Urban Cowboys
Dozens of medical students gear up to volunteer at a new, off-campus clinic for the uninsured

Constantine Demetracopoulos at the side of the Men's Center.

Walking the empty streets lined with boarded-up row houses, first-year medical student Constantine Demetracopoulos looks out of place in this desolate East Baltimore outpost. But as he arrives at the building in the 2200 block of Jefferson Street with the weather-beaten sign advertising “the Men’s Center,” it’s clear he is brimming with purpose.

Demetracopoulos recently took the reins of a project in which medical students are blazing a trail into health care’s forgotten frontier: the uninsured. Starting this month, he’ll oversee 47 of his classmates who have volunteered to staff a new, full-service health clinic at the Men’s Center, the community-based organization housed here on Jefferson Street.

The seed for the clinic was planted last spring, when the Johns Hopkins Urban Health Institute (UHI) and the School of Medicine’s Division of Infectious Diseases partnered with the Men’s Center to offer free HIV/AIDS testing and counseling there. Hopkins medical students, supervised by a physician, provided these services as volunteers after completing state counseling requirements. By June 2003, they had tested 130 men.

Now, a broader partnership, similarly supervised, is set to replace that clinic with a new one that will tackle any health issue that comes through the door. “Our mission is to provide a complete health home for people who have nowhere else to turn,” says Tom Morford, UHI deputy director. “When their problems get bad enough, they go to the emergency room. But there’s a lot of prevention that can take place before it reaches that point.”

Sitting in a metal folding chair inside one of the Men’s Center’s musty, make-shift exam rooms, Demetracopoulos muses over how much his classmates have been willing to sacrifice. They’ve spent evenings in the HIV clinic without a single patient. They’ve turned down opportunities to work in labs and publish papers. Even so, he says, it’s worth it. “It’s easy to just go to school, shield yourself from your surroundings and not care,” he says. “But when you realize how much this community needs, there’s no choice but to get involved.”

The students have learned how to test for HIV and what the numbers mean in context. All have completed the official state HIV testing and counseling certification, where they learn how to send blood and paperwork to the lab, ask open-ended questions during assessment, and establish trust and exhibit empathy while counseling. Now, for four hours each Tuesday evening, Demetracopoulos and his army of fellow students will perform STD testing and counseling, blood pressure and cholesterol screenings, weight management and diet counseling, and diabetes-related blood glucose testing. They will work under the guidance of physician Katy Close, a master’s student at the School of Public Health who was medical director of a similar clinic in South Carolina.

Funding, medication and software have been donated by Pfizer. The Pfizer grant also will enable UHI to open two more clinics over the next two years, one at the Wald Clinic, operated by the schools of Nursing and Public Health, and another to serve Baltimore’s growing Hispanic population.

“It’s hard out here,” says Demetracopoulos. “It’s like we’re in the middle of nowhere. But we feel strongly about empowering people and teaching them to take ownership of their health.”

- Lindsay Roylance

Call to Action Early last fall, before classes began, each first-year medical student received an invitation to participate in a volunteer project on the day before orientation. More than 70 students signed up—over half the class. Some cleaned parks, others lent a hand at after-school programs, and all delivered lunches to the homes of HIV-positive East Baltimore residents. It was all part of the School of Medicine’s new Baltimore Awareness and Service Experience program, an initiative organized by InterAction, a School of Medicine group that links medical students with the kinds of volunteer opportunities that allow them to develop a long-lasting relationship with East Baltimore. More than 300 Hopkins medical students volunteer through the organization, donating their time to mentor students at local schools, serve as “big sibs” to HIV-positive teens and distribute discarded medical equipment to developing countries. In the works are plans to establish a community clinic volunteer program that joins medical students with nursing students, to foster the spirit of teamwork early on. Info: www.hopkinsmedicine.org/interaction