Effective Legislative Advocacy - Lessons from Successful Medical Trainee Campaigns.

medical students. Many of them have never been politically active, having assumed that the arc of progress would continue uninterrupted, and so, understandably, have focused instead on a demanding training process that largely treats advocacy as extracurricular rather than as a core competency. Now, recognizing the myriad ways in which politics and policy influence the health care we deliver, many trainees feel a new sense of urgency to get involved. Medical student and resident interest in advocacy is, of course, not entirely new. Among other organizations, the American Medical Student Association has tackled many critical issues, from the Vietnam War to primary care access. Several medical training programs have developed innovative advocacy curricula, and I benefited from an elective course on the politics of medicine while I was a medical student at the University of California, San Diego, and from elective advocacy training as a resident. The vast majority of students and residents, however, still receive very little or no training in advocacy. Having worked in the U.S. House of Representatives and the California State Assembly before I went to medical school, I’ve learned some lessons about effective legislative advocacy, which I later solidified as a medical trainee successfully advocating for policy change. These lessons may serve other trainees and physicians with a newfound interest in legislative advocacy on behalf of their patients. First, advocacy is a team sport. With a very demanding day (or dayand-night) job, it is nearly impossible for any trainee to have a meaningful effect in legislative advocacy without collaborating with others, either within an existing organization or by creating a new one. For most people, joining an existing organization will be more practical, given the sizable demands of starting a new one. When choosing an organization to work with, I consider three elements: the organization’s effectiveness in creating change, my alignment with its goals, and my ability to effect change within it. The best way to address these questions about a particular organization may be to ask mentors who are politically active. However, these considerations will often have to be weighed against each other, and would-be advocates will Effective Legislative Advocacy — Lessons from Successful Medical Trainee Campaigns