The mission of the PLUS program is to train and inspire future leaders in pediatrics to identify and address the varied issues that affect the health of underserved children. The PLUS program will provide a foundation of skills, knowledge and mentorship from which its graduates will build careers in research, policy, and community engagement for underserved children.

The training for this program is integrated with the Categorical Pediatric Residency Program at UCSF to include all components of clinical training to maintain the high standard of clinical care required to practice General Pediatrics.

Program Definition of Leadership

The ability to bring positive change to the health of underserved populations.

Curricular Pillars

• Leadership
• Critical Thinking
• Community Engagement
• Clinical Excellence

These Pillars address the skills necessary to investigate, understand and impact the issues that affect child health.

I. PLUS residents will gain academic and personal skills to be effective leaders in the arena of underserved medicine by receiving specific training seminars and experiences in leadership.

II. PLUS residents will gain skills and experience to foster successful community partnerships.

III. PLUS residents will obtain a fundamental knowledge of the historical perspectives and current issues of core topics in underserved medicine such as heath care financing and health disparities.

IV.  PLUS residents will gain excellent clinical skills, maintaining the outstanding clinical training expected of all UCSF pediatric residents

PLUS Advisor Pods.  To provide a framework of support, PLUS residents are organized into Pods of a faculty advisor, upper level and PGY-1 PLUS residents.  These Pods will be formed from continuity clinic assignments in order to facilitate relationships and advising amongst the Pod.

Mentors.  In addition to their faculty advisor, there is a cadre of faculty and community individuals who may serve as mentors to the PLUS residents.

Continuity Clinic:  PLUS residents have their clinic on either Monday, Tuesday or Thursday afternoons at the San Francisco General Hospital (SFGH).

PLUS Block.  This rotation provides PLUS residents with the opportunity to focus on the PLUS curriculum and community partnership.  During this rotation, residents will have skill building sessions, participate in seminars on vulnerable populations, meet potential community and academic mentors, and spend time on their community engagement.

PLUS Potlucks/Journal Clubs.  The 3rd Wednesday of every month is a PLUS Noon conference at Moffitt Hospital.  This conference serves to educate PLUS and categorical residents and faculty about topics from the PLUS curriculum or from other activities of the PLUS residents.  We have informal monthly dinner gatherings for social time, resident presentations, critical reviews of relevant journal articles or policies, curriculum committee and good food.

Community Partnership (CP) Schema

Purpose:  Direction has always been one of the defining marks of an effective leader and that is what purpose is all about. How to take where we have been, the challenges we face today, and the desired future state and translate what we have learned into a vision which appeals to both the heart and the head, motivating others to move forward. This core leadership dimension includes competences in:

• understanding the changing environment both internal and external
• understanding and responding to organizational mandates,
• developing and projecting organizational mission, 
• clarifying and using core values, 
• embracing a capacity for creativity in vision
• translating vision into effective strategies for action 
• moving strategy to action by using short-term objectives, plans and budgets,
• communicating strategy,
• developing an awareness of institutional culture and its impact on purpose
• and, developing and sustaining new partnerships and collaborations.

This is a long list, but there is one more essential trait for the competent leader to project around purpose: adaptability and responsiveness. While there will always be some things that one cannot anticipate, purpose prepares the leader to respond to the unanticipated with grace and courage.

People - The essential difference between doing a good job and doing a good leadership job is the ability to accomplish work through others. Many people have the technical skills to be an effective physician or nurse and many of these even have a vision of what needs to be done. Fewer have the ability to create relationships that bring others to the work in a unified manner. The elements of this core leadership domain are varied but include the following:

• building effective teams, 
• creating environments for giving and receiving feedback,
• managing relationships up, down and to the side, 
• motivating and developing others, 
• building consensus, 
• gaining and using power, 
• developing interpersonal communication skills including listening,
• having difficult conversations, 
• working with diverse populations and needs, 
• and, building positive work environments.

Together, these competencies help create relationship capital which combines have the power to align and inspire the contributions of those we seek to lead.

Process - Work still needs to be accomplished and it will fall to the competent leader to possess an array of technical process skills to accomplish these tasks. In all leadership work there is a need to understand the core activity that one is leading. There are more generic organizational skills that need to be a part of every leader's toolkit. These include:

• designing operational plans to enact strategies,
• using project management structures for planning, control and evaluation, 
• using budgeting and financial management principles and techniques,
• making a relevant business case for an undertaking, 
• managing a change process, 
• managing conflict within the organization, 
• using negotiation to push a process, 
• working with and through systems,
• using decision making techniques,
• performance assessment 
• and, developing and using process improvement projects.

These competencies must be linked back to the purpose. Much mischief occurs in health care because these core process competencies are not present, which can cause the implementation of any strategy to fail.