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BackgroundPersons who experienced persecution in their home country may apply for asylum with the United States. This population has complex medical needs complicated by cultural and linguistic barriers. This report outlines the design and evaluation of the Patient History Project (PHxP), a collaborative program between the University of Michigan Asylum Collaborative (UMAC) and a local non-profit, Freedom House Detroit (FHD), to improve the quality of health care for asylum-seekers while training medical students to work with vulnerable populations.MethodsIn the PHxP, medical students trained by UMAC interviewed FHD residents and created electronic medical records that residents could share with subsequent medical providers. These sessions additionally provided an opportunity for asylum-seekers to rehearse health care utilization in the comfort of their home. Surveys of students and asylum-seekers, and a semi-structured interview with FHD staff, were conducted to evaluate the program’s performance on multiple dimensions.ResultsAsylum-seekers reported high levels of overall satisfaction with PHxP and increased confidence in the health care setting. Medical student volunteers reported gaining cultural sensitivity and clinical skills. FHD staff noted greater insight into resident medical needs.ConclusionsAs the number of asylum-seekers in the United States continues to rise, so will the need of specialized services including medical care. This program is one strategy to help address the medical needs of asylum-seekers. Medical schools with programs to provide forensic medical exams and affidavits for asylum-seekers would be particularly well situated for the trial of such a program.

The Patient History Project: Medical Student Innovation in Improving Medical Care for Asylum Applicants