Three social medicine courses are part of the core medical school curriculum of the first and second years: Medicine and Society, Seminars in the Humanities and Social Science, and Clinical Epidemiology.
Medicine and Society runs the length of the first year, covering a wide spectrum of social medicine topics using materials that range from family case studies to policy analyses to poems and short stories. This introductory course covers three broad areas: (1) the social and cultural environment as it affects health and disease, the roles of physicians and the experiences of patients; (2) the historical, educational and ethical forces that shape the professional lives of physicians; and (3) the social, political and economic forces that influence the organization and delivery of health services. One aspect of this course involves an imaginative role-playing Health Care Reform Exercise designed to introduce students to the issues and interest groups involved in health care reform.
The textbook for Medicine and Society is The Social Medicine Reader, a collection edited by five of the faculty of the Department and recently published (1997) by Duke University Press. Designed to reflect the format of the course, it is organized into five sections: A Cultural Perspective of Experiences of Illness, Disability, and Deviance; The Influence of Social Factors on Health and Illness; The Culture of Medicine and Medical Practice; Health Care Ethics and the Provider's Role; and Medical Care Financing, Rationing, and Managed Care. The Reader includes fiction, medical reports, scholarly essays, poetry, case studies, and personal narratives by patients and doctors-all revealing in one way or another how medicine and medical practice is influenced by social, cultural, political, and economic forces.
Seminars in the Humanities and Social Sciences offers second year medical students the opportunity to do additional study in one of the topics or disciplines introduced in the first year course. The thirteen semester-long seminar offerings are given either in the spring or fall of the second year of medical school. Each has twelve or thirteen students and meets for eleven two-hour sessions. The seminars vary widely in subject matter; some are essentially humanities courses while others deal with a central problem, topic or discipline in the social sciences as it applies to the medical field.
Clinical Epidemiology is also a required course in the second year. The fundamental goal of the course is to introduce students to the skills of epidemiology that are applicable to the care of individual patients and their communities. Students learn how to use rational principles to select diagnostic and screening tests, and how to interpret their results. In addition, students learn to use the skills of critical appraisal and evidence based medicine to evaluate the importance, validity, and applicability to individual patients of clinical research articles. The course emphasizes both analysis of individual studies and synthesis across multiple studies. Although most of the course is devoted to quantitative research, qualitative designs are examined as well.
The course is taught in small groups with faculty from a wide range of Departments within the medical school, including Emergency Medicine, Family Medicine, Internal Medicine, Pediatrics, Psychiatry, Radiology, and Social Medicine.