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Integrating Social Determinants of Health Into Graduate Medical Education: A Call for Action
Jennifer Siegel1, David L Coleman, Thea James
1J. Siegel is assistant professor of medicine, Boston University School of Medicine, and associate program director, Boston Medical Center Internal Medicine Residency Program, Boston, Massachusetts. D.L. Coleman is Wade Professor of Medicine and chair, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts. T. James is associate professor of emergency medicine, Boston University School of Medicine, and vice president of mission, Boston Medical Center, Boston, Massachusetts.
Abstract:
Social determinants of health (SDH) are the major drivers of health and disparate health outcomes across communities and populations. Given this, the authors assert that competency in recognizing and mitigating SDH should become a vital component of graduate medical education in all specialties. Although the most effective approaches to educating trainees about SDH are uncertain, in this Invited Commentary, the authors offer several key principles for implementing curricula focusing on SDH. These include universalization of the material, integration into clinical education, identification of space for trainee introspection, clarification of specific competencies in identification and mitigation of SDH, and creation of robust faculty development programming. The authors highlight several examples of curricular approaches to SDH, touching on orientation, experiential learning, community-based and service-learning opportunities, interprofessional activities, and the hidden curriculum. The authors argue that all clinical trainees must learn to recognize and mitigate SDH and that doing so will allow them to achieve meaning and mastery in medicine and to better meet society's pressing health needs.
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