Empowering Internal Medicine Residents Through Health Policy: A Simple Approach to Inspire and Teach Action.

Abstract

Background Most physicians receivelittle or no teaching about health policy during residency, despite accreditation organizations emphasizing the need to do so. Lack of time, expert faculty, and institutional financial support can be barriers to implementing a health policy experience. Aim Our goal was to educate internal medicine residents about the legislative process, improve their ability to engage with lawmakersand inspire them to effect policy change in their role as physicians. We aimed to impart a basic knowledge of how health policy decisions are made and give residents hands-on experience in speaking to lawmakers without requiring significant faculty or resident time. Settings Residents attended an hour-long classroom presentation at our medical school. A portion of them attended a lobby day with the Texas Medical Association (TMA). This consisted of introductory training at the TMA building and then a meeting with individual legislators at the Capitol. Participants Sixty-three internal medicine residents received the classroom presentation. Thirteen residents attended the lobby day, ten of whom were in the primary care track, and three were residents in the categorical program who expressed interest and had scheduled availability. Three Dell Medical School faculty members also attended the lobby day. Program description Residents attended a one-hour classroom presentation about the legislative process, current health policy proposals, and local organizations and their policy priorities. Residents then participated in a lobby day with the Texas Medical Association (TMA) in the spring of 2023, which consisted of an introductory session with an issue briefing and training sessions. Residents were then separated into groups based on their zip code, guided in how to speak on behalf of their experiences, and met with their local lawmakers. Program evaluation We administered a pre- and post-experience survey. Only 16.7% had ever met with a lawmaker, but they highly rated the importance of engaging in health policy (mean±SD, 4.42±0.79). The experience significantly increased from pre- to post-experience their ability to contact their lawmaker (2.75 to 3.89), confidence in their ability to discuss policy with a lawmaker (2.33 to 3.56), and their sense of empowerment that they have a voice that can influence policy (2.92 to 4.22). Discussion Internal medicine residents view engagement with health policy as an important experience during training. By utilizing existing resources in our institution combined with an existing lobbying opportunity, we were able to improve resident confidence and abilities to engage in policymaking without substantial financial or time costs.