Training Internal Medicine Residents in Social Medicine and Research-Based Health Advocacy: A Novel, In-Depth Curriculum.
Health disparities are pervasive worldwide. Physicians have a unique vantage point from which they can observe the ways social, economic, and political factors impact health outcomes and can be effective advocates for enhanced health outcomes and health equity. However, social medicine and health advocacy curricula are uncommon in postgraduate medical education.



In academic year (AY) 2012, the Cambridge Health Alliance internal medicine residency program transformed an elective into a required social medicine and research-based health advocacy curriculum. The course has three major innovations: it has a yearlong longitudinal curriculum, it is required for all residents, and all residents complete a group research-based health advocacy project within the curricular year. The authors describe the structure, content, and goals of this curriculum.



Over the last four years (AYs 2012-2015), residents (17/32; 53%) have rated the overall quality of the course highly (mean = 5.2, where 6 = outstanding; standard deviation = 0.64). In each year since the new course has been implemented, all scholarly work from the course has been presented at conferences by 31 resident presenters and/or coauthors. The course seems to enhance the residency program's capacity to recruit high-caliber residents and faculty members.



The authors are collecting qualitative and quantitative data on the impact of the course. They will use their findings to advocate for a national health advocacy competency framework. Recommendations about how to initiate or further develop social medicine and health advocacy curricula are offered.
G. Basu is instructor in medicine, Harvard Medical School, and course director, Social Medicine and Health Advocacy Curriculum, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. R.J. Pels is assistant professor of medicine, Harvard Medical School, and residency director, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. R.L. Stark is instructor in medicine, Harvard Medical School, and associate residency director, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. P. Jain is instructor in medicine, Harvard Medical School, and associate residency director, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. D.H. Bor is Charles S. Davidson Associate Professor of Medicine, Harvard Medical School, and chief academic officer, Cambridge Health Alliance, Cambridge, Massachusetts. D. McCormick is associate professor of medicine, Harvard Medical School, and course director, Social Medicine and Health Advocacy Curriculum, Internal Medicine Residency Program, Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts.
Gaurab
G
Basu
Richard J
RJ
Pels
Rachel L
RL
Stark
Priyank
P
Jain
David H
DH
Bor
Danny
D
McCormick
D003254:Consumer Advocacy; D003479:Curriculum; D006302:Health Services Research; D054624:Health Status Disparities; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007857:Leadership; D012922:Social Change; D064890:Social Determinants of Health; D012936:Social Medicine / Q000193:education*