Letters to the Editor
To the Editor:
Pediatrics residency programs across the nation have incorporated advocacy training into their curricula, yet the dire need for pediatricians to serve the poor still exists. The challenge lies in how to motivate students who have chosen a residency in pediatrics, or in primary care, to work with the underserved. Future pediatricians must learn to advocate in many realms, as pediatricians have the unique skill set and knowledge of what best will serve our patients and their families. The multi-institutional collaboration of 13 pediatric residency programs described by Chamberlain et al1 in the March issue highlights the importance of partnership to develop advocacy curricula that can be shared in an era of restricted funding and time constraints for clinical faculty. Their work is to be lauded, since the importance of advocacy is often overlooked, but the day-in and day-out advocacy training that takes place at the bedside with patients is equally crucial in teaching trainees to be physician–advocates.
Our pediatric faculty are dedicated to the common mission of providing patient-centered care to the underserved. Providing a Christmas present for an oncology patient or finding the means to pay a family’s electric bill can mean as much as a cure. In 2008, Wear and Kuczewski,2 in Academic Medicine, highlighted “physician role models who believe deeply in compassionate respectful care of indigent patients must be the leaders in bringing about change in individual and institutional attitudes toward care of the poor.” Our faculty are those kind of role models.
As an associate program director for a pediatrics residency program at the largest safety net hospital in California, I believe that we can make our greatest difference by combining formal curricula, like those described by Chamberlain et al, with committed role models demonstrating compassionate advocacy. It is my dream to inspire young physicians through the power of small victories to see the possibilities of working with underserved populations.
Acknowledgments: The author is grateful to Julie G. Nyquist, PhD, for her guidance and support.
Michelle I. Cornman-Thomas, MD
Associate program director, Los Angeles County + University of Southern California Pediatrics Residency, Department of Pediatrics, and assistant professor of clinical pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California; e-mail: firstname.lastname@example.org.
1. Chamberlain LJ, Wu S, Lewis G, et al.California Community Pediatrics and Legislative Advocacy Training Collaborative. A multi-institutional medical educational collaborative: advocacy training in California pediatric residency programs. Acad Med. 2013;88:314–321
2. Wear D, Kuczewski MG. Perspective: medical students’ perceptions of the poor: what impact can medical education have? Acad Med. 2008;83:639–645