Advocacy in Pediatric Academia: Charting a Path Forward

Advocacy and Health Equity: The Role of the Pediatric Pulmonologist

Pediatric pulmonologists have the expertise to be advocates in many areas that affect the respiratory health of children. This article provides an overview of selected advocacy topics related to health equity and provides key examples that can improve child respiratory health in the clinical encounter and beyond.

How Are We Teaching Advocacy? A National Survey of Internal Medicine Residency Program Directors

BACKGROUND

Although internal medicine (IM) physicians accept public advocacy as a professional responsibility, there is little evidence that IM training programs teach advocacy skills. The prevalence and characteristics of public advocacy curricula in US IM residency programs are unknown.

OBJECTIVES

To describe the prevalence and characteristics of curricula in US IM residencies addressing public advocacy for communities and populations; to describe barriers to the provision of such curricula.

DESIGN

Nationally representative, web-based, cross-sectional survey of IM residency program directors with membership in an academic professional association.

PARTICIPANTS

A total of 276 IM residency program directors (61%) responded between August and December 2022.

MAIN MEASUREMENTS

Percentage of US IM residency programs that teach advocacy curricula; characteristics of advocacy curricula; perceptions of barriers to teaching advocacy.

KEY RESULTS

More than half of respondents reported that their programs offer no advocacy curricula (148/276, 53.6%). Ninety-five programs (95/276, 34.4%) reported required advocacy curricula; 33 programs (33/276, 12%) provided curricula as elective only. The content, structure, and teaching methods of advocacy curricula in IM programs were heterogeneous; experiential learning in required curricula was low (23/95, 24.2%) compared to that in elective curricula (51/65, 78.5%). The most highly reported barriers to implementing or improving upon advocacy curricula (multiple responses allowed) were lack of faculty expertise in advocacy (200/276, 72%), inadequate faculty time (190/276, 69%), and limited curricular flexibility (148/276, 54%).

CONCLUSION

Over half of US IM residency programs offer no formal training in public advocacy skills and many reported lack of faculty expertise in public advocacy as a barrier. These findings suggest many IM residents are not taught how to advocate for communities and populations. Further, less than one-quarter of required curricula in public advocacy involves experiential learning.

Pediatric advocacy: Advancement in academic institutions

IMPACT

Children are facing many threats to their health today that require system change at a sweeping level to have real-world impact. Pediatricians are positioned as natural leaders to advocate for these critical community and policy changes. Academic medical center (AMC) leaders recognize the importance of this advocacy and clear steps can be taken to improve the structure to support pediatricians in their advocacy careers through faculty development and promotion, including standardized scholarly measurement of the outcomes.

Clinical and Educational Training About Diversity, Equity, Inclusion, and Justice for Pediatric Residents

Education and clinical training about diversity, equity, inclusion, and justice (DEIJ) is essential for the personal and professional development of pediatric residents in preparation for a career providing health care to diverse pediatric populations. The ability of pediatric residents to reflect on their lived experiences while gaining perspectives about their patients has the potential to positively affect the health care of patients and decrease health inequities. Clinical rotations were established for students from underrepresented populations in medicine as a pathway for matching and diversifying pediatric residency programs with the potential to help diversify the pediatric workforce. The Accreditation Council for Graduate Medical Education formulated standards about DEIJ in pediatric residency training. Curricula, internships, and mentoring programs have been created by medical institutions and professional medical organizations to provide learning experiences about DEIJ and foster a sense of belonging. This review article highlights the multifactorial approach needed to achieve the goal of diversifying the pediatric workforce through DEIJ instruction in pediatric residency training. [Pediatr Ann. 2023;52(7):e256-e260.].