A 2021 study found that 34% of nonelderly Hispanic residents in the United States do not have a physician — compared to 18% of African Americans and 16% of Caucasians. This lack of access to care, along with poverty, language challenges, food insecurity and other societal factors — called the social determinants of health — lead to higher rates of diseases including diabetes, heart disease, HIV/AIDS and cancer for Hispanics.

“Where you live – your zip code — is the most important determinant of your health, regardless of race or ethnicity,” says Caridad Hernandez, professor in the College of Medicine. “Let’s look at ways that we, as educators, researchers and clinicians, can make a difference.”

One solution on the horizon is a new mobile healthcare clinic — a collaboration of the UCF Academic Health Sciences Center (AHSC).  The 38-foot van is expected to launch in June 2024, with participation from faculty and students of the AHSC’s three colleges: Health Professions and Sciences, Medicine and Nursing. It will provide preventative and screening services, with the goal of improving chronic disease management and unnecessary ER visits. By providing care where patients are, Hernandez says the mobile clinic will allow providers to be more engaged in the community and learn first-hand the community’s needs. The mobile clinic will schedule visits in poverty hot-spots across Central Florida, including Apopka, East Orlando, Kissimmee, Parramore and St. Cloud.

In 2003, medical experts across the nation produced a book titled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Twenty years later, while some progress has been made, Hernandez says that these disparities continue and have worsened due to COVID-19. The coronavirus pandemic showed once again that underserved and minority populations became seriously ill and died from COVID-19 more than their Caucasian counterparts.

According to the U.S. Census, 63.7 million Hispanics now live in the U.S., accounting for 19% of the population. Hispanics make up 27.1% of the population in Florida, 32% of the population in Orange County and 55% in Osceola County. Many of Osceola County’s Hispanics — 41% — are from Puerto Rico, relocating to the U.S. after Hurricane Maria in 2017. In addition to other social determinants of health, many of these families face displacement issues and trauma from the hurricane, Hernandez says.

As the College of Medicine and the healthcare industry look at addressing healthcare disparities for Hispanics, Hernandez and Deborah German, UCF’s vice president for health affairs and dean, have suggested examining ways to diversify people entering medicine. For example, as technology helps improve care and health monitoring, medical schools might consider admitting more engineers who can help create new, more accessible delivery systems. And increasing the numbers of bilingual medical students — in languages such as Spanish and Portuguese — will create more doctors who can communicate with Hispanic patients in their native language.

Hernandez shares her personal journey through medicine as an illustration.

She arrived in the United States as a Cuban refugee at the age of 3. Her parents were farmers in Cuba and had little advanced education. Her mother worked as a seamstress in America. Her family only spoke Spanish in their home and Hernandez was their interpreter for all of their medical appointments.

“I didn’t end up here by accident,” she says of her life’s work.

The annual conference drew more than 400 students from medical schools nationwide who are working with free clinics or are interested in establishing one.  Third-year students Erin Kane, Mike Arnold, Lynda Yu, Kayla Avery, Glenn Gookin offered two platform presentations and two poster presentations on the KNIGHTS Clinic, run in partnership with  Grace Medical Home near downtown Orlando. About 25 patients are receiving continuing care at the free clinic one night a month and the students have helped Grace ease a backlog of uninsured patients needing primary and specialty care.

Dr. Caridad Hernandez, the KNIGHTS Clinic faculty adviser, praised students for their dedication in making the facility successful. “The KNIGHTS Clinic is truly a student run clinic and I am so proud of what the student leaders have accomplished,” she said. “There has also been tremendous support from the entire COM student body and to date over 111 students from M-1 to M-4 years are active volunteers; that represents one-third of the entire study body!”

Kane and Avery’s 25-minute presentation, titled “Collaboration for Patient Care,” discussed how students collaborated with community organizations  to open the clinic. The Diebel Legacy Fund at the Community Foundation of Central Florida provided $10,000 to support the clinic and the Winter Park Health Foundation donated $5,000. “Students from other institutions were amazed by what we were able to set up so quickly being such a young school,” Kane said. “UCF was as well represented as many older, longer established schools and clinics.”

Yu’s poster presentation on  “Navigating the Challenges of an Affiliation Agreement between a şŁ˝ÇÖ±˛Ą and a Private Free Clinic,” detailed how the College of Medicine was able to partner with the existing  Grace Medical Home.  “It was an honor to represent UCF COM and the KNIGHTS Clinic at the conference, to show our peers all that the clinic has accomplished in the past year.” Yu said. “The timing, with the clinic’s first anniversary the day before the conference, just made things even better.”

Another 25-minute platform presentation from Arnold titled: “Development of a Laboratory Training Module at a Student Run Free Clinic,” explained how students were trained to run the KNIGHTS Clinic’s lab and get more hands-on learning experiences. Gookin’s presentation on “Partnership between a Student-Run Clinic and a Private Medical Home” drew a great deal of interest. “At one point there was a line students and faculty waiting to ask me questions about the unique components of the project,” he said. “This reflects how fortunate we are to have such a successful collaboration with Grace Medical Home.”

The students have continually expressed their gratitude to their physician mentors, Dr. Marvin Hardy, director of Grace Medical Home,  Dr. Pinkal Patel, a family medicine specialist who works at the clinic and also is a preceptor to first- and second-year students, and core faculty members Drs. Hernandez and Judy Simms-Cendan, who helped guide them through the process of opening a medical clinic.

UCF’s 18-month effort, led by Dr. Caridad Hernandez, will include a systematic review how humanism is taught in medical education across the span from medical student to practicing physician. The study will examine how contextual factors – such as workplace learning, task demands, team dynamics, time constrains, fatigue and support systems – influence the way physicians express humanistic attributes such as empathy.

The study will look at how medical training, practice and the learning environment can impact humanism and empathy and hopes to identify specific interventions that can more significantly promote a humanistic approach to physician training.

“It’s an honor to be selected to participate in this endeavor, to help contribute to identifying best practices for teaching, sustaining and promoting humanistic attributes amongst medical trainees and physicians,” Dr. Hernandez said.

In notifying Dr. Hernandez of the award, the Gold Foundation noted that this year’s review process was “extremely competitive,” with many more proposals than the organization anticipated on important questions related to increasing humanism in medical care.

Dr. Hernandez’s collaborators on the study are: