Background In 2002, the Institute of Medicine's report “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare” recommended that all U.S. medical schools implement cultural competency training as one of the solutions to improving the quality of health care for ethnic minorities in the U.S. There are few data available that describe the formats, number of hours, or the timing of such training during medical school or residency.
Methods The CCTOP Study (Cultural Competency Training and Outcomes in Patients) is an ongoing multi-center, cross-sectional study of patients and physicians regarding their opinions on culture and health. A 93-item survey was administered to internal medicine physicians. Physicians were asked open-ended questions regarding the format, duration, and timing of cultural competency training in medical school, residency, and postgraduate years (eg. lecture, small group workshops, cultural immersion). Physicians' opinions about the relationship of training to their ability to care for culturally diverse patients were also measured. We also asked physicians if they had any interest in attending a course on cultural competency training if one were offered for CME credit.
Results There were 130 physicians surveyed (83 residents and 47 attendings). During medical school, 84% received cultural competency training in the form of lectures, 58% in small groups, and 34% in a cultural immersion experience. During residency, 48% received training in the form of lectures, 26% in small groups, and 24% in a cultural immersion experience. The most commonly reported times for cultural competency training were: the 2nd year of medical school (63%), the 1st year of medical school (54%), and residency (40%). Cultural competency training improved the ability to care for culturally diverse patients in 68% of physicians surveyed, and 97% disagreed that cultural competency training was not important in medical school. Also, 71% of physicians surveyed would attend a CME course on cultural competency.
Conclusion Inital data suggest that medical schools use multiple methods of cultural competency training for physicians during preclinical years and residency. Physicians surveyed benefited from their training and would be receptive to further training when available. Further research should identify the best methods and timing of cultural competency training coupled with hard outcomes showing patient benefit.