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Resident Experiences at a Community Hospital Caring for Patients Who Are Incarcerated
Samantha K Chao1, Rachel Clark2, Michael Susalla3
1Department of Emergency Medicine, Michigan Medicine, Ann Arbor, Michigan, USA.
Abstract:
There is no standardized curriculum that teaches medical residents to navigate the ethical and logistical complexities of bedside care delivery to patients who are incarcerated. In this article, we describe resident physician bedside experiences at a community teaching hospital caring for patients who are incarcerated. From 2022 to 2023, residents in emergency medicine, general surgery, internal medicine, and obstetrics and gynecology were offered an anonymous survey, self-administered via REDCap software, to explore their experiences caring for this patient population. Of 168 resident physicians, 78 (46.4%) completed the survey. The majority were cisgender women (62.3%), 20 to 30 years old (78.2%), and White (70.5%). Of these residents, 98.7% had cared for a patient who was incarcerated or in custody, yet only 15.4% reported receiving formal education regarding caring for this patient population, and only 24.4% were aware of relevant institutional policies. Qualitative analysis revealed themes including barriers to care, permission and authorization, conditional treatment, inconsistency, and conflict. Resident curricula that target knowledge gaps related to procedure and policy and address ethical concerns at the bedside may improve the clinical learning environment and lead to more consistent, equitable care delivery for patients who are incarcerated.
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