Preparing Clinicians to Conduct Forensic Medical and Mental Health Evaluations for People Seeking Asylum

Teaching graduate medical trainees to conduct forensic medical and mental health evaluations (FMEs) of people seeking asylum fosters knowledge and skills needed to care for displaced and trauma-exposed populations. The national Asylum Medicine Training Initiative (AMTI) is the new standard for training clinicians to conduct FMEs but has not yet been evaluated in graduate medical education.

We designed a novel, year-long, interdisciplinary, graduate medical elective in asylum medicine that combines AMTI's asynchronous didactics with experiential learning in the form of small group skills practice and mentored FMEs. We used a formative, mixed-methods approach to evaluate participants' acquisition of knowledge essential for conducting FMEs, self-reported comfort with relevant skills, and self-reported preparedness for conducting independent FMEs.

Eight trainees participated in the elective from September 2022 to June 2023. The evaluation (response rate 100%, 8/8) showed a significant increase in knowledge essential for conducting FMEs, and most participants felt prepared to conduct FMEs independently. Qualitative analysis showed participants felt they benefited from the experiential learning and that, despite barriers to conducting FMEs, they intend to apply these skills in future work with displaced populations.

Though limited by small sample size and reliance on self-assessment, our results indicate that this novel curriculum helped prepare interdisciplinary trainees to conduct FMEs and improved their comfort with skills applicable to working with displaced populations. This elective could be replicated at other institutions because of the accessibility of the AMTI curriculum and use of virtual space for small groups and mentored FMEs.