title: Social accountability of medical schools and academic primary care training in Latin America: principles but not practice.
abstract: BACKGROUND
  Latin America has one of the highest rates of health disparities in the world and is experiencing a steep increase in its number of medical schools. It is not clear if medical school authorities consider social responsibility, defined as the institutional commitment to contribute to the improvement of community well-being, as a priority and if there are any organizational strategies that could reduce health disparities.
  
  
  OBJECTIVE
  To study the significance and relevance of social responsibility in the academic training of medical schools in Latin America.
  
  
  METHODS
  The study combined a qualitative thematic literature review of three databases with a quantitative design based on a sample of nine Latin American and non-Latin American countries.
  
  
  RESULTS
  The thematic analysis showed high agreement among academic groups on considering medical schools as 'moral agents', part of a 'social contract' and with an institutional responsibility to reduce health disparities mainly through the implementation of strong academic primary care programs. The quantitative analysis showed a significant association between higher development of academic primary care programs and lower level of health disparities by country (P = 0.028). However, the data showed that most Latin American medical schools did not prioritize graduate primary care training.
  
  
  CONCLUSIONS
  The study shows a discrepancy between the importance given to social responsibility and academic primary care training in Latin America and the practices implemented by medical schools. It highlights the need to refocus medical education policies in the region.
authors.affiliation: Department of Family and Community Medicine, School of Medicine, Pontificia Universidad Católica de Chile and kpuschel@med.puc.cl.
authors.forename: Klaus
authors.initials: K
authors.lastname: Puschel
authors.affiliation: Department of Family and Community Medicine, School of Medicine, Pontificia Universidad Católica de Chile and.
authors.forename: Paulina
authors.initials: P
authors.lastname: Rojas
authors.affiliation: Division of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Erazo
authors.affiliation: Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.affiliation: Department of Family and Community Medicine, School of Medicine, Pontificia Universidad Católica de Chile and.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopez
authors.affiliation: Department of Family and Community Medicine, School of Medicine, Pontificia Universidad Católica de Chile and.
authors.forename: Jorge
authors.initials: J
authors.lastname: Barros
mesh_terms: D004503:Education, Medical, Graduate / Q000941:ethics; D004992:Ethics, Medical; D058006:General Practice / Q000193:education; D054625:Healthcare Disparities; D006801:Humans; D007843:Latin America; D011320:Primary Health Care; D012577:Schools, Medical / Q000941:ethics*; D012941:Social Responsibility
keywords: Academic medicine; graduate medical education; health disparities; medical ethics; primary care; sociology.