Reimagining Residency at Montefiore Einstein
AMA Reimagining Residency at Montefiore Einstein: Training Tomorrow’s Physicians by Empowering Residents to Address Health-Related Social Needs
Montefiore Einstein’s Reimagining Residency initiative is transforming how we train future physicians by equipping them to recognize and act on the social and structural factors that impact health. Through this multi-year project, Montefiore Einstein integrated education on social determinants of health (SDH) into residency training across four primary care specialties including Internal Medicine, Family Medicine, Pediatrics, and OB/GYN, reaching over 700 residents.
Overview
The project began with an in-depth, comprehensive analysis into existing SDH teaching across departments, followed by a national Delphi study that identified key knowledge and behavior priorities in SDH education. This work shaped the development of a new curriculum and faculty development efforts. A four-session curriculum was developed and implemented across all four specialties, addressing key competencies identified by national experts:
- Medical Knowledge: Frameworks for SDH and structural determinants, with local examples
- Systems-Based Practice & Teamwork: Workflows for HRSN screening and referrals to CHWs
- Interpersonal Skills: Application of trauma-informed care in conversations about social needs
- Advocacy: Training in the Midwest Academy Strategy for patient and community advocacy
In partnership with Montefiore Einstein’s Community Health Worker Institute, the curriculum focused on real world skills: understanding inequities, conducting health-related social needs screenings, working with interdisciplinary teams, and advocating for patients. These efforts were reinforced by hands-on clinical experience and data-informed feedback loops supported by the Community Health Systems Lab.
A key evaluation metric was the clinical process data provided by the Community Health Systems Lab—particularly rates of SDH screening, referrals to CHWs, and successful connections to services. These data informed responsive adaptations to educational efforts across disciplines. Focus groups with residents provided qualitative insights into their experience within both the explicit and hidden curriculum, guided by an implementation science framework.
In addition, a competitive microgrant program empowered residents and faculty to design and implement innovative SDH-focused education projects. Faculty development impact is also being analyzed through interviews with microgrant recipients, highlighting the importance of interdisciplinary teamwork and meaningful project-based learning.
As the Reimagining Residency project evolved, Montefiore Einstein extended this work upstream, building bridges between undergraduate and graduate medical education. Through collaboration with Einstein’s Service-Learning Course, the initiative is fostering a continuum of education that prepares medical students and future residents to serve patients with empathy, humility, and a deep understanding of community health.
Through this project, we were able to develop and study an exemplary model of integrating educational change with organizational change supporting faculty roles as curriculum and practice change champions.
By embedding social responsibility and equity into medical training, Montefiore Einstein’s Reimagining Residency project is shaping a new generation of physicians well-prepared to meet the challenges of modern healthcare.
Research
Highlighted Publications on Social Determinants of Health and Medical Education
Hassan, I. F., & Bui, T. (2022)
The Structural Analysis: Incorporating Structurally Competent Clinical Reasoning into Case Based Presentations. Journal of General Internal Medicine, 37(13), 3465–3470.
Hassan, I. F., Gorski, V., Sanderson, D., Braganza, S., Benfield, N., Nadas, M., Amursi, E., & Gonzalez, C. M. (2023)
Consensus on Social Determinants of Health Knowledge Topics and Behavior Learning Goals Across Primary Care Residencies: Results of a Delphi Study. Academic Medicine, 98(8), 941–948.
Gutierrez, A. K., Twito, V., Ni, J., Liu, J., Atrio, J., Rolston, R., Menezes, M., Dunbar, J., Talib, H., Nguyen, H.-A., Fiori, K., Cassese, T., Cervera-Hernandez, M. E., Zwerling, J., & Jariwala, S. (2023)
The Impact of a Twitter-Supplemented Educational Intervention to Promote Training in Social Determinants of Health Among Medical Residents. Current Journal of Applied Science and Technology.
Metaxas, A., Hantgan, S., Zwerling, J., Desai, J., & Jariwala, S. P. (2023, August 31)
The Impact of a Social Media–Based Educational Intervention to Promote Training in Social Determinants of Health Among Medical Residents. NeurologyLive.
Moon, C. (2023, May 31)
Climate Education and Advocacy Go Hand in Hand. AAP Voices Blog, American Academy of Pediatrics. Retrieved from https://www.aap.org/en/news-room/aap-voices/climate-education-and-advocacy-go-hand-in-hand/
Moon, C., Braganza, S., & Bathory, E. (2024)
Incorporating Climate Change Education Into Residency: A Focus on Community Risks and Resources. Journal of Graduate Medical Education, December 2024 Supplement, p. 86.
Cogen, J., et al.; APPD LEARN Climate Change Study Group. (2024, January 12)
Pediatric Resident and Program Director Views on Climate Change and Health Curricula: A Multi-Institution Study. Academic Medicine.
Messineo, E., Pardo, C., Lee, J., & Moon, C. (Accepted August 12, 2024)
Becoming Climate-Informed Physicians. Journal of Graduate Medical Education.
Skae, C. C., Gorski, V., Flattau, A., Gurung, M., Varaklis, K., & Hallen, S. (2025)
Integration of Interprofessional Education Into Routine Resident Practice: 2 Cases of Successful Implementation. Journal of Graduate Medical Education, 17(2s), 53–56.
DeWaters, A. L., Cooney, R., Gonzalo, J. D., Gorski, V., Goss, E., Kim, J. G., & Skae, C. C. (2025)
Systems-Based Practice and Health Systems Science in Graduate Medical Education: Recommendations for Embracing This Critical Core Competency. Journal of Graduate Medical Education, 17(2s), 53–56.
Richardson, J., Yarris, L. M., Carney, P. A., Goss, E., Zelaya, M. I., Morgan, H. K., Chen, F., Schumacher, J. A., O’Rourke, P., Gillespie, C., Thompson, B. M., & Goldhamer, M. E. (2025)
Program Evaluation for Graduate Medical Education: Practical Approaches From the Reimagining Residency Evaluation Community of Practice. Journal of Graduate Medical Education, 17(2s), 53–56.
Shi, M., Woo, S., Levano, S., Fiori, K., & Iyer, S. (2025)
Impact of a housing and health focused residency curriculum on community health worker utilization for unmet housing needs. Journal of Primary Care & Community Health, 16, 21501319251340818.