Medical students, whether focused on Family Medicine or other specialties, tend to be driven individuals with a wide range of interests and experiences. Throughout their undergraduate years, many have already become proactive volunteers and leaders at their universities and within their communities. However, the question remains, will previously learned leadership skills successfully transfer toward their goals associated with their medical careers? How does a physician-in-training plan and work toward becoming a chief resident, a medical student coordinator at a clinic, a residency program director, a research director, a preceptor or mentor, or possibly, the department chair?

UW-Madison medical students have had the opportunity to participate in LOCUS, (Leadership Opportunities with Communities, the Underserved and Special Populations) (http://www.fammed.wisc.edu/medstudent/locus/index.html). LOCUS is aservice-learning program at the University of Wisconsin School of Medicine and Public Health that aims to enhance:

• leadership knowledge and skills,
• self-awareness, and
• preparation for community health service.

A network of faculty mentors is actively involved with LOCUS fellows to guide health related projects in the community. Students, staff, and faculty collaborate to improve the program to meet the needs of students and address health needs in communities.

Medical students, faculty, and staff of the UW Department of Family Medicine established LOCUS in the fall of 1998. The idea for the program was developed by Cynthia Haq, MD and medical students who had strong interests in remaining actively involved in community service during medical school. Some of these students had community health experiences prior to entering medical school. These students wished to strengthen their leadership skills and work with others who had similar goals. Their vision was to create a program to support medical students who:

• enter medical school with a strong commitment to community service;
• acknowledge problems in our current health care system and wish to enhance health care for medically underserved populations;
• recognize that effective leadership skills may be combined with medical skills to improve health care;
• wish to collaborate with a community of like-minded students, staff and faculty; and
• are self-directed learners who are willing to enhance their skills through participation in the program and completion of a community health project.

Students apply to the LOCUS program at the beginning of medical school. They are selected through a written application and interview process. They remain LOCUS fellows until they graduate, and may refine their skills and continue LOCUS activities throughout their medical careers. Students sign an agreement detailing the program’s expectations, but participation is entirely voluntary. LOCUS fellows work with physician and community mentors, participate in the core curriculum, and complete a community health project. The group meets monthly and holds two retreats a year off-campus.

Even leadership groups have growing pains. In late 2006, the main advisors of the group, Cynthia Haq, MD, Don Carufel-Wert, MD, Byron Crouse, MD, John Frey, MD and Sharon Younkin, PhD, expressed their concerns about resources and funding, whether the group was really reaching students as thoughtfully as they intended, and if the group’s size had become overwhelming. They questioned whether they could even find enough mentors in the UW system and within the larger community with whom students to collaborate. The fellows requested that LOCUS continue. They expressed their appreciation for the group as a whole and its members, advisors, and mentors as well as the invaluable benefits of the networking opportunities and leadership training experiences they had gained. Their message was heard by the advising team and LOCUS is alive and thriving as a result.

This past spring, all first year medical students were asked to consider participating in LOCUS, and twenty-three first year medical students were welcomed to LOCUS in October. LOCUS advisors had the difficult task of considering whether to limit the number of new LOCUS fellows to fifteen considering the budget concerns and the affect of that many students on group dynamics. The advisors once again went to the fellows with their concerns and the senior fellows resoundingly encouraged the advisors to accept all twenty-three first year medical students into the group. The established and experienced fellows vowed to take the new fellows under their wing for mentoring, guidance, and project development. Small, practical cuts were made in the budget, the mentoring program was revamped, and all twenty-three first year medical students were welcomed into LOCUS on October 22, 2007. This brings the total number of LOCUS fellows participating in the program to seventy-four during the 2007-08 academic year. Over one hundred fifty students have participated in the program since 1998.

Within the last year, Patrick Remington, M.D., M.P.H., has joined the LOCUS advisory team. This addition to the team has not only been inherent due to Remington’s interest, experience, and expertise in public and community health issues and his research, but was also inspired by the renaming and redesign of the UW School of Medicine’s inclusion of public health in its mission. Remington is a professor of Populations Health Sciences, the director of the UW Population Health Institute, and the associate director of the Comprehensive Cancer Center. His research examines the translation of evidence-based public health into practice, with a focus on tobacco and cancer. Additionally, he is examining ways to use preventative health practices, such as those to increase mammography in low-income, rural populations and policies that ban smoking in bars, to improve community health, such as through the publication of the Wisconsin County Health Rankings (http://www.pophealth.wisc.edu/UWPH/research/rankings_2007/
snapshots.htm). Dr. Remington’s leadership in the group has been welcomed by the LOCUS advisory team and fellows. He has helped to explain and support the School of Medicine’s transition into public health.

Thomas Wolfe’s belief that “you can’t go home again” is not shared with Daniel Schaefer, M.D. Schaefer was one of the founding members of LOCUS in 1998, along with his classmates and housemates KJ Williams (2000) and Steve Murphy (2000). After medical school at UW-Madison, he did his residency at the Department of Family Medicine, Harbor-UCLA and worked in family medicine at the Farmington Community Health Center/San Juan Regional Medical Center in Farmington, NM and the Aspen Family Medical Group in Modesto, CA before he returned to Madison in 2006. He worked for Group Health Cooperative until August 2007, when he joined the Department of Family Medicine and the UW Health Clinic in Mount Horeb. He was recruited by Drs. Cindy Haq and Don Carufel-Wert to step back into LOCUS as an advisory team member. He has done so happily and passionately. He has always held a special place for LOCUS in his heart and it shows. His pride in the program and his belief in its mission encourages the current LOCUS fellows to follow his lead.