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SMHS Medical Residents Cross the Bridge to Health Policy

The conference room at the Milken Institute School of Public Health at The George Washington University (GW) was abuzz on the afternoon of March 27. Residents from GW’s School of Medicine and Health Sciences (SMHS), along with visiting faculty members, moved between health policy topics – the implications of the King et al vs. Burwell lawsuit over the health care law, cyberterrorism and health information technology, a restructuring of the graduate medical education, and the anti-vaccination movement – with each discussion punctuated by laughter and thoughtful questions.

The residents, ranging from first- to fourth-year and from a variety of disciplines, were at the conclusion of a three-week elective course, the Residency Fellowship in Health Policy (RFHP). The fellowship, run by the Milken Institute Department of Health Policy for GW residents, is the only course of its kind in the country.

“We are told that many residents come to GW because of it,” said Fitzhugh Mullan, M.D., Murdock Head Professor of Medicine and Health Policy, professor of pediatrics, and program director of RFHP.

According to Mullan, students spend about half their time in the classroom learning the basics of U.S. health policy and law, and the other half taking advantage of what Washington, D.C. has to offer: a front-row seat to policy-making.

“We hit the road often,” Mullan said, describing the site visits residents make as part of the class. “This session, for example, we visited the OMB, the CCNV Homeless Shelter, PhRMA, Brookings, the Senate and the House, and Upper Cardozo Community Health Center, to mention a few.”

Paige Armstrong, fourth-year emergency medicine chief resident and RFHP participant, who also holds a master’s degree in public health from Johns Hopkins Bloomberg School of Public Health, added that site visits – at least one per day – varied from think tanks to Non-Governmental Organizations to the Supreme Court.

“[The visits] were really wonderful and unique,” Armstrong said. “You got to hear what’s going on in health policy directly from the horse’s mouth.”

For Courtney Paul, a third-year internal medicine resident at GW, the site visits and the cadre of guest lecturers were two halves of an essential medical whole, the “meat and bones of how health policy really works and advocacy really works.” Paul has already spoken with some of the lecturers about incorporating elements of the course into the medical education curriculum.

The class has proved so valuable for residents wanting to bridge the gap between medicine and health policy that its reputation has spread; Kaiser Permanente has invited Mullan and his team to teach a similar two-week course in Los Angeles this spring. The program, which will have 25 Kaiser Permanente residents as participants, will be tailored to its new location with more e-learning and an emphasis on state government and local health policy issues.

“We hope this is a step on the road to making the GW program a national standard for teaching health policy to residents all over the country,” Mullan said.

In the meantime, GW residents continue to line up for the popular course. RFHP is in its 10th year and is offered biannually, in the fall and spring. Residents sign up through their departments, which grant them release time from their clinical duties.

“[The fellowship] is an experience you can’t get anywhere else,” said program co-director Guenevere Burke, M.D., M.B.A., clinical instructor of emergency medicine.