In a classroom on the University of Wisconsin campus, 18 future doctors from across the Midwest gathered this spring to tackle a subject rarely mentioned in medical school — preventing gun violence. Over two days, they shared their institutions’ current approaches to incorporating gun violence prevention into curriculum and heard from gun owners and injury prevention specialists.
The students were all members of their schools’ chapters of Scrubs Addressing the Firearm Epidemic, or SAFE, an organization working to reframe gun violence as a preventable public health crisis — one that doctors are uniquely positioned to address through patient education and community engagement. The University of Wisconsin group was part of SAFE’s pilot training initiative, which aims to support medical education so that every future doctor graduates with evidence-based strategies to prevent firearm injuries before they occur. The goal is to make what has long been a political issue into a standard medical competency that could save lives.
While medical schools routinely teach students how to treat the aftermath of gunshot injuries, they rarely address how to talk with patients about avoiding them in the first place. As federal efforts to address gun violence prevention through public health channels stall, SAFE’s network is keeping firearm injury prevention on the national agenda, reshaping how future physicians are trained and embedding prevention into the heart of clinical care before the next crisis demands it.
This new generation of physicians is leaning in with open minds, community partnerships, and a message that’s becoming harder to ignore: Gun violence is a preventable crisis, and the medical field has a role to play.
Changing medical education
Firearm injuries claim over 45,000 lives and cause even more nonfatal injuries each year, representing a significant public health crisis, particularly for younger generations. Yet, despite the scale of the problem, only about a quarter of medical schools include training on how to discuss safe gun storage and firearm injury prevention with patients, according to a 2021 study. Some institutions, like Michigan State University and the University at Buffalo, offer comprehensive education on the topic, including a joint annual conference — though that was implemented only after a shooting occurred on or near each campus.
SAFE seeks to ensure that every medical school in the country incorporates this training into their curriculums. The organization plans to connect and provide comprehensive teaching materials to curriculum administrators at all medical schools in the U.S. by the end of 2027.
Allison Volkman, SAFE’s executive director, says the organization has worked since its founding in 2019 to address the gap in medical education around gun violence, normalizing these crucial conversations before a tragedy, not in response to one.
This collective effort is grounded in a shared belief: that addressing gun violence requires early and sustained education for health care providers. To support this, SAFE offers a self-paced course titled “Clinicians and Firearms,” designed to introduce medical professionals to gun-related issues through four core modules: firearm epidemiology, firearm basics, providers and firearms, and firearms and resources for clinicians.
Though initiatives like this course offer a valuable starting point, Volkman says they shouldn’t be the endpoint. She believes firearm injury prevention should be embedded directly into health science curriculums, eliminating the need for students to seek out this knowledge on their own.
SAFE, she says, is uniquely positioned to help make that happen. By sharing resources and fostering collaboration across institutions, the organization can accelerate integration efforts and help schools avoid duplicating work.
“Instead of individual schools recreating the wheel, SAFE can help connect them with institutions that may have similar values or approaches to see what’s worked for them,” Volkman said.
Today, SAFE has 73 chapters at medical schools across 32 states and Washington, D.C. Each chapter supports community-focused projects that align with the organization’s mission, giving medical students opportunities to engage with the public early in their training. Volkman believes that SAFE’s growing national footprint is helping unify a field that too often works in silos. The organization’s regional trainings, collaborative networks, and shared curriculums are building a foundation for change that’s both systemic and sustainable.
“These medical students are ready to step up and do the work in gun violence prevention at their medical schools, clinics, hospitals, and communities,” Volkman said.
Andrew Lithen, a SAFE board member and recent graduate of East Tennessee State University Quillen College of Medicine, says involvement with the organization deeply shaped his medical education. Lithen, who attended the March training, plans to pursue aerospace medicine, but was initially drawn to SAFE because he saw it as a way to step outside the “bubble” medical school can create.
Since joining, he’s participated in several initiatives through his school’s chapter. One of their first projects involved distributing gun locks to pediatric and family practices, ensuring that physicians could offer patients practical tools for safe firearm storage during visits. They later began leading safety presentations to students in elementary and middle schools, incorporating gun safety alongside topics like car seat use, medication precautions, and pool safety.
