Like so many Americans, we watched in horror the news reports about the mass shootings in Buffalo and Uvalde, and the heartbreaking aftermath of families grieving their losses.
As medical students, we are being trained to one day manage the consequences of gun violence: people dead on arrival in the emergency department or those wounded so badly there is little that can be done; bodies torn apart by bullets and shrapnel that will never be the same again; the lingering pain or post-traumatic stress disorder; and more. What we aren’t being taught is what matters most: how to prevent gun violence in the first place.
Gun violence is a ruthless epidemic. Each year, about 120,000 people in the U.S. are shot. In 2020, the last year with complete statistics, over 45,000 people died from gun-related injuries, including suicide and murder. Today, gun violence is the leading cause of death among youths, surpassing deaths from car crashes. People across the globe mourn for the lives lost to such tragedy while loved ones and survivors suffer unbearable physical and mental strains.
While Americans wait for Congress to pass meaningful gun legislation, we must do all that we can to prevent future lives from being lost to gun violence. Millions of children and adults live with a gun in their homes, and research shows that suicides and child deaths from gun use significantly decrease with safe gun storage. Doctors, functioning as public health advocates and trusted voices in their communities, are well positioned to talk with their patients about medical problems and factors outside of clinical medicine that directly shape their patients’ health. Those factors should include gun safety.
Over the last several years, medical schools — the training ground for all doctors — have reformed their curricula to include topics like the social drivers of health and health policy that influence a person’s well-being. For example, medical students learn not only how to recognize and treat alcohol withdrawal, but also how to discuss safe alcohol use with their patients. They are then tested on that content, both through scripted patient encounters and examination questions. Some students even decide to become experts on these topics alongside their clinical specialty.
The same could happen regarding gun violence — a pressing public health issue — if medical schools integrated gun-related safety into their curricula. In our own experience, we have not had any education in medical school on how to discuss or even counsel patients on safe gun ownership, unlike the education we have received on counseling patients on substance use and even safe driving practices. Nationwide, only about 15% of medical schools include gun-related content in their curricula.
Medical schools that heed our call to ramp up gun safety education do not need to start from scratch. Student-led efforts to introduce the topic of gun prevention into curricula exist at the Warren Alpert Medical School of Brown University and the UCSF School of Medicine. Organizations like Medical Students for Gun Safety and academic research by medical students also pave a path forward.
There are several ways that medical schools can practically integrate gun safety into their curricula. At our medical schools (Harvard and the University of Michigan), doctors often invite their patients to discuss the ups and downs of their clinical journeys, typically those related to navigating a rare disease, during the first two years of classes. Hearing from patients who have suffered from gun violence, so that students have a better understanding of its physical and emotional burdens, would be a natural extension of this. Learning about such personal experiences would help build the foundation for delivering empathetic care. Medical schools can teach students the basics about gun ownership and safety in the classroom.
Then, as students prepare for their clinical rotations (typically the last two years of medical school), educators can help students learn how to discuss gun safety with patients. UCSF did this via a small group discussion-based curriculum for medical students. Medical schools can even assess students’ competency by incorporating exam questions related to gun safety and by scripting practice patient encounters that include the topic.
More specific content matter can be introduced once students enter their clinical rotation years — child-related gun safety education on pediatric rotations, for example — to create a longitudinal curriculum like what Brown has done. In addition to curricular changes, medical schools can consider taking public stances rooted in public health on gun safety.
At the end of the day, transformative policy reform will be needed to prevent lives from being lost to gun violence. This includes instituting red flag laws that prevent individuals who show signs of being a threat to themselves or others from purchasing a gun, government buyback programs for automatic weapons, raising the minimum age for buying guns, and more. But reform is slow and uncertain, and doctors directly manage the repercussions of gun violence, making it all the more necessary to practice prevention. The shooting in Buffalo and Uvalde should prompt everyone who has an opportunity to make gun violence a thing of the past — small businesses, large corporations, nonprofits, governmental bodies, health care groups, and others — to act quickly and boldly. Medical schools can help by ensuring that tomorrow’s doctors are ready for one of today’s most pressing challenges.
David Velasquez is a fourth-year student at Harvard Medical School. Jesper Ke is a third-year medical student at the University of Michigan School of Medicine.
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