The Role that Graduate Medical Education Must Play in Ensuring Health Equity and Eliminating Health Care Disparities.




Despite the 2002 Institute of Medicine (IOM) Report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of healthcare disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education (ACGME) places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the ACGME Clinical Learning Environment Review (CLER) visits as part of the Next Accreditation System (NAS) is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities of which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and employing strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students, residents, and faculty. Graduate medical education has a clear charge to ensure a generation of physicians who are firmly grounded in the principles of practicing culturally competent care, and committed to the reduction of health care disparities.
PMID: 24708150 [PubMed - as supplied by publisher]
PMID: 24708150 [PubMed - as supplied by publisher]
関連論文
- Providing culturally competent care: residents in HRSA Title VII funded residency programs feel better prepared.
- Designing a cultural competency curriculum: asking the stakeholders.
- Culturally competent care pedagogy: what works?
- Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.