Consequently, competition for training positions is intensifying. Provenance and peer review Not commissioned externally peer reviewed.In Australia, the number of medical graduates per year has increased at a greater rate than the increase in the number of specialist training places. Patient consent for publication Not required. MR planned the study and edited the manuscript.įunding This study was funded by Department of Internal Medicine, Yale School of Medicine Department of Emergency Medicine, Yale School of Medicine Department of Pediatrics, Yale School of Medicine Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine. JS and VS assisted in designing the tour curriculum and planning the tours, and led tours. LC assisted in designing the tour curriculum and planning the tours and led tours. PV distributed surveys, collected data and edited the manuscript. DB planned the study and edited the manuscript. BH planned the study, collected data, analysed data and edited the manuscript. AA planned the study, collected data, analysed data and edited the manuscript. Society for General Internal Medicine National Meeting 2018.Ĭontributors JJC planned the study, distributed surveys, collected data, analysed data, compiled the manuscript, and was responsible for the overall content as guarantor. Neighbourhood Walking Tours for Physicians-in-Training. Twitter at Prior poster presentation: Cross JJ, Arora A, Boatright D, Vijayakumar P, Cruz L, Smart J, Spell V, Greene A, Berg D, Rosenthal M. Walking tours helped physician-residents recognise the importance of SDoH and the value of community resources, and may have broadened frameworks for counselling patients on healthy lifestyles. Percentage of respondents aware of community resources changed from 5% to 76% (p<0.001). In describing ways to improve diet and exercise, among pre-tour survey respondents, 67% discussed individual-level strategies and 16% discussed neighbourhood-level, while among post-tour survey respondents, 39% of respondents discussed individual-level strategies and 37% discussed neighbourhood-level. Pre-tour, the factor ranked most frequently affecting patient health was ‘access to primary care’ (67%) compared with post-tour: ‘income’ (44%) and ‘transportation’ (44%). Eighty-one physician-residents participated in walks (pre-tour surveys (93% participation rate (n=75)), and post-tour surveys (53% participation rate (n=43)). In both pre-tour and post-tour, we asked participants to (1) rank the importance of individual-level and neighbourhood-level factors affecting patients’ health, (2) describe strategies used to improve health behaviours and (3) describe knowledge of community resources. Using a community-based participatory research approach, in 2017 we implemented a neighbourhood walking tour curriculum for physician-residents in internal medicine, internal medicine/primary care, emergency medicine, paediatrics, combined internal medicine/paediatrics and obstetrics/gynaecology. We assessed the impact of a neighbourhood walking tour on physician-residents’ perceptions of SDoH, plans for counselling patients and knowledge of community resources. Neighbourhood walking tours may help physician-residents learn about the social determinants of health (SDoH). However, education about these factors has been inconsistently incorporated into residency training. Social and economic factors have a profound impact on patient health.
5 Yale School of Medicine, New Haven, Connecticut, USA.4 Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.3 National Clinical Scholars Program, Yale School of Medicine, New Haven, Connecticut, USA.2 Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.1 Emergency Medicine Residency Program, Highland Hospital, Oakland, California, USA.