"As a first-year medical student, I am not confident in asking the right questions to rule out certain diagnoses. I feel like my ability to conduct a thorough interview is contingent on my ability to diagnose disease and therefore, as a first-year, my interviews are definitively inadequate. However, at the SUSTAIN training we explored important questions to ask that might reveal evidence of being trafficked.
The nuance in the question-asking required to elucidate a case of sex trafficking is reliant on intuition, trust, and time. We reviewed various studies outlining barriers to identification and care of trafficked victims -- lack of training, awareness, and time topped many of the lists. When I interview patients at my weekly clinical off-site, my lack of diagnostic skills actually frees up time to dig deeper into the patient’s social and sexual history. I have the luxury of time to build up trust, to ask about things like tattoos, and to have a conversation led by my intuition. I’m starting to think of my inexperience as an advantage, allowing me to connect deeper with patients on a personal level to better understand the sociocultural factors – including screening for sex trafficking -- that contribute to their health and wellbeing. “History being 90% of the diagnosis” starts to make a little more sense.
As informed medical students, we can use our time interviewing patients to ask some of the nuanced questions that often go unasked. Not screening for sex trafficking in our hospitals is doing a disservice to our community here in the Bronx. It is easy to fall into the mind-trap that us medical students are purely passively learning until given all the tools to care for patients, but the SUSTAIN training revealed how we can be huge assets in acknowledging risk factors and identifying victims of trafficking."
Amanda Orley is a medical student at Albert Einstein College of Medicine and a past participant with SUSTAIN.