Health Disparities Training in Residency Programs in the United States

BACKGROUND AND OBJECTIVES: Our objective was to review and summarize extant literature on US-based graduate medical education programs to guide the development of a health disparities curriculum. METHODS: The authors searched Medline using PubMed, Web of Science, and Embase for published literature about US-based graduate medical education programs focusing on training residents to care for underserved and vulnerable populations and to address health disparities. Articles were reviewed and selected per study eligibility criteria and summarized to answer study research questions. RESULTS: Of 302 initially identified articles, 16 (5.4%) articles met study eligibility criteria. A majority, 15 (94%), of reported programs were from primary care; one (6.25%) was from surgery. Eight (50%) programs reported longitudinal training; seven (44%) reported block experiences, while one (6.25%) described a one-time Internet-based module. Four (25%) programs required residents to develop and complete a research project, and six (37.5%) included community-based clinical training. All 16 programs utilized some form of evaluation to assess program impacts. CONCLUSIONS: There are few published reports of graduate medical education programs in the United States that focus on preparing residents to address health disparities. Reported programs are mostly from primary care disciplines. Programs vary in curricular elements, using a wide variety of training aims, learner competencies, learning activities, and evaluation methods. This review highlights the need for published reports of educational programs aimed at training residents in health disparities and underserved medicine to include the evidence for effectiveness of various training models.