Domestic Global Health: A Curriculum Teaching Medical Students to Evaluate Refugee Asylum Seekers and Torture Survivors

Background: Seven to 12% of foreign-born patients in the United States has experienced torture. We aimed to teach medical students to identify and care for asylum seekers/torture survivors. Description: One hundred twenty-five students participated in a program consisting of a workshop covering sequelae of torture, asylum law, and an approach to patient evaluation; twice-monthly clinical sessions; and mentored preparation of medical affidavits. We observed clinical encounters; evaluated medical affidavits; and assessed students' knowledge, attitudes, and skills pre- and postcurriculum. Evaluation: Students successfully performed physical and psychological evaluations and prepared affidavits resulting in 89% asylum application approval. We observed improvement in student attitudes toward working with survivors (p <.05), knowledge of sequelae of torture (p <.001), and self-efficacy in clinical evaluation (p <.001). Conclusions: Medical students learned necessary skills to provide services for survivors, which will also serve them in caring for other vulnerable populations. As an advocacy, cultural competency, and domestic global health opportunity, this training was feasible and achieved its educational goals.