Course Syllabus

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Clinic on the Border: Health Frontiers in Tijuana 

GLBH 111/211 - Summer Session 2 

Theme: Health Services Issues Facing Structurally Vulnerable Populations

Class Time and Classroom:

Mondays between 1:00 PM - 2:30 PM (Zoom or in-person option, Medical Teaching Facility MTF 175) 

Saturday: Pre-Clinic discussion (7:45 AM - 8:55 AM) in the HFiT Clinic. 

Monday classes via Zoom using the following link: 

 https://uchealth.zoom.us/my/hfit2020?pwd=MFJUYytXUWEreCtYcXZ5dWswaXJXUT0

PW: hfit2020

Please note that all lectures will be delivered live and recorded for students to access after the class session has ended.

Selected in-person classes: MTF 175 

Scope and Objectives

Description 

Tijuana, Mexico, is a metropolis that experiences high volumes of migration flows from within Mexico and from migrants who are in transit to the US or other destinations. This course introduces students to the physical and mental health needs of vulnerable migrants and socially marginalized communities, including substance users, LGBTQ, deportees, and the homeless and medically indigent. Students will integrate into a free clinic in Tijuana, where they will gain community-based field experiences interacting with these populations while learning about delivering evidence-based healthcare in underserved settings. Academic deliverables will help students acquire new skills that can be applied to their current and future courses, as well as prepare them for an academic career.

Objectives

  1. To learn about the physical and mental health needs and social determinants of health among marginalized populations living in Tijuana’s Zona-Norte, adjacent to the Tijuana-San Diego border. We emphasize HIV, substance abuse, mental health, and issues affecting the LGBTQI community.
  2. To list barriers to accessing healthcare services by migrants living in Tijuana using case studies and virtual visits to the clinic.
  3. To identify binational social, healthcare, and mental health resources to address marginalized individuals' needs in Tijuana’s Zona Norte.
  4. To build a cross-border community amongst students, faculty, and community workers participating in the HFiT program.
  5. To gain experience analyzing and writing about a public health topic about vulnerable communities in Mexico and the border region, and its implications for health service delivery at the HFiT clinic.
  6. During the Summer Session 2, the course will focus on how individuals connect with the healthcare system. Through diverse readings and this case study, it is expected that students will be able to consider the health system factors that contribute to patient health and well-being.

Course Organization

Classes

During the 2025 Summer Session 2, classes will be delivered via Zoom with an in-person option (MTF-175) on Mondays (1:00-2:30 PM). Students will have the option to use a Zoom link or attend in person. Classes will also be recorded, allowing students to access the lectures at any time. Attendance for Mondays will not be enforced. HFIT clinic visits will be in person (Saturdays) with a virtual format (via Zoom) also for selected Fridays (see Canvas calendar).

Video Recording of Classes

Monday class sessions will be recorded on Zoom to facilitate students’ access to materials outside class time. Please be aware that the instructors expect students to use the chat and discussion features conscientiously, considering the needs of all class participants.

Class Websites

Course material can be found on the Canvas course website, AND clinic procedures and guidelines will be available at: https://sites.google.com/ucsd.edu/hfit-teams/hfit-protocols-and-scales 

Visits to HFiT, a Primary Care Clinic

Students will attend clinic sessions on Saturdays (in-person) and selected Fridays (virtually). This course component will allow students to become familiar with the HFIT clinic and participate in supplementary clinical discussions about HFIT patients and collaborators.

Dress (Per the UCSD School of Medicine Student Dress Code.)

Students represent themselves and the medical profession to those with whom they have contact. Please dress appropriately for our in-person or virtual video conferencing meetings.

Homework and Assignment Instructions

File Upload Instructions

All assignments and homework will be submitted via Canvas course website by the established deadline. The filename should be written as follows:

GLBH111S2_WK#_[student initials in capital].docx

Written Assignment 1: Research Report

Students will select a target population and topic (see below) to research using PubMed, Google Scholar, or databases that include peer-reviewed literature. Please focus your study on Mexico or the Mexican side of the border region (you can use references from other areas, make sure they are relevant to the clinic's environment). The report should include references to at least five peer-reviewed published articles you cite, and references should be formatted with Zotero using the American Journal of Public Health style. Students will have the option to work in teams of two students. For students working in teams, a minimum of ten peer-reviewed references will be required. Please include your full name and student ID in your report. This assignment is due via Canvas.

For students working in teams of two, include information for each team member and a section describing each member's contribution in the research report. 

