Physician, healthy system: the challenge of training doctor-citizens

The need for committed "doctor-citizens" engaged in health system improvement has led to a variety of medical curricular overhauls in North America and elsewhere. In a research paper published in this edition, we evaluated one such curriculum and found it to be modestly successful. But, what are the limits of residency curriculum in producing such doctors? Much of the culture of medical practice runs against the grain of our efforts. In this piece we reflect on broader lessons learned in the process of trying to teach health policy and advocacy to family medicine residents.