Firearm Injury Prevention in Undergraduate Medical Education in the United States: Current Landscape, Barriers, and Future Directions.

BACKGROUND: Firearm injuries remain a leading cause of preventable death in the United States (US), with physicians uniquely positioned to contribute to firearm injury prevention (FIP). Despite this, there is a lack of recent national assessment of FIP inclusion in US undergraduate medical education (UME). Thus, we looked to assess how medical schools currently incorporate FIP into curricula and what challenges affect its implementation. METHODS: We distributed a REDCap-based survey to medical education leadership at all LCME- and COCA- accredited medical schools in the US between April and December 2024, assessing FIP curricular content, timing, modes and settings of instruction, assessment strategies, extracurricular opportunities, and perceived barriers to implementation. RESULTS: Fifty-five institutions (27%) responded, with 64% reporting the inclusion of FIP content in their curricula. Most schools (62%) introduced FIP during clinical years, particularly in pediatrics, emergency medicine, and surgery, and some schools (51%) integrated content preclinically. Common curricular topics included firearm safety counseling, access screening, and identifying risk factors. Only 27% of schools reported formally assessing FIP knowledge. The most frequently cited barriers to implementation were limited curricular time and political/ideological concerns. CONCLUSIONS: Our findings suggest encouraging progress in the incorporation of FIP education within UME compared to the most recent previous data, but they also highlight significant variability and persistent gaps. Broader adoption of standardized FIP curricula, earlier integration during training, and development of robust assessment strategies may enhance awareness and preparedness among future physicians to address firearm injury as a vital public health issue.