Global Health Track: PACT LRS

Pittsburgh’s Ambulatory Curriculum for Trainees in Low-Resource Settings (PACT LRS)

The Pittsburgh’s Ambulatory Curriculum for Trainees in Low Resource Settings (PACT LRS) is an open access, evidence-based, ambulatory care syllabus designed for medical learners caring for people in underserved areas around the world.

This project was initially conceived to focus the professional interest of internal medicine residents within the Global Health and Underserved Populations Track from the University of Pittsburgh Medical Center (UPMC) to address the educational priorities of their international partners, the medical students from the Catholic University of Mozambique (UCM for its initials in Portuguese). A needs and opportunity assessment performed at UCM in 2015 revealed that the diagnosis and clinical management of non- communicable chronic diseases (NCDs) was not greatly emphasized in other portions of the medical school’s curriculum. Therefore, the modules encompass subjects that UPMC residents are quite familiar with, specifically NCDs, and other clinical topics that Mozambican students requested via the aforementioned survey. To enhance the medical knowledge and clinical competencies of other medical trainees in low resource settings, we disseminate these modules free of cost via this online platform.

How can I use the modules?

You may use these case-based modules for teaching and/or self-directed learning. The modules are meant to guide a didactic conference or teaching session. Each module includes two complementary versions. The learner version comprises educational objectives, case descriptions, and questions. The facilitator version encompasses the learner version, but also contains answers to the questions. The goals of the facilitator are to initiate lively discussion of the questions posed and elicit input from the participating learners. The facilitator version may also be used for self-directed learning.

By emphasizing practical aspects of diagnosis and management, these exercises prompt not only information recall, but also higher order cognitive skills, such as solving problems, evaluating current guidelines developed by the World Health Organization, and rendering clinical judgements.

Who are the authors?

The authors are current and former internal medicine residents within the Global Health and Underserved Populations Track from the University of Pittsburgh Medical Center who generously dedicated their time, knowledge, and effort to writing these modules.

Who are the reviewers and editors?

The reviewers and editors are either internal medicine or subspecialist physicians with clinical experience in low resource settings who kindly contributed their expert feedback to the modules. Most of them are currently or were formerly affiliated with the University of Pittsburgh Medical Center.

About the Chief Editor

Elena Jiménez Gutiérrez completed her Internal Medicine residency as a member of the Global Health and Underserved Populations Track in 2016 from the University of Pittsburgh Medical Center Montefiore/Presbyterian. Over the years, she has attended to medically underserved populations in Chinle, Arizona, Pittsburgh, Pennsylvania, San Antonio, Texas, Chiapas, Mexico, La Romana, Dominican Republic, and Beira, Mozambique. She is currently an Assistant Professor in the Division of Hospital Medicine, Co-Director of the nascent Health Equity track for Internal Medicine residents, and Director of the nascent Human Rights and Asylum Medicine elective for medical students at the University of Texas Health Science Center at San Antonio. Dr. Jiménez Gutiérrez serves as an outpatient preceptor for medical students at San Antonio Refugee Health Clinic and Pride Community Clinic as well as faculty advisor for Global Health electives for medical students and residents. In addition, she volunteers once or twice a year with Partners In Health in Chiapas, Mexico, as an outpatient preceptor for newly graduated Mexican physicians during their social service year in rural public clinics. As a member of Physicians for Human Rights’ Asylum Network, she regularly performs pro bono forensic medical evaluations that can corroborate asylum seekers’ claims of having suffered torture or persecution and support their application for asylum. Her passions include health equity, care of underserved populations, asylum medicine, medical education and evidence-based clinical practice in low-resource settings, and chronic kidney disease of unknown etiology (i.e. Mesoamerican Nephropathy or Sri Lankan Nephropathy).