Perceived barriers to success for resident physicians interested in immigrant and refugee health

Jonathan D. Alpern, Cynthia S. Davey, John Song

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Background: Cross-cultural care is recognized by the ACGME as an important aspect of US residency training. Resident physicians' preparedness to deliver cross-cultural care has been well studied, while preparedness to provide care specifically to immigrant and refugee populations has not been. Methods: We administered a survey in October 2013 to 199 residents in Internal Medicine, Pediatrics, and Medicine/Pediatrics at the University of Minnesota, assessing perceived knowledge, attitudes, and experience with immigrant and refugee patients. Results: Eighty-three of 199 residents enrolled in Internal Medicine, Pediatrics and Medicine/Pediatrics programs at the University of Minnesota completed the survey (42 %). Most (n = 68, 82 %) enjoyed caring for immigrants and refugees. 54 (65 %) planned to care for this population after residency, though 45 (54 %) were not comfortable with their knowledge regarding immigrant and refugee health. Specific challenges were language (n = 81, 98 %), cultural barriers (n = 76, 92 %), time constraints (n = 60, 72 %), and limited knowledge of tropical medicine (n = 57, 69 %). 67 (82 %) wanted more training in refugee and immigrant health. Conclusions: The majority of residents enjoyed caring for immigrant and refugee patients and planned to continue after residency. Despite favorable attitudes, residents identified many barriers to providing good care. Some involved cultural and language barriers, while others were structural. Finally, most respondents felt they needed more education, did not feel comfortable with their knowledge, and wanted more training during residency. These data suggest that residency programs consider increasing training in these specific areas of concern.

Original languageEnglish (US)
Article number178
JournalBMC medical education
Issue number1
StatePublished - Jul 15 2016

Bibliographical note

Funding Information:
The authors wish to thank Dr. William Stauffer and Dr. Patricia Walker for their guidance and assistance with creation of the survey questionnaire. The project described was supported by Award Number UL1TR000114 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Minnesota.

Publisher Copyright:
© 2016 The Author(s).


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