Development of a virtual asylum medicine curriculum: applying a medical education model to a global health priority.

Abstract

Each year, millions of people fleeing persecution seek asylum in the USA and elsewhere. Many have experienced psychological and/or physical trauma that can be documented with objective forensic medical and mental evaluations (FMEs) performed by trained clinicians. FMEs can assist adjudicators in deciding claims, and asylum seekers who undergo an FME are significantly more likely to be granted asylum. However, there is a shortage of clinicians trained to perform FMEs, and existing training models have shortcomings, including lack of accessibility and consensus-driven best practices. To meet the rising need for FMEs and improve training in the burgeoning field of asylum medicine, we used Kern's model to design an interdisciplinary, consensus-driven, virtual curriculum that prepares clinicians to conduct FMEs. The curriculum development process involved a diverse group of 80 contributors from over 40 US organisations and academic centres. We used a staged needs assessment to identify critical issues in the existing training paradigm. Through an iterative process, we then developed an introductory curriculum consisting of eleven modules paired with assessments. Contributors reported high rates of satisfaction with the curriculum development process. To our knowledge, this is the first consensus-based training in asylum medicine that is national in scope, and it has since been adopted by Physicians for Human Rights as the standard for FME training. The process employed here offers a model for developing and improving training relevant to other global health priorities internationally.