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The mission of Departments of Community Medicine in Geneva University hospitals is to offer marginalized populations living in vulnerable conditions guaranteed access to the health system and to promote education and research in general as well as internal medicine (primary care). This activity, which has a twofold focus (medical-social and academic) as demonstrated by the type of care offered to homeless people and other undocumented groups, allows for the achievement of a number of objectives of the Towards Unity for Health program. However, evidence to date emphasizes that such a structure remains fragile.