not prepared to provide specific components of cross-cultural care, including caring for patients with health beliefs at odds with Western medicine (25 percent), new immigrants (25 percent), and patients whose religious beliefs affect treatment (20 percent). In addition, 24 percent indicated that they lacked the skills to identify relevant cultural customs that impact medical care. In contrast, only a small percentage of respondents (1 percent-2 percent) indicated that they were not prepared to treat clinical conditions or perform procedures common in their specialty.

Approximately one-third to half of the respondents reported receiving little or no instruction in specific areas of cross-cultural care beyond what was learned in medical school. Forty-one percent (family medicine) to 83 percent (surgery and obstetrics/gynecology) of respondents reported receiving little or no evaluation in cross-cultural care during their residencies. Barriers to delivering cross-cultural care included lack of time (58 percent) and lack of role models (31 percent).

"These findings have implications for how residency training programs prepare physicians to provide high-quality care to an increasingly diverse nation. The practice of medicine continues to be complex and it is difficult to achieve a high level of competence in all areas. Nevertheless, the views from residents indicate that a lot of additional training and the presence of good role models and mentors go a long way to ensure that they are sufficiently skilled to deliver high-quality medical care," the authors write.

"Our study is the first, to our knowledge, to obtain a national estimate of the readiness of new physicians to deliver high-quality care to culturally diverse populations. While attitudes regarding the importance of cross-cultural care seem to be positive, there appear to be relatively few opportunities for meaningful education and mentoring, and little evaluation. These findings highli
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Contact: Donita Bodie
617-724-5627
JAMA and Archives Journals
6-Sep-2005

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