Carolyn Sufrin, MD, PhD
A rotation where Ob/Gyn residents care for women in prison and jail can be a transformative experience for residents and provides important services for a vulnerable population of women. The clinical and didactic experience can enhance their communication skills and teach them key aspects of structural competency which are bound to benefit them and their patients well beyond the walls of a jail. The following articles provide a more detailed account of resident responses to the rotation and the broader benefits.
How can other residency programs set up this kind of a rotation?
Getting support from within your department to develop a partnership with a nearby jail or prison which houses women, and designating a faculty member to lead the rotation. You will need to work with your residency program director to find a time slot in the resident rotation schedule—ambulatory blocks usually work well. You may have to do some leg work to then get in touch with the medical director at a jail or prison you’ve identified as a possible site; local Sheriff’s and public health departments can be helpful places to look.
The correctional facility and the academic department will need to determine the institution-specific arrangements, such as a memorandum of understanding, malpractice coverage, and salary support for the precepting faculty member.
This faculty member will need to get a sense of what services are currently available for women at the facility and the site-specific details of how clinical services fit into the routine of jail or prison—ideally by working there for at least a few months before having a trainee.
The faculty member will need to figure out how to get temporary security clearance for the resident to enter the facility; we have interns fill out the necessary paperwork during their orientation. The faculty member should then put some thought into the didactic component of the curriculum, including a brief orientation session at the beginning of each resident’s rotation. The following article provides a list of the readings we have residents choose from, and also provides more information about how our rotation is set up. A template for the slide presentation and Caring for Challenging Patients exercise we use at the orientation, as well as a reading guide for instructors can be found here.
Educational grants offered by your institution may help to jump start the process, and faculty members can also work with the jail or prison to procure supplies that might not already be there; having services on-site is more cost effective for the facility than transporting an inmate off-site for specialty ob/gyn care.
Once these key logistical pieces are put into place, the resident can start accompanying the faculty member and the integrated, didactic component can begin.
Dr. Sufrin is an Obstetrician-Gynecologist and a medical anthropologist who has worked on reproductive health issues for incarcerated women for the last seven years. She is currently working on a book, Jailcare: The Safety Net of a U.S. Women’s Jail.