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Integrating Social Determinants of Health Into Graduate Medical Education: A Call for Action

Siegel Jennifer MD; Coleman, David L. MD; James, Thea MD
doi: 10.1097/ACM.0000000000002054
Invited Commentary: PDF Only

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. While 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.

To read other New Conversations pieces and to contribute, browse the New Conversations collection on the journal’s Web site ( follow the discussion on AM Rounds ( and Twitter (@AcadMedJournal using #AcMedConversations), and submit manuscripts using the article type “New Conversations” (see Dr. Sklar’s announcement of the current topic in the November 2017 issue for submission instructions and for more information about this feature)

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Editor’s note: This New Conversations contribution is part of the journal’s ongoing conversation on social justice, health disparities, and meeting the needs of our most vulnerable and underserved populations.

Correspondence should be addressed to Jennifer Siegel, Department of Medicine, Boston University School of Medicine, 72 East Concord St., Evans 124, Boston, MA 02118; telephone: (617) 638-6506; e-mail:

© 2018 by the Association of American Medical Colleges