For more than a year, The Night Ministry's Street Medicine Program has been welcoming medical residents—physicians who are receiving their post-graduate training—to join staff in providing health care and supportive services to Chicago's unsheltered homeless population.
The residents gain valuable hands-on experience while assisting the Street Medicine Team's Nurse Practitioners and Volunteer Physicians with patient care. But residents' involvement has also become a means to, little by little, improve the medical culture from the inside-out.
"Initially we began working with the residents to broaden our capacity to provide care," said Stephan Koruba, Senior Nurse Practitioner. "But as we reflected on the adverse experiences many of our clients have shared with us about the medical system, we saw the medical residency program as an opportunity to affect change inside the medical community."
"The Western medical paradigm does not treat homeless people very well. Part of our job is to change that culture. One way we can do that is to bring folks, mostly students and younger doctors, out with us so that they can see what the realities are for our patients experiencing homelessness and how we provide compassionate street-based care," he said. "The residents can see the progress that's made with our approach, and then they can go back into their institutions and try to incorporate that experience into their practice."
Residents learn about Street Medicine through The Night Ministry's connections at the University of Illinois at Chicago or Loyola University of Chicago and, if interested, sign up for three six-hour shifts with the team.
Extra pairs of hands have proven useful, as residents are able to perform the same tasks as Street Medicine's medical professionals, such as administer wound care, provide antibiotics for infections, perform primary care referrals, or give prescriptions for two weeks' worth of medication for chronic conditions such as diabetes or asthma.
When the Street Medicine team introduces residents to the outreach experience, it can be something of a shock. "Some of them feel a bit unmoored. The clean regular clinic space is not like Street Medicine at all. They're dealing with factors such as the elements and scene safety on the streets – it definitely takes them out of their comfort zone," shared Koruba.
The team hopes that residents will take The Night Ministry's lessons with them on into their own clinical practices, along with a wider perspective and more compassionate approach to medicine. "Now if they're identifying a client as homeless," said Koruba, "they'll have an idea of all the things that are harder for that client to do than it would be for a housed patient with a cell phone and a job."