TeAMS in the Community: Teaching Advocacy to Medical Students

Ashraf A. Sabe¹*, Philip Chen ¹, Melissa Smith-Parrish ¹, and Allison Brindle, M.D. ², ¹ Case Western Reserve University School of Medicine, Cleveland, OH 44106 U.S.A., ² Cleveland Clinic Foundation, Cleveland, OH 44106 U.S.A.

Purpose

Residency Review Committees and professional organizations emphasize physician advocacy and community involvement.  However, traditional medical education lacks structured instruction on physician advocacy.  Given other rigorous requirements of medical education, incorporating distinct advocacy training into medical school curricula is challenging.

Methods

Medical students will participate in group and self-directed activities to enhance their advocacy education.  First-year weekly didactics will provide students with necessary advocacy “tools”.  Introductory topics include: defining civic professionalism, contacting legislators, and working with the media.  An advocacy elective will allow application of skills to a chosen community health issue. During this application students will identify relevant items on the local, state, or federal legislative agenda and will use evidence based medical literature to support their position.  Students will journal experiences, meet with a faculty member overseeing their progress, and prepare a final presentation.  Medical students will have the option to pursue an advocacy project as their thesis.

Results

Pre-clinical medical students focused on gaining knowledge to pass USMLE exams may find advocacy topics irrelevant. Interested students may have difficulty securing protected time to pursue advocacy work. Though there is little literature on implementation of structured advocacy education into medical student curricula, it has been successfully implemented into some residency programs, specifically pediatric and family medicine training programs. 

Conclusion

Medical education lacks sufficient advocacy training.  Emphasizing advocacy early in medical school will better prepare physicians for the challenges of practicing medicine in the community.  It may also empower physicians to pursue health care issues they otherwise might have ignored.