PM3024: Immigrant Health: A Pediatric Residency Curriculum

Background: While residents at both SF and Oakland receive immigrant health content during their residency, feedback from current and past residents indicates that the content is insufficient and disjointed. An inter-professional team from UCSF Benioff Children’s Hospital Oakland and San Francisco (SF) Pediatric Residency programs are developing a comprehensive curriculum to better prepare pediatric residents to care for new immigrant patients.

Methods: A large inter-professional team met regularly over the last two years to create an outline of an optimal vision for an immigrant health curriculum, modeled after Kern’s six step approach for curriculum development. To measure progress towards these goals and objectives, the team designed a web-based survey for pediatric residents to self identify their ability in each objective based on a 5 point scale, with initial data collection in September, 2021 from 24 Oakland pediatric residents. Survey data is planned to be collected annually to study progress made and continually reassess objectives that residents may need further training in.

Results: Curricula Goals
Increase Pediatric Resident knowledge and skill in managing a new immigrant in an outpatient clinic setting.
Increase clinical competency in the screening, diagnosis, and management of communicable and non-communicable disease processes for the immigrant patient.
Increase Pediatric Residents’ understanding of migration and immigration status as social determinants of health and understand the impact of immigration policy on health from a socioecological model.
Increase Pediatric Residents’ understanding of the impact of immigration on a child’s mental health and development.
Increase Pediatric resident knowledge of community resources for immigrant families.
Increase Pediatric resident skill in how to advocate for immigrant patients in and out of the clinical setting.

* further objectives within each goal not listed

24 out of 83 residents (29%) responded to the survey. There were 4 objectives that a majority of residents “strongly agreed” that they were competent in, all within goal 1 and 15 other objectives for which a majority of residents choose “agree.” 13 objectives were marked by a majority of residents as neutral and none were marked by a majority as “disagree” nor “strongly disagree.” By resident year, there were several objectives that a majority of PL1’s marked as “disagree,” within goals 4 and 5.

Conclusion: There is a gap identified in our current pediatric resident curricula in caring for new immigrants/refugees. We plan to continue to monitor self identified gaps in learning by residents as well as measure outcomes of the curricula and continue to build our curriculum accordingly. With this resident-led, comprehensive and multi-disciplinary approach to resident curriculum around immigrant health, our pediatric residents will be more equipped to partner with their immigrant patients, other inter-professionals, and community to achieve better health outcomes/reduce health care disparities for immigrant children.