Street Medicine is the direct provision of healthcare and social support to those experiencing street homelessness. These are individuals who live under bridges, along river banks and in other outdoor settings. They have been referred to as the unsheltered homeless or rough sleepers. This population has uniquely high mortality and morbidity due to the complex interplay between their own characteristics and those of our current healthcare system.
By going directly to the people, street medicine strives to weave professionals into the fabric of the street community and create a new platform of solidarity through which healthcare challenges can be systematically addressed. The field of street medicines has to date been a grassroots movement. But over the past few decades, recognized street medicine programs are becoming much more prevalent in the United States and overseas. Street medicine both pioneers a direct approach to caring for those on the streets and provides a conceptual model for the inclusion of excluded groups.
The UPMC Mercy Street Medicine Fellowship is the first of its’ kind. It is a program of the UPMC Mercy Hospital Department of Internal Medicine in Pittsburgh, Pennsylvania. The Fellowship was created in collaboration with Pittsburgh Mercy’s Operation Safety Net which serves as the primary arena for the street medicine experience. A particular emphasis of the Fellowship is the interface of care between the unsheltered population and the hospital systems of Pittsburgh. These areas include the Emergency Medicine Department (UPMC Mercy has the highest volume ED in the city), the inpatient street medicine consult service, outpatient referral and care (the Fellow will have a continuity clinic at UPMC Mercy), the Respite Care Center (for homeless patients who require medical recovery) as well as a focus on patient navigation throughout the larger health system of the city.
The core activities of the UPMC Street Medicine Fellowship will be the practice of street medicine, research and quality improvement projects, teaching of medical students and residents, leadership development and advocacy. There will be flexibility in the pathways that enable the fellow to achieve their leadership goals. The UPMC Mercy Street Medicine Fellowship is at this time a non-accredited Fellowship. The fellow will have the opportunity to assist in the actual development of the Fellowship towards the goal of ultimately creating an accredited fellows program. As the first such Fellowship in the world, this is an historic opportunity. Access to the global leadership of the field will be accomplished through the Street Medicine Institute and participation at the annual International Street Medicine Symposium.
The UPMC Street Medicine Fellow will develop expert level street medicine skills under the direction of Dr. James Withers and the staff of Pittsburgh Mercy’s Operation Safety Net. This will allow the Fellow to practice street medicine anywhere in the United States and should adequately prepare the Fellow to create a quality street medicine program in any community. A third partner of the experience will be the Street Medicine Institute (www.streetmedicine.org) through which the Fellow will make arrangements to visit other street medicine programs in the global network in order to explore the emergent conceptual framework of this new field of medicine. The goal is to develop the Street Medicine Fellow as a leader in both clinical excellence and advocacy.
The UPMC Street Medicine Fellow will work closely with the medical director, Dr. James Withers, who is on the teaching staff of the UPMC Mercy Department of Medicine and an Assistant Clinical Professor of Medicine at the University of Pittsburgh. He is also the medical director and founder of Pittsburgh Mercy’s Operation Safety Net (OSN). The Fellow will have daily contact, often working directly with Dr. Withers in the range of practice settings. The OSN staff is comprised of clinicians, administrators, social workers, outreach workers and others who run this large city-wide street medicine program embedded in the even larger Pittsburgh Mercy health system.
Within the UPMC Mercy Hospital component, Dr. Anthony Pinevich serves at the Chief Medical Officer and lead administrative director of all teaching programs, including the UPMC Mercy Hospital Street Medicine Fellowship. Dr. Mershid Kiazand will provide faculty support and mentorship – especially in the area of clinical research.
Within the Pittsburgh Mercy system, Dr. J Todd Wahrenberger will provide guidance and supervision of clinical activities at the Pittsburgh Mercy Family Health Center. Dr. Wahrenberger is the Medical Director of the Pittsburgh Mercy health system.
Applicants will be considered who have graduated from Internal Medicine, Family Medicine and Social Medicine residencies. Applicants must provide the following:
Those who are selected for interview will visit the Pittsburgh program for a 2 day period to see the program and to be interviewed by the director and key staff members. Hotel accommodations will be provided by UPMC Mercy Hospital nearby.
The UPMC Street Medicine Fellowship begins on July 1st and ends the following year on July 31st.
Those interested in the UPMC Street Medicine Fellowship are invited to contact the Program Director:
James Withers, MD FACP
Teaching Faculty, UPMD Mercy Dept. of Medicine
Assistant Clinical Professor, University of Pittsburgh
Medical Director and Founder
Pittsburgh Mercy’s Operation Safety Net
249 South Ninth Street, Pittsburgh, PA 15203