Health Equity Track


Hope for health equity in our community and around the world requires preparing the next generation of physicians to understand social determinants of health and to act as partners for improved living conditions, health literacy, and access to services. Our track is grounded in a commitment to prepare residents in this shared effort. Residents will practice and learn how to improve health outcomes, to reduce health inequities, to demonstrate empathic understanding and cultural humility, and to effectively advocate for health equity in our local and broader community.

Our mission is to promote health equity by empowering residents with the clinical competencies, advocacy skills, and community partnerships needed to identify and overcome health disparities.

Why Health Equity?

The practice of medicine is beset with many challenges, among them a sense of inadequacy and frustration when facing injustices and adverse health outcomes that are preventable. As clinicians, we can become keenly aware of the sociocultural and economic challenges many of our patients face. Our patients live with barriers to safe living conditions,access to clean water, reliable sources of food, adequate housing, and education. They face wage discrimination, structural racism, systemic sexism, generational poverty, and a lack of healthcare coverage, all of which can reduce quality of life,longevity, and the opportunity to participate fully in society. For everyone to have a fair and just opportunity to live well and be as healthy as possible, and for society to thrive, these obstacles to health must be eliminated. Physicians are uniquely positioned to be effective partners for identifying and addressing the social determinants of health at the patient, healthcare system, and community levels and to advocate for policies to further health equity.

It is our belief that all physicians-in-training have the personal experiences, curiosity, compassion, talent, and professional commitment it takes to recognize and tackle pressing health disparities. This track is intended to support and inspire those residents who seek to hone their clinical and advocacy skills while examining the many upstream and environmental sources of health disparities they will encounter throughout their careers.

Learning Objectives

The Health Equity Track offers a supportive learning environment for residents. The track complements the Internal Medicine Residency Program in developing the core ACGME competencies, including Interpersonal and Communication Skills (IC), Professionalism (P), Systems-Based Practice (SBP), Medical Knowledge (MK), Patient Care (PC), and Practice-Based Learning Environment (PBLE). By the end of this track program, residents will be able to:

  • Identify health disparities among individuals and communities in San Antonio and our partner sites (MK)
  • Recognize and build relationships with local stakeholders and partners in promoting health equity (PBLE, IC, P)
  • Define key public health principles related to social determinants of health and health equity and illustrate how they can effectively shape clinical decision-making, resource allocation, program development, policy formulation and governance, and other forms of practice (SBP, MK)
  • Analyze the relationships between health insurance coverage, access to services, quality of services, and health outcomes (MK, SBP)
  • Describe the nature and purpose of US health care safety-net programs including Medicare, Medicaid, and the Patient Protection and Affordable Care Act (MK, SBP)
  • Develop attitudes and skills related to empathic communication, cultural humility, and trauma informed care in the context of caring for underserved populations (P, IC, PC)
  • Assess patients for health disparities and preventable adverse health outcomes during clinical encounters and construct a plan to mitigate these outcomes for similarly situated patients (SBP, PC, PBLE)
  • Engage in activities that promote health equity through research, teaching, advocacy, and volunteerism (PC, PBLE)
  • Develop, complete, and present a capstone project offering a scholarly examination of changes in practices, environments, policies, laws, and systems to improve health equity and outcomes (SBP)

Track Outline and Requirements

The Co-Directors for the Health Equity Track intend to draw on our residents’ passion for service and change while helping to ensure a work-life balance. The structure of the track will balance residents’ other personal, educational, clinical, and research interests. Residents are asked to regularly and pro-actively communicate their interests and needs with the Internal Medicine Residency Program Director, Associate Program Director, and Chiefs, along with the Health Equity Track Co-Directors.

Applicants who enroll in this 24-month program will begin at the start of their PGY2 year. The track includes (1) a core didactic curriculum, (2) experiential learning and service opportunities, including required activities during plus-one weeks and elective rotations, and (3) a capstone project.

Successful completion of the track requires:

  • ≥ 80% participation in the didactic curriculum, including Interest Wednesdays, dedicated Health Equity Track sessions, and asynchronous online modules
  • full and accountable participation in experiential learning and service opportunities, including a minimum of two half-day activities during plus-one weeks and a minimum of one elective during PGY2 and one elective during PGY3
  • successful completion of a capstone project presented to peers by the end of PGY3

Each resident will meet with a track Co-Director every 6-months to ensure they are progressing within their program goals. Continued participation in the track is subject to good standing within the Internal Medicine Residency Program and among institutional partners within UT Health San Antonio. Learning and service sites may have specific requirements of participation that residents will be expected to honor. Residents are strongly encouraged to communicate clearly and promptly any concerns related to safety and security or their ability to participate in scheduled activities.