Lithen and his fellow medical students also visited a local gun club to better understand the perspectives of gun owners. There, they learned how to talk more effectively with patients about gun storage by recognizing the motivations behind gun ownership. This understanding is critical to broaching this topic with patients in a way that is nonjudgemental and focused on injury prevention, Lithen said.
“It was a chance to work around some of the ways of talking about safety with people that wouldn’t necessarily be amenable to storing their guns locked and separate from ammunition,” he said. “It’s more tools in the toolbox.”
Lithen’s experience reflects a growing movement among medical students nationwide. Across the country, SAFE chapters are engaging in similar community-based initiatives — partnering with clinics, hosting public safety events, and finding ways to embed firearm injury prevention into the culture of clinical care.
The gap
The University of Wisconsin pilot training, led by Dr. James Bigham, SAFE’s board vice chair and a clinical professor at the university, demonstrated how firearm education can be meaningfully integrated into medical training. Bigham, who has worked extensively to address the education gap around firearms in healthcare, invited local nonprofit leaders, police officers, hospital employees, and gun owners to engage with medical students about the role health care professionals can play in gun violence prevention.
These leaders shared what they see as the most pressing community needs and offered to help students build connections with similar organizations in their own cities. Each speaker acknowledged that there is no one solution to gun violence, but that harm can be reduced through collaborative work across fields.
The training created an environment for reflection. Drawing on their experiences with patients in diverse settings — from major cities like Chicago and Milwaukee to smaller communities like Ann Arbor, Michigan — students discussed effective strategies, identified approaches that haven’t worked, and suggested paths forward. Many advocated for elevating firearm safety education from an elective offering to a core component of medical curriculum.
Bigham shares this perspective. He says the topic has historically not been covered in curriculums, and where it has shown up, it hasn’t been adequate for what students need. He emphasizes that integrating lessons on firearm injury prevention throughout medical education, rather than in isolated training sessions, better prepares future doctors for real-world clinical encounters.
“We want to make sure that, from Day One of medical school, the way that we talk about firearms and firearm harm reduction is in line with best practices in respect to the language used, being culturally humble, culturally aware, and absent of bias,” Bigham says.
He acknowledges the difficulty of implementing this vision. Medical school curriculums are already tightly packed, and each institution has its own structure and priorities. Still, he believes firearm injury prevention deserves a place alongside other foundational topics. To him, this knowledge is essential for delivering inclusive, equitable care and for promoting public health at the community level.
Yet many students graduate with firearm injury prevention as a “blind spot,” he says. In places where the topic is especially politically sensitive, fear or uncertainty may discourage institutions from addressing it at all. That’s where Bigham believes SAFE can play a crucial role — bringing people and resources together to help move the conversation forward. And he emphasizes that this work isn’t just about curriculum, it’s about patient relationships.
“Our patients who own firearms are the very individuals that we want to influence on these harm reduction strategies,” Bigham says. “We’ve gotta make sure that we’re seeing them, hearing them, being there in a way where they feel valued and understood.”
To continue the conversation, the Wisconsin pilot participants will reconvene this fall for a follow-up session to share how concepts from the spring training have been implemented at their institutions. Volkman hopes more curriculum leaders will attend to hear directly from students about their visions for medical education.
After that, SAFE plans to launch similar programs in multiple U.S. regions, a move that acknowledges how cultural attitudes toward firearms vary widely across communities. Though the regions have not yet been confirmed, by tailoring education efforts regionally while maintaining a shared, evidence-based framework, the organization hopes to bridge divides that have long fragmented public health approaches to gun violence.
For students like Lithen, that nuance is essential. Raised in New York and trained in Tennessee, he’s experienced firsthand how geography shapes conversations around firearms. As he prepares for residency at a naval hospital, he says this understanding will make him a more effective and empathetic clinician — one who can meet patients where they are.
“Having the experience of living in Tennessee will help me quite a bit, especially being in a military hospital where a lot of service members do own personal firearms and gun culture is quite prominent,” Lithen said. “It will help me be a better physician, better approach this topic in terms of safety and educate patients on the right way of storing firearms, or inspire them to educate themselves a bit better.”
Now, he’s turning his attention to mentorship, helping new medical students navigate these complex conversations from the start.
“We’ve got to encourage students to take action and ownership sooner,” he says.
Correction: This story has been updated to clarify that a shooting near the University of Buffalo took place off-campus.
