KCCF Family Medicine Elective Rotation for Third Year Residents

Faculty Coordinator: Ben Davis, MD

Jail Elective:

Swedish First Hill Family Medicine residents (3rd year) may select an elective in correctional medicine rotation. This elective will occur every Wednesday from 7:15-11:45 am, with one resident per 4 week cycle at the King County Correctional Facility in downtown Seattle. Residents will have one on one supervision by Dr. Jennifer Jones-Vanderleest who is a board certified Family Physician with experience in resident teaching and supervision. 

A suggested reading list will be provided and the residents will have the opportunity to discuss the learning objectives with the supervising attending physician. A values clarification exercise will be given to residents to complete prior to coming to the rotation to encourage self-reflection about the complex legal and social issues that jail patients may present. Residents will have the opportunity to tour the jail and will care for patients with acute and chronic illnesses, as well as provide prenatal care. Depending on resident interest and supervising provider schedule, residents may also care for patients housed in the infirmary, where alcohol withdrawal management occurs, as well as the care of more seriously ill patients. All patients will be presented to Dr. Jones-Vanderleest and the resident will be responsible for entering their clinical encounter into the electronic medical record. Residents may be asked to write a one page reflection essay at the end of their rotation to process their experiences at the jail or the content discussed in the learning objectives. Dr. Jones-Vanderleest will be responsible for resident medical record review and the rotation evaluation.


Goals: 

To provide senior Family Medicine residents an elective rotation at the King County Correctional Facility in order to 1) understand the complex medical,psychiatric and social justice issues faced by jail patients and how to best care for the patients during incarceration and once transitioned back to their community and 2) consider correctional medicine as an avenue to care for underserved and vulnerable patients upon residency completion.


Learning Objectives:

At the completion of this rotation, the resident will be able to:  

  • Define jail and prison and describe unique challenges that exist in the provision of medical care in these settings (K)

  • List and discuss experiences common to incarcerated patients including homelessness,  substance abuse/dependence, violence, poverty, mental illness and sex work (K)

  • Define and discuss the concepts of prison industrial complex, racial disparity in incarceration, recidivism, reintegration, felony disenfranchisement and values conflict in custodial settings  (K,A)

  • List the most common medical and psychiatric issues for incarcerated patients (K)

  • Describe medical, psychiatric and social services that are available to patients housed in the King County Correctional Facility (K)

  • Demonstrate the ability to participate in team based medical care and discharge planning for currently incarcerated jail patients (K,S)

  • Demonstrate an understanding of personal safety measures used in clinical correctional settings (K,S)

  • Demonstrate the ability to communicate effectively with incarcerated men and women in order to establish a therapeutic relationship using a resiliency and harm reduction based framework (K,S,A)

  • Demonstrate sensitivity and responsiveness to the patient’s gender, culture, language, ethnicity, race, sexual orientation, gender identity and ability (K,S,A)

  • Demonstrate the ability to use motivational interviewing skills to elicit patient desire for behavior change and to respond to patient change talk (K,S)

  • Define the Prison Rape Elimination Act (PREA) and discuss its clinical implications (K)

  • Discuss the impact of incarceration on families and communities including the ramifications of the Federal Adoption and Safe Families Act and Fostering Connections to Success and Increasing Adoption Act (K)

  • Describe how the Affordable Care Act can positively affect incarcerated patients (K) 


Selected Resources:  

  • Alexander M. The New Jim Crow: Mass Incarceration in the Age of Colorblindness 2012 The New Press, New York, NY

  • Almagno SA, Wilkinson M, Levy, L. Medical education goes to prison: Why? Acad Med 2004;79:123-127.

  • Buck DS, Marconi Monteiro F, Kneuper S, et al. Design and validation of the Health Professions’ Attitudes Toward the Homeless Inventory (HPATHI). BMC Medical Education 2005;5;1-8.

  • Clarke JG, Adashi EY. Perinatal care for incarcerated patients: a 25 year old woman in jail. JAMA 2011;305:923-929

  • Dumond D, Brockman B, Dickman S, et al. Public health and the epidemic of incarceration.  Ann Rev Public Health 2012;33:325-359.

  • Evans Cuellar A, Cheema J.  As roughly 700,000 prisoners are released annually, about half will gain health coverage and care under federal laws. Health Affairs 2012;31:931-938.

  • Filek H, Harris J, Koehn J, et al. Students experience of prison health education during medical school. Med Teach 2013;35:938-43.                    

  • Freudenberg N. Jail, prison and the health of urban populations: a review of the impact of the correctional system on community health. Journal of Urban Health 2001;78:214-235.

  • Golembeski C, Fullilove R. Criminal injustice in the city and its associated health consequences.  Am J Public Health 2005;95:1701-1706.

  • Hill TE. How clinicians make (or avoid) moral judgments of patients: implications of the evidence for relationships and research.  Philosophy, Ethics and Humanities in Medicine 2010;11

  • Lee RD, Fang X, Luo F. The impact of parental incarceration of the physical and mental health of young adults. Pediatrics 2013;131:e1188-e1195.

  • Odom Walker K, Ryan G, Ramey R, et al. Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.  Am J Public Health 2010;100:2168-2175.

  • Sufrin CC, Autry AM, Harris KL, et al. County jail as a novel site for obstetrics and gynecology resident education. J Grad Med Educ 2012;4:346-350.

  • Wakeman SE, Rich JD. Fulfilling the mission of academic medicine: training residents in the health needs of prisoners. J Gen Intern Med 2010;25(Suppl2)186-8. 

Effective through June 2019

Updated 7/2018, Ben Davis