Social and Health Systems 1 and 2 (SHS 1/2) are taught in weekly seminars throughout the first two semesters of medical school. This introductory course covers three broad areas: (1) social, cultural, and historical forces that shape health and disease, experiences of patients, roles of physicians, and technologies of care; (2) ethical dimensions of medical professional work and major issues in bioethics; and (3) health care reform and the organization and delivery of medical services. Overall, the course teaches students to think critically about social contexts and conditions of health care and medical work.

Because the range of course topics summons expertise from a range of disciplines across humanities and social sciences, as well as from clinical medicine and public health, it is taught by a multidisciplinary faculty. It uses a broad range of reading materials—ranging from family case studies to policy analyses to poems and short stories—addressing how illness, medicine and medical practice are influenced by social, cultural, political, and economic forces. The 2-volume textbook for SHS 1/2 is The Social Medicine Reader, 3rd edition, Volume I, Ethics and Cultures of Biomedicine, and Volume II, Differences and Inequalities, edited by current and former faculty members of the Department and published by Duke University Press. Selections from the Reader are supplemented each week by other, current selections from scholarly, journalistic, and literary writing.

Students write several papers during the year and hone verbal presentation skills around controversial topics. One culminating element of this course is a health care reform exercise that introduces students (through stakeholder role-playing in a Senate committee debate) to issues and interests involved in US health care politics.

Sue Estroff is lead Course Director for Social and Health Systems 1/2. Jon Oberlander is SHS 1/2 Co-Course Director.