Social Medicine and Global Health: Essential Components of Undergraduate Medical Education

As doctors work to achieve optimal health outcomes for their patients, they struggle with issues that arise outside the clinic. Social, economic, and political contexts influence both the burden of disease and treatment access and outcome. This challenge has motivated recent calls for increased attention to the social history and social determinants of health. In parallel, there have been calls for increased attention to global health. As greater numbers of US medical students participate in global health experiences each year, their training in global health is marked by the heterogeneity of the field. The field of social medicine, with its attention to the social determinants of disease, social meanings of disease, and social responses to disease, offers a solution to both challenges. Social medicine’s analyses and techniques provide an invaluable toolkit for health care in the US and abroad. They provide intellectual coherence to global health, a field often described more as a collection of problems than a particular discipline or science. In 2007, Harvard Medical School implemented a new course, required of all first year medical students, that teaches social medicine in a way that integrates global health. We will summarize nine years of experience with this course, including our approaches to the problem, resistance we encountered from students, and our responses to that resistance. Informed by preliminary results from a student survey, it describes an integrated approach to teaching social medicine and global health that can be used at other medical schools in North America and globally.