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APHA Scientific Session and Event Listing

Recorded presentation

Eva Metalios, MD¹, Ramin G. Asgary, MD, MPH, MSc², Clyde L. Smith, MD, MPH, DTM&H², and Galit Sacajiu, MD, MPH². (1) Department of Medicine, Montefiore Medical Center, CHCC, 305 East 161 Street, Bronx, NY 10451, 718-579-2500, emetalio@montefiore.org, (2) Depts of Medicine and Family and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3544 Jerome Ave, Bronx, NY 10467

DESCRIPTION OF PROGRM More than 500,000 immigrant torture survivors live in the United States. Although the United Nations Convention Against Torture calls for educating doctors to assess torture survivors, few residency programs do. As such, there is a disconnect between what doctors are obligated to do, and what they are trained to do.

In 2002 the Bronx Human Rights Clinic (HRC) developed a novel curriculum. The program is co-sponsored by Montefiore Medical Center's Primary Care and Social Medicine residency training programs, and Doctors Of the World. The curriculum is a series of interactive workshops offered over a half-day. Experts in law, medicine and mental health teach the sessions.

RESULTS Residents were given anonymous Pre- and Post-test questionnaires with the trainings. Questions reflected the curriculum's five educational objectives: 1) Codes of Conduct; 2) General Knowledge; 3) Medical & Psychological Sequelae; 4) Attitudes & Perceptions; 5) Residents' Self-efficacy. Questions were analyzed both individually and through composite scores; 21 doctors participated.

Residents showed statistically significant changes in composite scores for General Knowledge (p=0.000), Sequelae (p=0.001), and Self-efficacy (p=0.000); statistically significant changes for several questions (ie, “I believe I know how to treat torture survivors”, p=0.00); and 81% reported that “Doctors should know how to evaluate torture survivors”.

SUMMARY 1) The Bronx HRC curriculum improved doctors' scores regarding general knowledge of torture & asylum, sequelae of torture, and self-efficacy evaluating applicants. 2) Doctors expressed awareness of their ethical obligation to treat torture survivors. 3) Future studies should assess if the curriculum affects clinical behavior.

Learning Objectives:

• To clarify doctors' ethical and professional obligation to evaluate and treat asylum applicants and torture survivors
• To explore the disconnect between what doctors are obligated to do, and what they are trained to do
• To describe a novel curriculum that teaches doctors to assess asylum applicants, evaluate the medical and psychological sequelae of torture, bear witness to survivors' experiences, serve as expert witnesses in asylum proceedings, and link applicants to services
• To encourage doctors to engage in activism by promoting health in an underserved population

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation