Empower, Educate, Lead: Developing Health Equity Leaders in Military Medicine

Abstract

Introduction

Despite growing recognition of health equity’s importance in healthcare and medical education, many educators struggle to lead discussions on topics like implicit bias, racism, cultural humility, and structural competency. Hesitation often stems from limited experience and the sensitive nature of these conversations. At our institution, this challenge was addressed through mentorship from senior health professions education (HPE) and health equity experts. After implementing an introductory and longitudinal case-based health equity curriculum tailored to our military medicine patient population, interest grew from other military hospitals seeking to adopt our approach. This led to the development of a 2-year “Train New Trainers” program, supported by the AAIM Building Trust Grant, to expand health equity education across military residency programs.

Our initiative aimed to scale our “Health Equity Rounds” curriculum—which includes introductory modules and case-based content— across military Internal Medicine residency programs. Recognizing the unique healthcare needs within the Military Health System, the program focuses on equipping military physicians to address healthcare bias, racism, cultural humility, and structural competency to provide more equitable care.

Results to Date

In June 2024, 22 representatives from U.S. military Internal Medicine residency programs attended our 5-day training seminar. Participants rated their pre-training ability to teach health equity as low (1.47/5), with significant improvement post-training (3.90/5, p < 0.001, Cohen’s D = 2.62). Qualitative feedback highlighted key benefits, including improved understanding of equity concepts, enhanced facilitation skills, and personal growth in cultural humility.

Challenges identified by participants included personal confidence, managing difficult questions, institutional buy-in, and time constraints. Participants requested ongoing support through a community network, continued institutional advocacy, and access to teaching resources like health disparities research and debriefing spaces.

Lessons Learned

A major barrier to integrating health equity into medical education is educators' discomfort addressing sensitive topics. Our Train New Trainers initiative helped build confidence and skills, demonstrating that case-based learning tailored to military patient populations fosters engagement. While the training successfully increased teaching confidence, continued support is vital while our participants implement this curriculum over the next year. Future efforts should focus on building a community of practice, offering mentorship, and addressing institutional barriers like time limitations and leadership buy-in. Supporting participants in integrating health equity work into their academic portfolios through research and scholarship will also further sustain program impact.