Returning Students will have the option to continue with Summer Session 1 Topics and will have the opportunity to learn about IRB approval, pilot data collection, quality improvement mini-projects, 

Please structure your report using the following sections (for new students): 

  1. Title (10 words or less)
  2. Abstract (200 words or less)
  3. Introduction: define the access to care concept you are studying based on your literature review; Explain what we DO and DO NOT know about this topic.  How many persons or communities are impacted by the subject being studied? What are this topic's financial or other consequences for individuals and communities? Please provide local, regional, and national statistics to support your statements.  (at least 1 page single-spaced)
  4. Target Population: Describe the demographic, socioeconomic, and health status characteristics of your target population (at least 1/2 page single-spaced)
  5. Current Conditions among HFiT patients: Based on your personal experience attending the HFIT clinic and discussions with instructors and other students, describe the current status of patients seen at the HFIT clinic as it pertains to your topic. What are the strengths of what is currently implemented at HFIT? What are the weaknesses of the health system in Mexico? Please use the model described in Figure 2 of the Levesque, Harris, and Russel article from Week 2 to characterize the challenges faced by your target population and possible solutions to improve access to care (1 page single-spaced)
  6. Proposed Recommendations to improve access to care in Tijuana, Mexico: Please use the model described in Figure 2 of the Levesque, Harris, and Russel article from Week 2 to make recommendations for improving access to care for your target population seeking care in Tijuana. (3/4 page single-spaced)
  7. Please include your peer-reviewed references using the American Medical Association style (at least ten peer-reviewed references are required).
  8. Acknowledgments: Please acknowledge the feedback or support anyone provides as you develop your project. Please recognize our community partners.
  9. Author contributions.  Provide a detailed description of the contribution of each team member (for team projects only)
  10. On a separate page, include your bibliography [include the heading] using the American Medical Association format. 

For returning Summer Session 1 Students, the assignment will be adapted to continuation projects.  

Technical Factors 

The writing assignment should also be reviewed for clarity in expressing ideas, spelling, and grammar. Were graphics, pictures, or other exhibits used to convey data or information about the project? Did you use at least five high-quality peer-reviewed resources (ten for students working in teams)?

Project Topics

See class Notes

Target Population

  • Migrants/ International Migrants
  • People who use substances
  • People who trade sex
  • Vulnerable women
  • Vulnerable pregnant women
  • Persons living with HIV
  • Persons living with mental illness
  • Persons who are unstably housed
  • Other population—please discuss with professors

Assignment 2: Oral Presentation

All students will disseminate the findings of their work to the class during Finals Week using a PowerPoint presentation to support their oral presentation.  The presentation should last no more than 5 minutes. Students will be expected to practice their work before submitting it via Canvas.

Suggested Slides to Include: 

A) Introduction

B) Target Population

C) Current Conditions in Mexico

D) Proposed Recommendations to improve access to care in Tijuana, Mexico

E) Acknowledgments

F) For students working in Teams: Student-Author individual contributions. 

Extra Credit: 7-10 minute Educational Health Promotion Video

  • Students may work in teams of up to two to create a 7–10 minute health promotion video to educate HFIT patients on the topic they selected for their brief report or another issue from the list provided in Canvas. Note that this must be original work and cannot be taken from previously published videos online. Each team member should list their role in making the video on a credits page at the end of the video. Include team members' contributions to the educational video. 
  • Contact the course instructor for authorization if you wish to work in teams of more than two students. 
  • Note: Some videos may be selected for presentations at the HFIT Clinic.
  • Students can use any software to create the video; some options include:

HFiT Clinic Visits

  • Clinic visits will occur on selected Fridays (virtually) and Saturdays for in-person visits (option for virtual visits will be available upon special request) to the HFIT clinic in Tijuana. 
    • To learn about cases, community partners, and clinical issues, meet HFIT staff, and support the development of a binational student community.
    • To provide students with the opportunity to obtain field hours for their Global Health minor/major degree.
  • Friday and Saturday sessions will enhance students’ understanding of current events in Tijuana/Mexico.
  • Students participating in clinic visits will receive class credit and field hours.
  • Clinic visits will start on Saturdays from 7:30 AM – 1:00 PM, and optional virtual visits for Selected Fridays from 9 AM - 12 PM (See Canvas Calendar) 
  • Students, faculty, and the Scripps Family Medicine residency team are invited to participate during the live sessions.

Student Evaluation of Course and Faculty

Students must complete the anonymous course and faculty evaluations of this course.

Grading/Assessment & Evaluation of Student Performance

Grading Scheme

Grade Points

Assignment #1: Scientific Report

25

Assignment #2 Oral Presentation

20

1 Office Hour visit (2 for students working on team projects)

15

Certifications and Quizzes

15

Participation in the HFiT clinic sessions (Report at least 3 clinic visits)

25

Extra Credit (Educational Video in Teams)

5

Grading Scheme

Letter Grade

Range

A+

Outstanding Performance

A

>100%to94%

A-

< 94%to90%

B+

< 90%to87%

B

< 87%to84%

B-

< 84%to80%

C+

< 80%to77%

C

< 77%to74%

C-

< 74%to70%

D+

< 70%to67%

D

< 67%to64%

D-

< 64%to61%

F

< 61%to0%

 

Course Summary:

Course Summary
Date Details Due