Addressing the need for interprofessionalism and bioethics training among medical students to better serve the refugee population

Purpose: As the refugee population in Texas is increasing, in order to provide a patient-centered, comprehensive plan of care, medical students would be well-served to understand how to work within the legal system to address key determinants of health, especially in regards to asylum seekers. Our goal is to implement a training program at UNTHSC that would equip future physicians to better serve their patients when legal and ethical issues arise, prepare them to work in areas of public policy, and conduct research that betters the lives of our communities. As previous literature has shown, this has reciprocal benefit for law students and MPH students who gain insight into the interconnectedness of public health, medicine and law for creating robust opportunities for patient wellness and community health. In light of the recent pandemic and the many worldwide issues pertaining to public health, medicine, law, and ethics, this program will be crucial in establishing a community network of interprofessional resources and applying systems-thinking to patients who are often bereft of adequate medical care or legal assistance. Equipping future physicians here in the DFW area with experience in law, public health and bioethics is pivotal to fulfilling HSC's mission of "creating solutions for a healthier community by preparing tomorrow's patient centered physicians and scientists and advancing the continuum of medical knowledge, discovery, and osteopathic care." This project, if implemented according to stakeholders' needs, will serve as a foundation for medical professionals to play a role in policy change and advocacy, practice clinical decision-making, and bring forth advancements in healthcare. Methods: Utilizing a self-administered questionnaire, 2 cohorts of the Texas College of Osteopathic Medicine were targeted to determine interest and availability within the curriculum. One resembled the "Pre-Clinical" era of Medical School, composed of first and second year medical student responses. The other, denoting the "Clinical" era of Medical School, composed of third and fourth year medical student responses. The questionnaire was designed using the Likert scale, carrying a minimum score of 1 (Strongly Disagree) and a maximum score of 5 (Strongly Agree). Statistical analyses were performed using SPSS, to reveal unforeseen gaps in education between both eras of Medical School. Conclusions: Once a need for a new curriculum became apparent, two medical students developed a four-year medical bioethics curriculum. Interested medical students would be trained with five core courses; Philosophy of Bioethics, Medicine and Law, Introduction to Clinical Bioethics, Global Ethics, and Bioethics in Practice. Students would also have elective opportunities to become certified in Medical Evaluation Forensics, as well as conduct research in public health, policy, or bioethics. The curriculum places emphasis on learning through case studies and creates a collaboration with Texas A&M Law school to guide students in clinical decision-making with particular focus on systems-thinking and interprofessionalism construed broadly to encompass law and public policy. Through providing an intellectual space to reflect and partake in group conversations, students will mature professionally to become culturally-responsive, compassionate and innovative physicians.