Background/Purpose: As noted in the 2015 ACR Workforce Study, few in the rheumatology identify as being from a community of color. Therefore, most rheumatologists do not have first-hand experience being part of these communities — which are often those most affected by the rheumatic diseases. We therefore devised a community tour for our fellows to 1. better understand the community of patients they serve and 2. have an appreciation of the community resources available to the patients of the Bronx, NY.

Methods: In order to devise the tour, an assessment was done of the zip codes from patients seen in the Montefiore general arthritis clinic. We found that patients from across the borough were seen in clinic, therefore the decision was made to leave the neighborhoods where the clinics were located in order to bring the fellows to an area of the Bronx that they did not commonly visit. No traditional tourist sites were visited on the 3 hour tour. While on the tour, fellows learned about the history of the Bronx including several key events, such as the construction of the Cross Bronx Expressway, in addition to concepts such as “White Flight” and the discriminatory housing practice known as “Red-Lining.” While on the tour the fellows visited 3 major community resources: Women’s Housing and Economic Development Corporation (WHEDco); Institute for Family Health: Urban Horizons and Bronx Works. WHEDco provides award winning affordable housing, an Early Childhood Discovery Center, home-based childcare training institute and the Bronx Cook Space — where street vendors can safely prepare food for purchase using shared industrial kitchen space. Institute for Family Health: Urban Horizons is a federally qualified health center that was created to address health disparities in innovative ways by working with programs such as the CDC’s REACH program. Bronx Works, located adjacent to housing court, offers in addition to eviction prevention and homelessness services, health insurance assistance, and youth programs.

Results: 5/7 fellows completed the post-tour survey. None of these 5 fellows had ever participated in something similar. 5/5 felt that the tour was: “Informative/Very Informative” and “Helpful/Very Helpful” All respondents “Recommend doing it next year” and felt that it “Enhanced their fellowship”.

Conclusion: Most of the physicians that work for Montefiore do not live in the Bronx and many use public transit and local highways thus avoiding local streets and neighborhoods. This, in addition to the typical media portrayal of the Bronx, can lead to providers not engaging with the community outside of the clinical setting. This can also lead to the reinforcement of biases often faced by communities of color. By taking the fellows into the neighborhood and having them interact with community members it begins to give them a nuanced perspective of the patients they serve.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/an-innovative-pilot-educational-program-to-inform-rheumatology-fellows-about-the-population-of-the-bronx-issues-affecting-and-resources-available-to-the-community/