Clinical Scorecard: Food Insecurity Among Resident Physicians and Clinical Fellows

At a Glance

Key Highlights

• In the study by Mahan et al, 30.5% of respondents screened positive for food insecurity using the 10-item USDA Adult Food Security Survey Module.
• Food insecurity was reported by 45.3% of PGY-1 respondents and 23.4% of respondents in PGY-2 through PGY-4 or higher.
• The study had a 28% response rate (165 of 600) and a single-site design, limiting generalizability and leaving potential for response bias.
• The survey asked about the preceding 12 months, so PGY-1 responses may reflect circumstances during medical school, residency, or both.
• The article identifies the transition into residency as a period when relocation costs, delayed pay, fees, and loan repayment may coincide.

Guideline-Based Recommendations

Diagnosis

• Mahan et al used the 10-item USDA Adult Food Security Survey Module to assess food insecurity among trainees.

Management

Monitoring & Follow-up

• The source calls for future research to define more precisely when financial hardship develops across the transition from medical school to residency, including assessment of living circumstances, other debt, household dependents, and related factors.
• The commentary calls for further quality and nonresponse analysis because the reported confidence interval may not account for self-selection.

Risks

Patient & Prescribing Data

Not applicable; the article concerns resident physicians and clinical fellows rather than patients receiving treatment.

No medication or patient treatment data are reported. Proposed trainee supports include financial counseling, food assistance, relocation stipends, grocery access, and meal credits.

Clinical Best Practices

• The commentary cautions against overgeneralizing prevalence estimates given the single-site design and low response rate.
• The source notes that the 12-month survey window complicates attribution of PGY-1 food insecurity specifically to residency.
• The authors propose institutional supports including financial counseling, food assistance, relocation stipends, grocery access, and meal credits; the commentary notes implementation challenges and does not establish intervention effectiveness.
• The commentary calls for further research on the timing and circumstances of financial hardship and for quality and nonresponse analysis.

Related Resources & Content

• Mahan et al. Study of food insecurity among resident physicians and clinical fellows, as described in the source article.
• Thomas et al. Study reporting food insecurity among resident or fellow physicians at four sites.
• US Department of Agriculture Adult Food Security Survey Module.