Dr. Hussein Saghir was most recently Associate Program Director and Assistant Professor at Michigan State University College of Human Medicine/McLaren Family Medicine Residency Program in Flint, MI. He also served as a Primary Care Sports Medicine Physician in the greater Flint area, providing pro bono sports physicals to underserved students and athletes participating in the Special Olympics. He obtained his medical degree from Michigan State University College of Osteopathic Medicine and completed his residency training in Family Medicine at Michigan State University/Genesys Regional Medical Center. Dr. Saghir went on to complete his Sports Medicine Fellowship at Wayne State University School of Medicine/Detroit Medical Center where he provided coverage to Detroit’s professional sports teams. After his fellowship, he returned to Flint to serve as the team physician for the Flint Firebirds Hockey team and is an active member of the Physician Advisory Board to the Genesee Health Plan, an insurance plan that provides coverage to uninsured residents of Genesee County. Dr. Saghir has extensive experience in serving vulnerable populations in Flint particularly during and after the Water Crisis, which has compelled him to champion social, economic, and health equity and further solidify his commitment to a career in public advocacy and health policy. He plans to continue his work in graduate medical education and to making Primary Care Sports Medicine more accessible to underserved populations in large urban areas.
Hussein Saghir, DO, CAQSM, MPH
Program Director at Michigan State University/Authority Health Family Medicine Residency and Sports Medicine Physician, East Lansing, MI
“Development of an Advocacy and Health Policy Curriculum for Family Medicine Residents in an Urban Underserved Community”
1. Help residents develop capacity for meaningful engagement in healthcare policy decisions and outcomes.
2. Help residents define major public health policy challenges that the U.S. and Michigan face.
3 Help residents become familiar with State Legislative Calendar and Legislative committees.
4. Help residents be confident in describing the advocacy priorities as set forth by the Michigan Academy of Family Physicians and the American Academy of Family Physicians.
5. Help residents identify and address health inequities with an emphasis on health equity and the social determinants of health
The U.S. health care system is constantly in flux with complicated health policy changes being made by non-physicians and those who are not intimately involved with health care delivery and its intrinsic challenges. As a result, these policy changes may not serve patients and providers well. Inherent in Family Medicine is the role of the provider as an advocate. The American Academy of Family Physicians (AAFP) serves as the professional organization that represents over 130,000 family physicians in the U.S. (1). The AAFP also serves as a platform for advocacy within the field, allowing for medical students and residents to participate in advocacy and health policy work at the National Congress of Students and Residents every year (1). It also enables physician members to inform policy changes that affect practice guidelines. Moreover, the American Medical Association (AMA) also serves to promote advocacy work among its resident and physician members. In recent years, there have been increasingly more offerings of workshops on advocacy and health policy at national meetings for primary care providers (2). However, despite the amount of advocacy work that is being done through the AAFP and AMA, advocacy and health policy training in Family Medicine residency is currently not an ACGME-required competency. As a matter of fact, little is known about the advocacy activity of physicians during their training. Recent efforts have increased in making advocacy and health policy training more accessible to providers – especially in Internal Medicine – and also to medical students (2-5). For example, the Society of General Internal Medicine launched their one-year health policy career development program called Leaders in Health Policy Program in 2017, creating an opportunity for clinician educators to become leaders in health policy efforts (2). At the medical student training level, the University of Colorado Denver School of Medicine created the Leadership Education Advocacy Development Scholarship to train students to become advocates and health policy leaders (3). Although Family Medicine providers serve as the critical access point for patients navigating the health care system, there is a paucity of publicly accessible data regarding the extent to which Family Medicine residents are informally or formally receiving this type of training.
The McLaren-Flint Family Medicine Residency Program is located in the largest city within Genesee County, which ranks 3nd for worst health outcomes out of 83 Michigan counties (6). Advocacy is believed to be inherent within family medicine, but the tools and resources to advocate for and effect change in healthcare at the policy level are not readily accessible, especially in resource-limited communities such as Flint. The Development of an Advocacy and Health Policy Curriculum at Mclaren-Flint was born out of a desire to empower Family Medicine resident trainees and faculty to advocate on behalf of the patients they serve in both a clinical and social context.
(1) American Academy of Family Physicians. Advocacy, 2019, https://www.aafp.org/medical-school residency/fmig/lead/programming/advocacy.html. Accessed 15 June
(2) Robinson CL, Fisher M, Lane SW, Candler SG. “Creating a national health
policy and advocacy curriculum.” SGIMForum. 2018;41(6): 1-2.
(3) Earnest MA, Wong SL, Federico SG. “Perspective: physician advocacy: what is
it and how do we do it?” Journal of the Association of American Medical Colleges. 2010;85(1): 63-67.
(4) Long JA, Lee RS, Federico S, Battaglia C, Wong S, Earnest M. “Developing
leadership and advocacy skills in medical students through service learning.” Journal of Public Health Management and Practice. 2011;17(4): 369-372.
(5) Hubinette MM, Ajjawi R, Dharamsi S. Family physician preceptors’
conceptualizations of health advocacy: implications for medical education. 2014; 89(11):1502-1509.
(6) County Health Rankings & Roadmaps,
www.countyhealthrankings.org/app/michigan/2018/downloads. Accessed 20 April 2020.
One resident and three faculty members from the McLaren-Flint Family Medicine Residency Program formed a task force to develop an Advocacy and Health Policy curriculum with the assistance of the legislative liaison of our state chapter of American Academy of Family Physicians (AAFP) – the Michigan Academy of Family Physicians (MAFP).
The Advocacy and Health Policy Curriculum comprises engagement activities and a capstone project that includes policy analysis with an emphasis on health equity to teach residents the skills to lend a voice to support policies that would benefit patients and preserve the integrity of our practice.
To gauge interest in the curriculum, the program invited the MAFP legislative liaison to lead two courses on advocacy with online evaluations conducted.
Course #1: “Advocacy and Health Policy Overview” (1 hour)
• 18 in attendance; survey response rate = 78%
• 50% were initially interested in advocacy and health policy; after course #1, 93% were interested.
• 100% said their understanding of advocacy improved
Course #2: “Resolution Writing Workshop” (2 hours)
• 14 in attendance; survey response rate = 57%
• 50% were initially uncomfortable with resolution writing; 75% felt comfortable after course #2.
• 50% were likely to engage in resolution writing
Ultimately, the Advocacy and Health Policy Curriculum was approved by the Performance Evaluation Committee in March 2020 as a 3-year longitudinal curriculum in the McLaren-Flint Family Medicine Residency Program.
1) Writing resolutions regarding increasing resources to help individual family medicine residency programs develop advocacy and health policy curricula; these resolutions are to be presented at the National Conference of Constituency Leaders
2) We were asked by our state chapter of AAFP to develop an online toolkit to assist other programs develop their own advocacy curriculum
Preceptor: Prabhat Pokhrel, MD, PhD, MS, FAAFP, Program Director, McLaren-Flint Family Medicine Residency Program/Michigan State University College of Human Medicine