An advocacy experience for medical students

Abstract

Background: Promoting advocacy and social responsibility is a requirement of medical education. This article describes a brief clinical educational initiative to foster advocacy amongst medical students, and explores student attitudes towards homelessness.

Methods: A compulsory clinical experience in homeless health was integrated into the family medicine clerkship curriculum for a subset (n = 30) of all third-year medical students (n = 254) at the University of Toronto in 2012/13. This programme consisted of four half-days, in which students provided primary care within a shelter setting under supervision from a physician. The experience was paired with a supportive and reflective debriefing session, and feedback was collected from participating students. Surveys on attitudes towards homelessness were also administered to all third-year students before and after their rotation in family medicine. Students provided primary care within a shelter setting under supervision from a physician RESULTS: Student feedback indicated that the programme was very well received; however, some students described feeling overwhelmed at times when working with this vulnerable population. On attitude surveys, female sex, age, earlier month of survey administration and interest in certain specialties was associated with more positive attitudes towards homelessness.

Discussion: A brief clinical experience outside of a traditional health care setting in which students are exposed to the day-to-day reality of advocating for vulnerable populations can meaningfully contribute to a comprehensive advocacy curriculum. We suggest this programme could be feasibility adapted to other settings and populations. The importance of supportive and reflective mentorship and diverse clinical settings are highlighted.