Societal Determinants

Social determinants of health, which are factors that affect people’s health that are outside their control, such as where they live, their race, and gender, cause disparities in health and life expectancy in the UK, especially in rural populations. Communities must be empowered to control their health, alongside clinicians being more generalist and holistic.

Background research

After conducting a detailed literature search into experiential learning and service-learning programs in medical education, virtual interviews were held with researchers worldwide to discuss how they created, implemented, and evaluated similar projects.

The curriculum was created using Health Education England’s (HEE) ‘Enhance’ handbook, the Internal Medicine Training (IMT) curriculum, and relevant literature. The teaching program was created with a Public Health specialist.

Health Education Midlands is pioneering the Leadership and Social Medicine program for Internal Medicine Trainees (IMT).

From August 2022 up to 6 IMTs will start the program in the Midlands. In IMT1 they will spend 1 of their 3 rotations in a community healthcare trust, focusing on community clinics and community hospitals, whilst developing their MDT skills. Alongside this they will have a teaching programme on relevant public health topics such as the social determinants of health, population health, and patient advocacy. They will spend a few days with different community organisations to determine who they want to undertake their research project with.

In IMT2 they will have block placements where they can undertake experiential learning with a community partner, working together to create and implement a Quality Improvement (QI) project. This will integrate doctors into communities, and help communities utilise assets to create sustainable changes. This longitudinal program will span over all 3 years of IMT.

This will be the first experiential learning program of this scale in UK Postgraduate medical education, with future expansion focusing specifically on rural communities. Afterwards, doctors in training will understand the social determinants of health, health policy creation, medical advocacy, leadership, and research including asset-based assessments and QI. Doctors in training will be more holistic and generalist, working with and empowering their local communities.