title: The necessity of social medicine in medical education.
abstract: Research and clinical experience reliably and repeatedly demonstrate that the determinants of health are most accurately conceptualized as biosocial phenomena, in which health and disease emerge through the interaction between biology and the social environment. Increased appreciation of biosocial approaches have already driven change in premedical education and focused attention on population health in current U.S. health care reform. Medical education, however, places primary emphasis on biomedicine and often fails to emphasize and educate students and trainees about the social forces that shape disease and illness patterns. The authors of this Commentary argue that medical education requires a comprehensive transformation to incorporate rigorous biosocial training to ensure that all future health professionals are equipped with the knowledge and skills necessary to practice social medicine. Three distinct models for accomplishing such transformation are presented: SocMed's monthlong, elective courses in Northern Uganda and Haiti; Harvard Medical School's semester-long, required social medicine course; and the Lebanese American University's curricular integration of social medicine throughout its entire four-year curriculum. Successful implementation of social medicine training requires the institutionalization of biosocial curricula; the utilization of innovative, engaging pedagogies; and the involvement of health professions students from broad demographic backgrounds and with all career interests. The achievement of such transformational and necessary change to medical education will prepare future health practitioners working in all settings to respond more proactively and comprehensively to the health needs of all populations.
authors.affiliation: M. Westerhaus is assistant professor, Department of Medicine, University of Minnesota, clinic chief, Center for International Health, and co-director, SocMed, Minneapolis, Minnesota. A. Finnegan is assistant professor, Department of Justice and Peace Studies, University of St. Thomas, St. Paul, Minnesota, and co-director, SocMed, Minneapolis, Minnesota. M. Haidar is assistant professor, School of Medicine, Social Medicine and Global Health Program, Lebanese American University, Byblos, Lebanon. A. Kleinman is professor of medical anthropology, Department of Global Health and Social Medicine, and professor of psychiatry, Harvard Medical School, Boston, Massachusetts. J. Mukherjee is associate professor, Division of Global Health Equity, Brigham and Women's Hospital, and medical director, Partners in Health, Boston, Massachusetts. P. Farmer is Kolokotrones University Professor, Harvard University, chair, Department of Global Health and Social Medicine, Harvard Medical School, and founding director, Partners in Health, Boston, Massachusetts.
authors.forename: Michael
authors.initials: M
authors.lastname: Westerhaus
authors.forename: Amy
authors.initials: A
authors.lastname: Finnegan
authors.forename: Mona
authors.initials: M
authors.lastname: Haidar
authors.forename: Arthur
authors.initials: A
authors.lastname: Kleinman
authors.forename: Joia
authors.initials: J
authors.lastname: Mukherjee
authors.forename: Paul
authors.initials: P
authors.lastname: Farmer
mesh_terms: D004501:Education, Medical / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D012577:Schools, Medical; D012936:Social Medicine / Q000458:organization & administration*; D013337:Students, Medical / Q000706:statistics & numerical data*