Health Policy Education in U.S. Dermatology Residency Programs: A Nationwide Survey of Program Leadership

September 2021 | Volume 20 | Issue 9 | Editorials | 1009 | Copyright © September 2021


Published online August 27, 2021

Zizi Yu BAa, Nicholas Theodosakis MD PhDb, Margaret W. Cavanaugh-Hussey MD MPHc, Vinod E. Nambudiri MD MBAc, Jennifer T. Huang MDd, Avery H. LaChance MD MPHc

aHarvard Medical School, Boston, MA
bHarvard Combined Dermatology Residency Training Program, Harvard Medical School, Boston, MA
cDepartment of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
dDermatology Program, Boston Children’s Hospital, Harvard Medical School, Boston, MA

Abstract

INTRODUCTION

Amidst the ongoing COVID-19 pandemic, widening health disparities, and uncertainty surrounding the future of healthcare reform, physicians have a unique opportunity to affect health policy and advocate on behalf of their patients. However, formal health policy and advocacy training throughout graduate medical education is limited.1,2 Studies across specialties suggest that while trainees feel it is important for physicians to participate in advocacy and policymaking, their perceived ability to do so is limited by knowledge gaps.3-5 In one survey of trainees across specialties, 94% of respondents agreed that “as a physician I have a duty to advocate,” but only 12% of respondents indicated receiving adequate advocacy training in residency.4 Within dermatology, residents have expressed dissatisfaction with their training in business management and health policy.3 Given these gaps, we sought to understand the current landscape of formal health policy instruction and opportunities available to residents in dermatology programs across the U.S.

MATERIALS AND METHODS

Between March-August 2020, a 30-question electronic Redcap survey assessing health policy education and curricular opportunities was distributed to program leadership, composed of program directors, associate program directors, and chief residents, at Accreditation Council for Graduate Medical Education (ACGME)-accredited dermatology residency programs. Statistical analyses were completed using Stata/ SE 15.1 (StataCorp). The Partners Institutional Review Board approved this study.

RESULTS

There were 94 responses from 144 programs (65% response rate) with roughly equal geographic distribution across the United States (Table 1). While a majority of programs reported presence of at least one faculty member with health policy expertise at their institution (n=48, 51%), a minority reported offering formal health policy curricula (n=14, 15%), elective opportunities (n=34, 36%), or research opportunities (n=43, 46%) in health policy. While most programs were affiliated with institutions that had other non-medical graduate schools (n=71, 76%), a minority reported definitive presence of a division or