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Urban Health Residency Program

Street Medicine Curriculum - Johns Hopkins Combined Med-Peds Program

We received a grant from The Health Resources and Services Administration in 2025 to support the development of our new Street Medicine Curriculum! The curriculum prepares residents to provide comprehensive, community-based care for people experiencing homelessness through longitudinal clinical experiences, interprofessional collaboration, and partnerships with community organizations.

Residents learn to deliver patient-centered care in nontraditional settings while addressing the medical, behavioral, social, and legal factors that influence health outcomes for people experiencing homelessness.

Learning Objectives

The Street Medicine Curriculum will enable our residents to:

  • Deliver evidence-based primary care in street, shelter, mobile, and community settings.
  • Apply principles of trauma-informed, culturally responsive, and patient-centered care.
  • Diagnose and manage chronic medical conditions in people experiencing homelessness.
  • Provide wound care in resource-limited environments.
  • Screen, diagnose, and treat substance use disorders.
  • Recognize and manage common behavioral health conditions encountered during street outreach.
  • Address social determinants of health through collaboration with community organizations.
  • Identify legal barriers affecting health and connect patients with medical-legal resources.
  • Function effectively within interdisciplinary teams that include physicians, nurses, social workers, community health workers, legal advocates, and outreach organizations.
  • Advocate for equitable access to healthcare for vulnerable populations.

Curriculum

Street Medicine Didactics

Residents participate in a longitudinal curriculum that includes:

  • Street Medicine 101
  • Wound care in street settings
  • Harm reduction and street-based addiction medicine
  • Chronic disease management outside traditional clinical settings
  • Behavioral and mental health in street medicine
  • Social determinants of health and barriers to care

Educational sessions are reinforced through Urban Health Noon Conferences, Academic Half Days, Grand Rounds, and interdisciplinary learning experiences.

Clinical Experiences

Residents participate in progressive, longitudinal training throughout all four years of residency.

PGY-1

Urban Community Medicine (2 weeks)

Residents work alongside community organizations providing outreach and services to people experiencing homelessness, including:

Focus areas include:

  • Community outreach
  • Substance use treatment
  • Housing insecurity
  • Community resource navigation

PGY-2

Health Care for the Homeless Rotation (2 weeks)

Residents train with Health Care for the Homeless across multiple care settings:

  • Street outreach
  • Mobile medical unit
  • Shelter clinics
  • Fallsway clinic

Clinical emphasis includes:

  • Acute and chronic disease management
  • Wound care
  • Mental health
  • Substance use disorders
  • Care coordination

PGY-3

Longitudinal Street Medicine Experience

Residents provide half-day street medicine sessions throughout the academic year with a consistent faculty preceptor, allowing them to develop longitudinal relationships with patients as they transition between outreach, shelter, clinic, and hospital settings.

PGY-4

Neighborhood Nursing Rotation (1 week)

Residents provide community-based care for older adults and individuals with unstable housing through an interdisciplinary Neighborhood Nursing team.

Interprofessional Education

Residents learn alongside:

  • Community health workers
  • Registered nurses
  • Social workers
  • Case managers
  • Medical office assistants
  • Behavioral health specialists
  • Advanced practice providers
  • Legal professionals and law students
  • Community outreach organizations

The curriculum emphasizes collaborative care, resource navigation, and coordinated management of medical, behavioral, and social needs.

Medical-Legal Partnership

Through collaboration with the University of Baltimore School of Law Civil Advocacy Clinic, residents learn to:

  • Recognize legal issues affecting health
  • Refer patients for legal assistance
  • Collaborate with attorneys and law students
  • Address housing instability, public benefits, employment, and other social determinants of health
Additional Areas of Training

Residents also receive enhanced education in:

  • Addiction medicine and medications for opioid use disorder
  • Trauma-informed care
  • Adverse Childhood Experiences (ACEs)
  • Behavioral and mental health
  • HIV and Hepatitis C care
  • Geriatrics
  • Cultural humility
  • Motivational interviewing
  • Quality improvement
  • Resident wellness and professional development

Community Partners

Training is supported through collaborations with: