Improving the social responsiveness of medical schools: lessons from the Canadian experience

The recent Canadian experience in promoting social accountability and social responsiveness of medical schools has been one of steady improvement in certain institutions, against a background lacking overall national policy direction. Canada has several distinct advantages in trying to devise means of enhancing social accountability of medical training and health services, including a strong national system of publicly supported and financed health care of high quality, a network of excellent academic medical centers, and well-established accreditation bodies. A review of the literature, complemented by a new survey of Canadian medical schools, confirms that some of the centers, conscious of the need to promote social responsiveness, are developing innovative programs to do so. Future progress toward the goal of social responsiveness of medical schools on a pan-Canadian basis will require a more cohesive approach involving systematic sharing of best practices among academic health centers, effective alliances with other health professionals to promote these objectives, and support by federal and provincial ministries of health. Canadian awareness of an international movement tending to similar objectives would support the efforts of Canadian health professionals engaged in practices of enhanced accountability.