Medical students and residents go to prison: An overview of prison health medical education in BC, Canada

Background: Social responsibility and accountability are core values of medical education. Prison health educational opportunities offer learners exposure to diverse medical and social needs including communicable diseases, problematic substance use and mental illness. At the University of British Columbia (UBC), undergraduate and post-graduate medical learners have engaged in prison health learning opportunities since 2008. A multi-method evaluation of the UBC prison health medical education program is underway. The objectives of this presentation are: 1. to review prison health learning opportunities currently offered to UBC undergraduate and postgraduate medical learners; 2. to discuss evaluation findings pertaining to the impact of prison health learning experiences on medical learners. Methods: In the UBC Doctor, Patient and Society course: all first year undergraduate medical students meet an individual with incarceration experience during a group discussion session; second year students may select ‘prison health' as a community service learning option, during which they develop and present health education modules to incarcerated men and women. Fourth year medical students and postgraduate medical residents may select 2- (or 4- ) week electives in prison health clinics. A logic model evaluation framework was developed to assess long-term and short-term outcomes of the impact of prison health medical education on correctional staff, inmates and students. As part of this evaluation, in-depth interviews were conducted with 20 learners who had participated in UBC prison health medical education activities. All interviews were transcribed. The transcripts were submitted to Interpretive Phenomenological Analysis (IPA) to explore the impact of students' experience of prison health on their understanding of a vulnerable population. Results: The logic model will be discussed in detail. Outcomes include: 1) medical students are providing a preventive health service to the prison population through presentations on topics such as Basic Hygiene, Mental Health, Infectious Disease, Women's Health and Navigating the Health Care System. Second year medical students in 2009/10 provided 36 seminars to over 600 inmates at three correctional centres. 2) A positive relationship is created between inmates and future health care professionals by allowing a safe interaction without judgment during the students' health education presentations. 3) Prison health experiences deeply impact the educational life of medical students and residents, as demonstrated by our analysis findings, which will be presented. Students reported that they confront their own stigma and preconceived ideas about vulnerable populations. In addition, prison health activities facilitate an understanding of the consequences of social determinants and health inequities.