The University of Wisconsin School of Medicine and Public Health developed an urban training program, Training in Urban Medicine and Public Health (TRIUMPH), in response to chronic shortages of physicians in urban areas of Wisconsin.

The Wisconsin Hospital Association and the Wisconsin Medical Society have identified current and future shortages of physicians. A follow-up analysis (pdf) concluded “there is currently a shortage of primary physicians in rural and inner-city areas of Wisconsin.”

Many Wisconsin counties are designated as Health Professional Shortage Areas (HPSAs). Due to the density of urban populations, nearly half of all people living in Wisconsin HPSAs are urban medically underserved populations. These shortages are expected to grow into the foreseeable future.

Training in Urban Medicine and Public Health was developed by UW School of Medicine and Public Health faculty in Madison and Milwaukee. The program was piloted during the 2008-09 academic year with six third-yearmedical students and has grown steadily since that time. The School of Medicine and Public Health has received funding from the state of Wisconsin since 2008 to support both TRIUMPH and the Wisconsin Academy for Rural Medicine.

A total of 150 have participated in TRIUMPH since it was established. All graduates have entered residencies serving urban, medically underserved populations. Sixty-six percent of graduates of the 18-month program have selected primary care careers; 33 percent have selected specialties in high demand in urban areas, such as emergency medicine, psychiatry and obstetrics and gynecology.

TRIUMPH graduates are now training and practicing in Milwaukee and beyond including cities such as New York, New Orleans, Minneapolis and Los Angeles.

How to apply

UW medical students with an interest in working with urban populations may apply for admission to the TRIUMPH program in late fall of their first year of medical school year.

An application, letters of recommendation and an interview are part of the selection process. Applications are submitted through Fluid Review (pdf). Students will apply late in the fall semester and will be notified by early spring of their acceptance into the program.

Interested TRIUMPH candidates are expected to enroll in the "Leadership in Medicine and Public Health" (PHS 712) course taught by Drs. Remington and Pillai. This course includes an introduction to core concepts in public health that will help prepare students for TRIUMPH and should be completed by the end of phase one of medical school. 

Training in Urban Medicine and Public Health students may also elect to participate in the Path of Distinction (PoD) in Public Health, the TRIUMPH/Master of Public Health or TRIUMPH/Medical Scientist Training Program dual degree programs, or the TRIUMPH/global health track.

Path of Distinction in Public Health (PoD)

The Path of Distinction was created to provide all UW medical students with options to enhance their medical training with a nine-credit concentration in public health. The Path of Distinction combines extracurricular courses, self-directed learning and mentoring to enrich medical school with public health related content tailored to the students’ interests.

PHS 712 (Leadership in Medicine and Public Health) is a required one-credit course for all PoD students. Students who apply to TRIUMPH will automatically be considered for the PoD program. TRIUMPH coursework fulfills the majority of the PoD requirements.

TRIUMPH/Master of Public Health dual degree

TRIUMPH students have the option to pursue master of public health degree in conjunction with TRIUMPH. TRIUMPH/MPH students join Training in Urban Medicine and Public Health in Milwaukee at the beginning of phase two. They enroll in the School of Medicine and Public Health Master of Public Health Program between phases two and three of medical school. Following the year of master of public health coursework, they continue by participating in the TRIUMPH program's phase three curriculum. TRIUMPH coursework provides eight hours of elective credits toward the MPH degree (out of 42 total credits).

Students may combine the TRIUMPH project and the Master of Public Health Program's six-credit, 400-hour field experience into one project, which will span 3½ years and represent 480 hours of total effort (80 hours in phase two and 400 hours during the Master of Public Health Program and phase four).

Master of Public Health Program students also complete a capstone project, which serves as a culmination of didactic and experiential learning by writing a scholarly paper, orally defending it and presenting it at a public health symposium. The capstone is traditionally linked to the field experience. Scholarships may be available for TRIUMPH students interested in pursuing a master of public health.

TRIUMPH/global health track

Training in Urban Medicine and Public Health students have the option to pursue global health work (pdf) in connection with TRIUMPH. These students may request to take a leave of absence from medical school between phases two and three to complete their global health experience. Following the global health experience, they return to TRIUMPH and the phase three curriculum.

Some global health students have integrated their global health and Milwaukee-based TRIUMPH projects. Upon their return, global health students are invited to share lessons learned and to explore the relationship between global and local health.

TRIUMPH and the MD curriculum transformation

Training in Urban Medicine and Public Health is evolving to complement the changes expected in the ForWard Curriculum transformation.

We select 16 first-year students to join TRIUMPH for phases two and three. Under the ForWard Curriculum, students will apply during the late fall of their M1 year.

TRIUMPH will become a 2½-year program providing most clinical training in Milwaukee with all four clinical blocks within Aurora Health Care. Students will begin TRIUMPH with the Community and Public Health Enrichment Experience during the late summer between their first and second years. They will join the program in Milwaukee full-time in January of their second year.

The transformed curriculum allows interested students to complete Path of Distinction, master of public health or global health track coursework. Either the master of public health or global health track can be completed between phases two and three of the transformed curriculum.

Under the transformed TRIUMPH curriculum, the program will begin to accept dual degree students who are enrolled in the Medical Scientist Training Program. Students would also pursue their PhD studies between phases two and three.

Admitted students will be matched with community organizations to pursue community health improvement projects throughout the duration of their clinical training.