- Amélie Mercadosecond year medical student,
- Taimur Siddiquisecond year medical student
Gun injuries have become an epidemic in the United States. In 2022, more than 48,000 U.S. citizens died from gun-related injuries of all types (unintentional, suicide, and homicide) and in 2020, guns surpassed motor vehicle crashes as the leading cause deaths among American children and adolescents.12 Firearms are also the deadliest method of suicide in the United States, with 89.6% of firearm suicide attempts resulting in death between 2007 and 2014.3 Additionally, in 2020, the gun homicide rate in the United States reached 6.1 per 100,000 people, its highest rate in more than 25 years.4 Clearly, firearm injuries are a public health problem, and as such, health care workers have a role to play in solving it.
With about a third of Americans owning a gun5 and approximately 4.6 million children living in homes with loaded and unlocked guns,6 Prevention should start with advice on safe storage of firearms. Doctor visits are an opportune time for these conversations, but doctors have yet to normalize the topic of guns during routine patient encounters. This is partly because most U.S. medical schools have yet to teach students how to counsel patients about firearm injury prevention, even in specialties such as pediatrics, where the Gun safety is essential to the safety of children.
Only 25% of U.S. medical schools covered gun-related injuries in their curricula during the 2020-2021 school year.7 This content is usually optional and is rarely integrated into the required curriculum. Some medical schools are leading the way to change this situation. For example, the University of California San Francisco School of Medicine implemented a breakout session for all first-year medical students that allows them to play a role in advising patients on safety firearms.8 Brown University’s Warren Alpert School of Medicine is implementing a four-year program that will teach students about firearm epidemiology and safe storage tips during their preclinical years so they can apply these skills through internships during their third and fourth years.9
Students can lead change
How can we involve more medical schools in teaching students these skills? As two second-year medical students at Baylor College of Medicine, we opened this conversation to faculty at our college and were amazed by their receptiveness to dialogue and willingness to support student-led change. This is especially noteworthy given that Baylor College of Medicine is located in Texas, where citizens can openly carry weapons without a license from the age of 21 and purchase an AR-15 assault rifle from the age of 18 years.
We are currently working with staff to set aside time to teach students firearm injury counseling as part of required preclinical courses. Baylor College of Medicine has set a tentative start date of October 2024 to implement this student-led program segment, which was built in collaboration with the Massachusetts General Hospital Center for Gun Violence Prevention.ten To ensure that older classes can access training, we also hold workshops on our medical school campus.
Our first advice to other medical students who are passionate about this topic is to start a dialogue with professors. With enough conversations and referrals, you might find yourself speaking with program development staff and gaining champions along the way. Second, if your institution is not willing to make firearm injury prevention a required part of the curriculum, see if it is willing to create an optional course. Many schools already offer electives on this topic, such as UMass Medical School, and they might be willing to exchange materials.11 Finally, start a workshop with student interest groups. Your fellow students may be more receptive to change than faculty in the short term, and demonstrating student interest in a workshop may persuade staff to offer more formal training. Students do not need to reinvent the wheel and can collaborate with their peers and reach out to institutions that already teach students about gun safety for resources.
Physicians should be able to discuss the topic of firearm injury prevention like any other health risk, whether it is for adults with suicidal ideation or families who have firearms at home. Medical trainees should feel empowered to discuss firearm storage with patients in different settings. There are many online out-of-school education resources that can prepare students for these conversations, such as those offered by Stanford Medicine, the American Academy of Pediatrics, and the American College of Surgeons.121314 Yet medical schools also have a role to play in showcasing this knowledge and teaching students to deploy these skills with confidence.
Gun violence takes a toll on the health of many communities and requires action by medical professionals, but we need training and support from medical schools to do this work. If medical schools are not taking the lead, student advocates should demand changes from them. Let’s play an active role in the fight against this epidemic.
