• Joel R Burnett, Bryanna De Lima, Emily S Wang, Kelly McGarry, Daniel I Kim, Michael Kisielewski, Kelsi Manley, Sima S Desai, Elizabeth Eckstrom, and Tracey L Henry.
• Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA. joel.burnett.md@gmail.com.
• J Gen Intern Med. 2024 May 6.

BackgroundAlthough internal medicine (IM) physicians accept public advocacy as a professional responsibility, there is little evidence that IM training programs teach advocacy skills. The prevalence and characteristics of public advocacy curricula in US IM residency programs are unknown.ObjectivesTo describe the prevalence and characteristics of curricula in US IM residencies addressing public advocacy for communities and populations; to describe barriers to the provision of such curricula.DesignNationally representative, web-based, cross-sectional survey of IM residency program directors with membership in an academic professional association.ParticipantsA total of 276 IM residency program directors (61%) responded between August and December 2022.Main MeasurementsPercentage of US IM residency programs that teach advocacy curricula; characteristics of advocacy curricula; perceptions of barriers to teaching advocacy.Key ResultsMore than half of respondents reported that their programs offer no advocacy curricula (148/276, 53.6%). Ninety-five programs (95/276, 34.4%) reported required advocacy curricula; 33 programs (33/276, 12%) provided curricula as elective only. The content, structure, and teaching methods of advocacy curricula in IM programs were heterogeneous; experiential learning in required curricula was low (23/95, 24.2%) compared to that in elective curricula (51/65, 78.5%). The most highly reported barriers to implementing or improving upon advocacy curricula (multiple responses allowed) were lack of faculty expertise in advocacy (200/276, 72%), inadequate faculty time (190/276, 69%), and limited curricular flexibility (148/276, 54%).ConclusionOver half of US IM residency programs offer no formal training in public advocacy skills and many reported lack of faculty expertise in public advocacy as a barrier. These findings suggest many IM residents are not taught how to advocate for communities and populations. Further, less than one-quarter of required curricula in public advocacy involves experiential learning.© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.

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