Why and How Civic Health Should Be Incorporated Into Medical Education

Abstract

Civic health refers to the ability of a community to organize and collectively address problems that affect the well-being of its members through democratic participation. Civic health should be an integral part of the medical school curriculum because improving a community's civic health shifts the distribution of power toward patients, better enabling them to address social determinants of health that are affecting their well-being. This article details how to effectively integrate civic health curriculum into already-existing medical education frameworks, outlines how these interventions will improve both patient care and the student experience, and addresses barriers that might restrict the implementation. Civic health can be integrated into the didactic curriculum in the form of lunchtime guest lectures, panels with community organizations, and small-group discussions; it can be integrated into experiential curriculum by distributing QR codes to aid in voter registration, organizing voter registration drives, and participating in nonpartisan canvassing. This civic health content can be integrated into existing social justice curricula without massive investment or structural change. Medical students are capable and effective messengers of civic health and can affect change at all levels of training. Notably, because civic health is directly actionable, it can be a source of motivation rather than burnout for medical students. As students develop into medical professionals, the training in civic health improves their understanding of social determinants of health and enables them to play an important role in promoting civic engagement and empowering patients with the democratic tools necessary to enact social change.

Reported Political Participation by Physicians vs Nonphysicians

“…Additionally, physicians are often members of professional societies that engage in advocacy and lobbying, but these are likely not reported by physicians as their own activity. Physicians could play a greater role in influencing health-related public policy given their expertise and socioeconomic opportunities . Why physicians are not more involved politically should be further investigated.…”

“…Physicians could play a greater role in influencing health-related public policy given their expertise and socioeconomic opportunities. 6 Why physicians are not more involved politically should be further investigated.…”

Metacommentary: Identifying and Mastering ‘Dear Reader’ Moments

“…Perhaps most important is metacommentary related to the fundamental premises of a paper, because if the reader resists you in these moments, the rest of the piece may not matter. Barrere-Cain et al [7] recognize this in a recent argument to include civic health advocacy in medical school curricula: While some argue that civic health advocacy is outside the purview of the medical profession, 14 these efforts are not dissimilar to other physician activist movements such as White Coats for Black Lives and American Foundation for Firearm Injury Reduction in Medicine (AFFIRM) that have gained popular support. The worry that readers might disagree with their call for curricular reform is acknowledged explicitly and handled persuasively by aligning the cause of civic health advocacy with other popular movements.…”