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PubMed1994

Social science education as a component of medical training.

The broad view of health espoused by the World Health Organization is now generally accepted by medical educators. Implicit in the new paradigm is a recognition of multiple determinants of health and of shifting divisions of professional responsibilities among providers. As a consequence, the importance of social and behavioural science education as a foundation to medical training is increasingly appreciated. At the same time medical programmes are under pressure to contend with the explosion of knowledge in basic biomedical and life sciences and with technological innovation. Curricula are being submerged in facts, causing medical schools to look for innovative teaching models that feature more flexible approaches to the diverse body of knowledge supporting professional practice. Independent learning methods are being explored and revised teaching programs are being organized around coordinating themes, such as aging, human development and environmental health. Future programmes must be designed to encourage multiprofessional approaches while fostering awareness of the important interplay between health care (both curative and preventive) and social/behavioural science. Within the curriculum students should be offered options that include sociology, child growth and development, gerontology, medical anthropology, psychology, medical geography, health economics, political science and related subthemes. More important than the inclusion of any specific discipline is the creation of an environment in which future physicians may be exposed to critical thinking across a wide range of themes that characterize the social and cultural context for medical practice. Such enquiry is also likely to drive a closer relationship between medical schools and their parent universities within which the social science expertize resides.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗
PubMed2004

Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry.

It has been consistently reported that the African-Caribbean population in the UK are more likely than their White counterparts to access psychiatric services via the police and under compulsion. The reasons for these differences are poorly understood. This paper comprises two main parts. The first provides a comprehensive review of research in this area, arguing the current lack of understanding stems from a number of methodological limitations that characterise the research to date. The issue of ethnic variations in pathways to psychiatric care has been studied almost exclusively within a medical epidemiological framework, and the potential insights offered by sociological and anthropological research in the fields of illness behaviour and health service use have been ignored. This has important implications as the failure of research to move beyond enumerating differences in sources of referral to psychiatric services and rates of compulsory admission means no recommendations for policy or service reform have been developed from the research. The second part of the paper sets out the foundations for future research, arguing that the pathway to care has to be studied as a social process subject to a wide range of influences, including the cultural context within which illness is experienced. It is further argued that Kleinman's (Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine and psychiatry, University of California Press, Los Angeles, 1980) Health Care System model offers a particularly valuable preliminary framework for organising and interpreting future research. It is only through gaining a more qualitative understanding of the processes at work in shaping different responses to mental illness and interactions with mental health services that the patterns observed in quantitative studies can be fully understood. This further reflects the need for a bridge between the social sciences and psychiatry if services are to be developed to respond to the increasing diversity of modern societies.

Black People↗