Presented By: Stephen Schneid, University of California at San Diego School of Medicine
Co-Authors: Rachel Bryant, University of California at San Diego School of Medicine
Karyssa Domingo, University of California at San Diego School of Medicine
Destiny Frederick, University of California at San Diego School of Medicine
Sidney Lin, University of California at San Diego School of Medicine
Sadie Munter, University of California at San Diego School of Medicine
Daniela Osowiecki-Feldman, University of California at San Diego School of Medicine
Kelsey Smith, University of California at San Diego School of Medicine
Eli Solomon, University of California at San Diego School of Medicine
Lauren Wedekind, University of California at San Diego School of Medicine

Purpose 
Drug-related overdose deaths continue to skyrocket, representing an ongoing public health crisis in the US. With the emergence of Health Systems Science as the third pillar of medical education, it is imperative for educators to ensure that trainees are equipped with the knowledge to provide non-stigmatizing care for people who use drugs (PWUD) and critically evaluate healthcare delivery systems. 

Methods 
Six second-year medical students were recruited from the Harm Reduction Student Interest Group (HRSIG) leadership to facilitate a session for the 23 incoming medical students enrolled in our online 7-week summer pre-matriculation course (PMC). Our two-hour long harm reduction session included an interactive didactic introducing harm reduction principles, an infectious disease physician who spoke about her clinical practice, and a case-based discussion in small groups facilitated by the second-year medical students.

Results 
After the session, students were asked to provide written reflections on what they learned during the session and what they hoped to learn more about. A major positive theme was our framing of harm reduction as a foundational approach to working with all patients, not just PWUD. Identifying the small decisions that many of us make throughout the day (e.g., sunscreen or seatbelts) as harm reduction helped offer more points of entry to a topic that has historically been stigmatized in medicine. The PMC was an ideal environment to introduce this topic as early exposure to student-led harm reduction efforts allowed incoming students a chance to engage with harm reduction in a practical and meaningful way once school started. During the first two months of medical school, there was an increase in student engagement with HRSIG, with many students citing our session as the reason for their interest.

Conclusion 
Integration of harm reduction education in the PMC setting provides incoming medical students an avenue to engage in tangible advocacy efforts early in their training.