MetroHealth Awarded $2.5 Million Grant to Expand Street Medicine Training

The MetroHealth System recently received a five-year, $2.5 million grant from the Health Resources and Services Administration (HRSA), an agency within the U.S. Department of Health and Human Services, to better prepare physicians to care for individuals experiencing homelessness.

MetroHealth's Ifeolorunbode Adebambo, MD, Chair of the Department of Family Medicine and Principal Investigator of the grant, said the program will train medical residents to care for people experiencing homelessness wherever they are, including in clinics, on the streets, in shelters and through community organizations. The training will focus on addressing both medical and social needs.

The five year-grant runs through June 2031.

"The data shows that when physicians train to care for patients in specific communities, they are more likely to continue practicing in those settings," said Dr. Adebambo, an Associate Professor of Family Medicine at CWRU. "That's going to multiply when trainees complete residency, and they go out and practice on their own."

Dr. Adebambo said demand for street medicine training continues to grow as more people experience homelessness and seek care outside traditional healthcare settings. She said factors such as discrimination, poverty, unemployment and other social drivers of health contribute to health disparities and make accessing traditional healthcare more difficult.

"It's important to be able to reach people where they are," she said. "An office is not always accessible, so taking care into non-traditional areas such as the streets or shelters is important to improve health outcomes."

Dr. Adebambo said the nation faces a shortage of primary care providers, particularly those trained to care for people who face barriers to accessing healthcare. People experiencing homelessness are disproportionately affected, with Black individuals, LGBTQ+ individuals and people with disabilities often facing additional obstacles to receiving care.

The program will combine classroom instruction with hands-on clinical experiences designed to prepare physicians to work outside traditional healthcare settings. Dr. Adebambo said residents will receive training in "person-first" language, behavioral health, substance-use disorders and recognizing the social needs that affect patients who are unhoused.

Training will also include practical clinical skills that are especially valuable in street medicine, including the use of point-of-care ultrasound and ophthalmoscopes when access to medical equipment is limited.

Community members with lived experiences will also contribute to the program. Focus groups and patient advisory teams will help guide the curriculum and ensure residents understand what matters most to the people they will serve.

Residents will also work alongside professionals in Family Medicine, Internal Medicine, MedPeds and Psychiatry as well as with community-based organizations to better coordinate care.

One partnership already established is with the Northeast Ohio Coalition for the Homeless (NEOCH), where Michael Seidman, MD, MPH, a long-time MetroHealth Family Medicine physician, provides weekly outreach services for unhoused individuals. You can learn more about that work in this video.