Family Medicine Resident Education About Health Disparities Associated With Incarceration: A CERA Research Study

We submitted research questions to the Council of Academic Family Medicine Educational Research Alliance (CERA) to assess the format of family medicine resident education about health disparities associated with incarceration and the perceived efficacy of efforts to prepare graduates for competent care of formerly incarcerated patients in practice. We think this is a universal problem, and current efforts are insufficient.

We evaluated data as part of the fall 2022 CERA survey of program directors (PDs). We reviewed descriptive statistics, generated comparative analysis, and reported relational analysis. We analyzed internal structure with principal component analysis and inter-item reliability.

A total of 286 out of 678 (42%) eligible PDs completed the survey. Most respondents felt that educating residents about health disparities associated with incarceration was important and that residents would welcome that education. However, PDs lacked existing curricula. PDs did not think that medical school graduates were well-prepared in this area, and ambivalence existed about whether residency graduates were well-prepared to treat formerly incarcerated patients upon graduation. Comparative analysis revealed differences in responses based on the type of program, the program and community size, and the PD demographics.

PDs acknowledged the importance of training residents about health disparities associated with incarceration and about care for formerly incarcerated patients in practice. However, they identified a gap between what was currently offered and what is needed to impact perception of resident readiness upon graduation. This training was felt to be most important in university-based programs with 31+ residents in US communities of greater than 150,000 people. We found no difference based on geographic location.