Recognizing the importance of developing leaders in community health, global heath and research, we have developed three pathways to allow interested residents to further develop skills in these areas. Our residents can apply to one of the pathways in their first year of residency, with dedicated pathway months in the R2 and R3 years.
Our REACH (Resident Education and Advocacy for Child Health) Pathways (including REACH–Toppenish and REACH–Kisii) train residents to look beyond the walls of the clinic and hospital to understand child health in a community context. Residents in these pathways explore fundamental questions related to child health. For example:
- How do families, schools, neighborhoods and communities shape child health for better or for worse?
- Why are some children healthy while others are not?
- How does experience in childhood impact health and well-being across the lifespan?
- And, most importantly, what can physicians do to improve the health of children by working outside the clinic walls?
This approach to understanding health and well-being is part of a paradigm shift in the medical profession. At the same time, working closely with local partners, we hope to benefit the communities, by bringing our time, talents and energy to bear on local issues.
Integrated Research Pathway
The Integrated Research Pathway is an American Board of Pediatrics–sanctioned pathway to foster the development of physician-scientists. This pathway provides the opportunity to sustain research interest, skills, knowledge and productivity during core pediatric training while offering a means for fostering transition into a physician-scientist career.
The REACH–Toppenish Pathway provides public health, clinical and advocacy experience. The goal is to understand and influence determinants of child health and health disparities at the community level. In their R2 year all REACH residents participate in a month-long curriculum, learning about the social determinants of health, health policy, practical advocacy and strategies for developing, evaluating and sustaining interventions to improve child health in the community. During a second month, residents learn to conduct a community health needs assessment, which encompasses developing skills in data collection, interpretation and reporting. After this R2 year the two REACH pathways diverge.
In the R3 year, each REACH–Toppenish resident spends 8 weeks in Toppenish, Washington, to learn from and about the community, its health and its healthcare needs. With just half a day per week working clinically at the
Yakima Valley Farm Workers Clinic, the remainder of residents' time is available to work with community organizations serving the children and youth of the Lower Yakima Valley. The specific focus of each resident's activities changes over time, as residents respond to community needs and develop and meet their own individual learning goals. Residents are encouraged to explore experiences that expose them to role models and career options in community pediatrics and advocacy.
Some projects have included:
- Learning about the social determinants of health through key informant interviews and a youth artwork needs assessment
- Understanding child health from the parent's perspective through surveys and focus groups and applying social network analysis to community needs
- Exploring the built environment using PhotoVoice
- Conducting a needs assessment on access to adolescent services and adolescent medical home
- Developing afterschool programs and mentorship for local youth
- Helping schools develop suicide prevention programs
- Expanding hands-on training opportunities for local youth interested in healthcare careers
The REACH–Kisii Pathway is an opportunity for those residents interested in global health to achieve more training in public health, clinical service and research. The goal is to understand and influence determinants of child health and health disparities at the community level. In their R2 year all REACH residents participate in a month-long curriculum, learning about the social determinants of health, health policy, practical advocacy and strategies for developing, evaluating and sustaining interventions to improve child health in the community. Later, residents learn to conduct a community health needs assessment, developing skills in data collection, interpretation and reporting. After this R2 year the two REACH pathways diverge.
In the R3 year REACH–Kisii Pathway residents participate in a 8-week experiential learning program in Kenya. Residents are exposed to pediatric health services through clinical experience at a 40-bed pediatric ward of a provincial hospital in rural Kisii, Kenya. The bulk of their time, however, is spent conducting community-based child health assessments and interventions working with the Kisii public health network that is headquartered at the
Kisii Provincial Hospital. The specific focus of these activities changes over time based on local priorities but residents are encouraged to develop and meet individual learning goals while enjoying exposure to role models and career options in global health.
Our REACH–Kisii program is unique in that our residents are paired with pediatric residents from the University of Nairobi for their time in Kisii. The pairs live and work together for the entire experience. The goal is to look upstream at the determinants of child health in Kenyan communities. This pairing allows for support and sharing of expertise between residents and promotes a more in-depth understanding of Kenyan culture and medical training. With each resident pairing, the program makes further inroads into building a sustainable partnership with the larger Kisii community.
Integrated Research Pathway
Residents in the Integrated Research Pathway have two dedicated research months in their R2 year and five months in their R3 year. Pathway faculty help residents find appropriate mentors and projects with the goal of entering fellowship training better prepared to be productive during fellowship, whether at Seattle Children's Hospital or a different institution. For more information on requirements for the Integrated Research Pathway, see the
American Board of Pediatrics website.