Core Curriculum

A curriculum with didactic teaching and asynchronous, self-guided learning assignments (e.g., assigned readings and online modules) will serve to advance fundamental clinical and system concepts relevant to social determinants of health, health equity, and health policy. The curriculum, maintained in the Health Equity site on Microsoft Teams, will focus on underserved populations in addition to specific health equity topics. A monthly speaker series and small group learning sessions (e.g., case-based learning and journal club) will take place on Interest Wednesdays (noon conferences).

Core topics and associated readings and modules include:

  • Social determinants of health
  • Physician advocacy
  • Cultural humility
  • Poverty, inequality, and health disparities
  • Violence and trauma-informed care
  • Migrant and refugee health
  • Community resources
  • Research methods
  • Health literacy
  • Medical ethics
  • Bias and racism
  • Health policy
  • Gender identity and sexuality
  • Systems of care
  • Rural, border, and global health
  • Incarceration and homelessness
  • Mental illness and substance use disordersInterprofessional teamwork

Experiential Learning and Service

Social Determinants Experiences

Every fifth or plus-one week, residents will participate in at least two half-day activities such as the following (note: location and time will vary for these clinical experiences and may include evenings):

  • Touring zip codes of San Antonio with an online equity atlas
  • Exploring important community resources throughout San Antonio
  • Accompanying patients or families through the CareLink enrollment process for uninsured patients
  • Partnering with community health workers for home visits
  • Collaborating with City of San Antonio and Bexar County advocates and programs
  • Promoting health literacy, e.g., at local schools or the Battered Women and Children’s Shelter
  • Engaging with University Health’s Patient Family Advisory Council
  • Providing clinical service in WellMed clinics and supportive care programs
  • Providing clinical care and education at UT Health San Antonio’s Student Faculty Collaborative Practices, including:
    • Alpha Home Clinic
    • Haven for Hope/Restorative Center Clinic
    • San Antonio Refugee Health Clinic
    • SAMM Transitional Living and Learning Center Clinic
    • Travis Park Dermatology Clinic
    • Pride Community Clinic

Advocacy/Policy Experiences

During their plus-one weeks, residents will have the opportunity to develop real-world advocacy skills, including:

  • Engaging with legislative stakeholders in Texas
  • Communicating professional and community priorities related to health equity in various ways:
    • Opinion pieces
    • Congressional testimonyLegislative and policy memos

Elective Rotations

Residents will participate in at least one health equity rotation of their choice during both PGY2 and PGY3 (total of two minimum electives) including, but not limited to:

  • Chinle Comprehensive Health Care Facility in Chinle, Arizona
  • Scottish Livingstone Hospital in Molepolole, Botswana
  • Health Systems Improvement rotation in the UT Primary Care Center

Housing will be available at various sites and some financial support for travel will be provided. There will also be opportunities to create specific health equity rotations in a given field (e.g., incarceration medicine,  immigrant care, etc.) upon request. Novel rotations can be developed in collaboration with the track Co-Directors. Schedules will be personalized for each resident and requested rotations will be accommodated as much as possible. All rotation offerings are dependent on clinical space and faculty availability.

Capstone Scholarly Project

Residents will complete a longitudinal scholarly project related to health equity, social determinants of health, underserved populations, global health, or health policy under the mentorship of UTHealth SA faculty (for global health projects, mentors must be local). Projects can include research, quality improvement, or meaningful contributions to ongoing community work. Residents will present a summary of their projects to their peers by the end of PGY3.


The Health Equity Track offers a diverse and broad experience for residents who will likely go on to focus their practices on specific populations and issues. Residents are invited to consider an informal and personalized pathway during PGY3 where they can begin to deepen their understanding of a population or issue, and they may tailor their scholarly project and their experiential learning and service accordingly. Pathways to understanding and achieving health equity include:

  • Global health
  • Asylum medicine, as well as migrant and refugee health
  • Lesbian, gay, bisexual, transgender and queer or questioning health
  • Mental health and substance use disorders
  • Disability and health
  • Incarceration medicine
  • Rural and border health
  • Homelessness and health
  • Other underserved populations

What roles will residents take on after graduation?

The purpose of this track is to train leaders in health equity. Typical career paths of graduates will include clinician-educators at academic institutions, primary care physicians in underserved settings, clinician-researchers with a focus on health equity and public health, and leadership roles in policy, advocacy, or service-oriented local and global health organizations.