Just Care in the Justice System

Adrian Thompson, Cameron Clark, Gabby Wimer, Jeremiah Douchee, and Mansi Shah

Access, quality of care, and outcomes for people involved in the carceral state clearly demonstrate health-related disparities compared to the general population. Despite the need for improved healthcare for this population, medical curricula overlook their needs and lack content on the advocacy skills needed to push for systemic change. This lacuna inspired a group of medical students at Vagelos College of Physicians and Surgeons to develop a curriculum to equip healthcare professionals with the skills to provide quality and equitable care to justice-involved patients. 

We hosted a teach-in on December 15th which was attended by over 50 medical students and faculty. The learning objectives were:

1. Describe justice-involvement and the demographics of incarcerated individuals
2. Identify challenges to patient autonomy, integrity, and privacy for individuals who are justice-involved
3. Interpret available guidance and/or lack thereof from state, institutional and specialty specific governing bodies regarding care of justice-involved individuals
4. Develop tools for advocacy that the health care team can use in the context of justice-involvement 

Medical students presented background information and 1 faculty member presented interactive cases which fostered audience participation.

Pre and post-surveys (completed by 28/50 participants) showed increases in knowledge about mass incarceration and how to best care for justice-involved patients.  

This teach-in yielded a number of lessons: 

1. Student-led initiatives can be essential in bringing vitally important, historically marginalized educational content into university settings. 
2. Students want to learn more about this topic. 
3. Teach-ins can provide useful pilot settings for demonstrating interest and feasibility for new curricular content.

Participant post-surveys revealed topics of interest for future teach-ins including learning about transitions of care during re-entry. We aim to build out our curriculum to prepare future clinicians to care for justice-involved patients and to advocate for change. Ultimately, we seek to train “a physician workforce who views prisons as obsolete.”