Students call for improved refugee health education in Ontario medical schools

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While Canada accepts thousands of refugees each year, all hoping for a safer, healthier future, refugee health care falls short.

Refugees face many challenges in accessing health care, including communication, cultural and socioeconomic barriers, poor health literacy, and difficulties in navigating the health-care system. Though physicians often help bridge these gaps, past research suggests they often are reluctant to treat refugee patients. This reluctance stems from a lack of experience with refugee health or anticipation of communication issues. For example, the Interim Federal Health Program, which offers extensive prescription drug, dental, vision care, home- and long-term care, physiotherapy, and mental health care, is underutilized. A recent study found that less than 20 per cent of providers were aware of the full range of services offered, negatively impacting refugees whose concerns go unheard.

Providing improved education on refugee health to Ontario medical students is one crucial step in addressing the health inequalities faced by this vulnerable population –and medical students are ready to learn.

A recent survey on refugee health education in medical schools found training to be inconsistent across schools. Refugee health is often grouped into education with other vulnerable populations; 40 per cent of schools have spent less than five hours of curriculum time on refugee/migrant health over the entire undergraduate curriculum. A lack of faculty support and curricular time constraints were noted as barriers to implementing refugee health curricula.

40 per cent of schools have spent less than five hours on refugee/migrant health over the entire undergraduate curriculum.

Leaders of Immigrant and Refugee Equitable Access to Healthcare (iREACH), an organization led by medical students at the University of Toronto dedicated to helping newcomers and refugees navigate our health-care system, continues to advocate for improved refugee health curricula. “Medical schools do a disservice to students and our future patients by treating refugee health in isolation,” the group asserts in a statement, “ as if it is only relevant to students who want to specialize in refugee care. There needs to be more effort on the part of medical schools, education coordinators, and lecturers to integrate curriculum across the spectrum.”

Refugee health topics should be integrated into students’ learning, for example during case-based learning sessions or through standardized patient interactions. “Refugees are such a diverse group that teachings can’t be captured in a list of bullet points. All refugees have a unique migration story that shapes who they are, their health needs and who they want to become.”

As future health-care providers, students must be given the opportunity to lay the foundation of communication, strong interpersonal skills and cultural humility. “Practicums with refugee care providers, skills workshops, expert panels, and volunteer opportunities to support refugees directly should become essential components of the medical student experience.”

Integrating refugee health care more seamlessly into the curriculum can train a generation of physicians who are prepared to care for diverse populations – physicians who have training in trauma-informed care and are confident in their abilities to advocate for vulnerable patients.

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