do a portion of their clinical work throughout the first three years of medical school at the health center. The continuity of teaching (typically one physician is the main instructor for the group of four CCHERS students for the year), and comfort of the environment (students have said it feels like “coming home” to return regularly to their health center), as well as the rich diversity of experience make the CCHERS placements great places to learn.
CCHERS at BUSM
Currently, BUSM sends students to the following neighborhood health centers as part of the CCHERS program:
- Codman Square Health Center (starts in the second year)
- Dorchester House Multi-Service Center
- Neponset Health Center
- South Boston Community Health Center
- Whittier Street Health Center
CCHERS students spend clinical time at the health center:
BUSM I: In the fall of the first year students are at their CCHERS site for the Introduction to Clinical Medicine (ICM-1 fall) and Integrated Problems (IP) courses. ICM-1 fall is an interviewing course, and IP involves working on paper cases with a small group and a clinician instructor. Usually IP and ICM occur together on Thursday afternoons. For the second semester, students work with a primary care provider at their CCHERS site for the clinical placement portion of ICM-1 spring. They interview patients and practice some basic physical examination skills. Some students continue to have IP at their CCHERS sites. In addition, some students have chosen to do research at the health center in the summer between the first and second year.
BUSM II: In the second year, students spend about 2/3 of their ICM-2 time at the CCHERS site. In the fall they learn basic physical examination skills, and in the winter they practice complete history and physical examinations, among other activities.
BUSM III: In the third year, students spend 4 weeks of ambulatory medicine at their CCHERS site during the 11-week Medicine clerkship. They also spend 2 weeks of their 6-week Pediatrics clerkship at their CCHERS sites.
BUSM IV: In the next few years the 4 week ambulatory medicine block may move from the third to the fourth year curriculum.
Program characteristics
The cohort of four students entering a CCHERS site becomes well acquainted. Students usually travel together, either by carpool or by public transportation (or by foot for the closest site). They come to know the CCHERS instructor well, and value the longitudinal mentorship. The sites, too, come to know the students well. One student commented “it feels like family”.
Students learn basic skills and progress through their medical school career learning first hand how health care is delivered in community health centers. They are able to explore other primary care services offered by their site such as family planning, HIV education and screening, and even outreach services. Some students have chosen to pursue a degree in public health in part based on their community exposure through CCHERS.
The cultural and ethnic diversity of patients and employees at community health centers are also appealing. Occasionally a student has chosen a certain site because of his or her own language skills. For instance, both Dorchester House and Neponset Health Center serve thriving Vietnamese-American communities. Codman Square has many patients who speak Haitian-Creole and Portuguese-Creole. Whittier Street has a vibrant Spanish-speaking population (and certainly working knowledge of Spanish is beneficial anywhere in the city, though the health centers have excellent interpreter services!).
How to enter the CCHERS Program
Entering first year students are given the option to join the CCHERS program. Students at other points may be able to opt into CCHERS if there is an opening (such as when a student chooses to return to the traditional program, or when a student takes a leave of absence).
