How the New Generation of Doctors Will Approach Gun Violence

Marcia Frellick

Disclosures

June 06, 2018

Students Moved to Create New Elective

The Las Vegas shooting at an outdoor concert that left 58 people dead on October 1, 2017, was the tipping point for Michael Bagg, who had just started his first year of medical school at the University of Texas in Houston. Before medical school, conversations among his peers flowed freely about such events, he said, but he found few outlets, as the people around him were firmly focused on the rigors of the first semester. Houston was also still reeling from the damage of Hurricane Harvey.

But days later, his dean sent an email newsletter addressing mass shootings in general, and the call to action at the end resonated deeply with Bagg. Bagg wanted to "force a conversation," and, with the help of another student and support of faculty, designed a five-part elective course to address gun violence.

He explained that because physicians are going to see the effects of gun violence in their work, they should be prepared. The organizers did not intend a political focus but rather a safe space for conversations. The first class in February 2018 drew 90 students and faculty. Shootings in a rural church in Sutherland Springs, Texas, in November of last year and then in Parkland kept emphasizing the relevance of the course, he said. Given the recent shooting at Santa Fe High School on May 18, attention isn't likely to wane any time soon.

Bagg said that it was because of the demands of medical school, not despite them, that he felt driven to develop the course. "If I didn't do this, I wouldn't be able to do med school," he said. "This is my way of coping. This is my way of saying I'm doing something about it."

Topics in the course include how to treat a gunshot wound, how to know if a patient should be considered a threat, and how to advocate for change to the laws and statistics surrounding gun violence. Now that the speakers have been identified and the curriculum has been approved, Bagg will be able to pass along the coordination duties to a first-year successor next year. He's hoping the course will become a mainstay at McGovern Medical School at The University of Texas Health Science Center at Houston. The first round "went about as well as it could possibly go," he said.

Professor Introduces Gun Violence Class

Ilana Rosman, MD, assistant professor of dermatology and pathology at Washington University School of Medicine in St. Louis, Missouri, also saw the lack of instruction and proposed a first-year elective course on gun prevention. As she explained, "I realized that I didn't learn anything about gun violence in medical school at all, and that was 2004-2008." Rosman, who is also co-chair of the Gun Violence Prevention Task Force for the American Medical Women's Association, developed a six-part course on gun violence prevention and is in her second year of teaching it.

I realized that I didn't learn anything about gun violence in medical school at all.

The eventual goal is to create a curriculum that can be used all 4 years and adapt it to the third-year and fourth-year clerkships. In a pediatric clerkship, the talk may turn to safe storage and unintentional injuries, she said. In psychiatry, guns could become part of the discussion on suicide and access to firearms. She said that the major goals of the course are to give students a broad understanding that gun violence is a public health issue and to explain the social, cultural, legal, and political implications. A secondary goal is in their role as physicians in discussing the issue with patients and intervening to prevent gun violence.

The course also exposes the students to advocacy, an aspect appreciated in feedback on the class, she said. "A lot of times in medical schools, you learn about things but not how to put them into action," she said. Starting the class in the first year is important timing, Rosman added. "The first year of med school is all about what it means to be a physician," she said. "There's a lot of foundation work that is laid down that year—anatomy, biochemistry, introduction to public health. I think it works really well to introduce gun violence in the first year."

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