A Passion for Service

Greater Lawrence Family Health Center’s Lawrence Family Medicine Residency Program

More than 800 applicants vying for eight coveted openings might sound like the premise for a cutthroat reality television show, but for Dr. Joseph Gravel, that kind of interest marks the beginning of an annual monthslong process to match doctors with the Lawrence Family Medicine Residency (LFMR) program sponsored by the Greater Lawrence Family Health Center, where Gravel has served as chief medical officer and residency director for the past six years.

The LFMR program was founded in 1994 as the nation’s first accredited community health center-sponsored family medicine residency. In 2011, it was designated by the Health Resources and Services Administration as one of the nation’s first 11 teaching health centers under the Affordable Care Act. Additionally, the residency program was selected by the Accreditation Council for Graduate Medical Education in May 2012 as one of 12 family medicine residencies for its national four-year length of training study. Today, with 30 active residents, it remains a model program for family medicine residencies across the country and attracts applicants from top medical schools.

Part of the LFMR program’s appeal is its Spanish language immersion program. It begins at Dartmouth College, where residents participate in the Rassias Method language program, an intensive 10-day course designed to support fluent speakers and beginners alike. Residents then spend a week in the Dominican Republic—the original home of many Lawrence residents—to experience the culture of their patients and to hone their language skills. Upon their return, each resident is assigned a group of 100 patients they’ll care for over the course of their residency. With the help of a bilingual staff and an on-site language teacher at Greater Lawrence Family Health Center, all residents become proficient in the language by the end of their program.

Residents also have the option to serve some of their time abroad in countries such as Guatemala and Nicaragua, where affiliated staff or former residents are stationed at medical centers.

Dr. Joshua St. Louis, a second-year resident, says the program has lived up to its reputation.

“I had spent significant time abroad studying Spanish in college and medical school, and it’s only now that I feel completely comfortable speaking exclusively Spanish with my patients every day,” he says. “The program provides lots of support for Spanish learners of all levels, and it’s incredible to see my co-residents attaining an impressive level of Spanish proficiency.”

Gravel says the LFMR’s Spanish language immersion program has been presented nationally as a model for other teaching health centers. “There is a growing need for Spanish-speaking doctors in family medicine, and it’s nice when our doctors are able to make a cultural connection with our patients,” Gravel says.

During the application process, Gravel and Dr. Wendy Brooks Barr, a graduate of the residency program and its associate director, look for candidates with a demonstrated commitment to helping underserved communities.

“We want our residents to be very engaged in the community,” says Gravel, who was the residency program director at Tufts University for nearly 15 years. “They come to the LFMR because they are community-oriented, and this is a place where health care is woven into the fabric of the community.”

Residents, who work 60 to 80 hours a week between the Greater Lawrence Family Health Center and Lawrence General Hospital, typically live in the community during the program. They engage in activities that enable them to experience what life is like for their patients, including “in-their-shoes” problem solving for matters such as applying for state or federal assistance, or searching for specific health services.

During the four-year program, all residents are trained in the full spectrum of family care services, but each can also choose areas of concentration, such as HIV medicine, women’s health, sports medicine, health systems leadership and advanced maternity care. Lawrence General Hospital provides opportunities for residents to work with advanced technologies, such as the latest in ultrasound imaging. The program also partners with local social organizations, such as the YWCA of Greater Lawrence, where residents can get involved in support, group health and educational programs.

These community experiences serve as the foundation for their future careers, Gravel says.

“The mission of the LFMR is to provide residents with the skills to provide medical care and medical leadership in the emerging new health care system, particularly in underserved communities,” Gravel says.

Indeed, St. Louis plans to follow his residency by working in an underserved urban population, where he intends to focus on HIV primary care, addiction medicine, and reproductive health access – for adults, children and pregnant women.

“I very much expect I’ll spend some of that time here in Lawrence,” he says.

According to Gravel, a number of residents return to Lawrence because of the personal connections they make with the community during their time in the program.

“Our residents are driven by a passion for service,” Gravel says. “The best people going into medicine work here.”

Greater Lawrence Family Health Center
Lawrence, Mass.  /  (978) 686-0090  /  GLFHC.org

Lawrence Family Medicine Residency
Lawrence, Mass. / GLFHC.org/Residency

Top photo caption, left to right: Psychologist Marty Cohen, Ph.D; Psychologist Alan Smith, ScD; Joseph Gravel, MD; resident Clark Van Den Berghe, MD; Wendy Barr, MD. Photo by Rob Huntley.