In 2017, there were 25.4 million refugees worldwide, of whom 33,400 were resettled in the United States. In fiscal year 2016, 20,455 individuals were granted permanent asylum status in the United Sates. Both in the United States and overseas, refugees/asylees face significant disparities in accessing needed medical, mental health, and social support.
The Refugee Health Partnership (RHP) was developed by Johns Hopkins University School of Medicine students and colleagues at a local refugee resettlement agency in 2011. The program pairs teams of preclinical medical students with recently resettled refugees/asylees who have special health care needs. After receiving training, students conducted monthly home visits and accompanied patients to appointments to assist them in navigating the health care system over one year. Students participated in monthly reflection exercises to process experiences and attended monthly seminars facilitated by expert faculty and guests.
From 2012 to 2016, the RHP served 20 refugee families and engaged 60 students across four cohorts. Refugee participant retention was 20/22 (90.9%), and student retention was 57/60 (95.0%). In surveys completed at the end of their programs, students reported improvement in all measures, including understanding of different patient perspectives as well as comfort in communicating with patients across cultures and language barriers.
The authors plan to integrate more objective measures of students’ progress into the evaluations. They are scaling this model up both locally and beyond and plan to gather data from refugee/asylee participants to more accurately assess how they benefit from the program.
L.J. Bernhardt is a fourth-year medical student, Johns Hopkins University School of Medicine, Baltimore, Maryland.
S. Lin is a fourth-year medical student, Johns Hopkins University School of Medicine, Baltimore, Maryland.
C. Swegman is project manager, Tahirih Justice Center, Falls Church, Virginia.
R. Sellke is program officer, Jhpiego, Baltimore, Maryland.
A. Vu is adjunct professor, American University of Beirut, School of Medicine, Beirut, Lebanon.
B.S. Solomon is associate professor of pediatrics and assistant dean for medical student affairs, Johns Hopkins University School of Medicine, Baltimore, Maryland.
C.N. Cuneo is a resident, Department of Medicine, Brigham and Women’s Hospital and Boston Children’s Hospital, and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-5824-2243.
Funding/Support: This program was supported in part by award SI-12-006 from the Arnold P. Gold Foundation and the Albert Schweitzer Fellowship. Funding from the Johns Hopkins University School of Medicine (JHUSOM) Office of Medical Student Affairs, the International Rescue Committee–Baltimore, and the JHUSOM Medical Student Senate provided further program support.
Other disclosures: None reported.
Ethical approval: The Johns Hopkins Medicine institutional review board approved the study’s protocol as an exempt research project.
Disclaimers: This article reflects the views of the authors only and does not reflect the opinions or views of any of the above listed funding sources or of the authors’ current affiliated institutions.
Previous presentations: Pilot results from this program were presented in a poster format at the 4th Annual Osler Center Day, Baltimore, Maryland, April 20, 2012, and in an oral presentation format at the North American Refugee Health Conference, Rochester, New York, June 21, 2014.
Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A622 and http://links.lww.com/ACADMED/A623.
The authors have informed the journal that they agree that both L.J. Bernhardt and S. Lin completed the intellectual and other work typical of the first author.
Correspondence should be addressed to C. Nicholas Cuneo, Department of Medicine, Brigham and Women’s Hospital, 75 Francis St., Boston, MA 02115; telephone: (617) 732-5500; e-mail: firstname.lastname@example.org; Twitter: @nickcuneo.