which students are taught to consider the social context of their patients’ lives. They learn to consider the possibility that uncooperative patients may actually just be struggling to follow simple orders to eat healthier and exercise in low-income, low-resource neighborhoods. This type of social education equips students with the mentality and tools necessary to work with patients of underserved backgrounds.
determined by the sociocultural context in addition to genetics and biology, why are our pre-medical students not getting a proper education in psychology and sociology? The obvious goal of the new MCAT section is to address this very question. However, topics in sociology, particularly those like the social determinants of health take up less than half of one section in
Over the past few decades, the medical field has increasingly acknowledged the importance of these social determinants [of patient health] Many students enter medical school with some degree of knowledge about the social determinants of health, but few have studied it enough to understand their full implications in health disparities and even fewer have sufficient knowledge to begin considering solutions to health inequalities. In a poll of Pritzker medical students before their health disparities course, 56% rated their knowledge on the causes of health disparities in America as “poor/fair” and 31% rated their knowledge as “good,” while only 13% rated their knowledge as “very good/ excellent.” More strikingly, 74% rated their knowledge on potential solutions to health disparities in America as “poor/ fair,” and only a meager 5% rated their knowledge as “very good/excellent.” The goal of these medical school courses is to train their students to think about and implement solutions, whether in their current community or future practices, to ultimately mitigate health disparities. However, this is a difficult task when over half of entering medical students have little to no knowledge on the topic. Pre-medical students endure a rigorous science education, covering biochemistry, genetics, physiology, developmental biology – to just name a few subjects – yet there are no required courses on psychology and, more relevantly, sociology. If health is © 2016, The Triple Helix, Inc. All rights reserved.
the entire exam, maybe about one-tenth of all the questions, if not fewer. I don’t want it to seem as though I think there should be fewer psychology questions. Psychology is an equally important subject for physicians to understand, as it provides scientific theories to understand and predict human behavior. For example, presenting choices to a patient increases their sense of control over their life, which helps explain why the shared-decision making style, in which physicians involve patients in treatment decisions by presenting options and their advantages and disadvantages to ultimately reach a mutually agreed-upon treatment plan, is becoming increasingly popular. There is also a multitude of situations that would require an understanding of both psychological and sociological principles. For example, if a diabetic patient still does not exercise regularly despite doctor’s orders, the doctor may assume the patient is just lazy or uncooperative. On the other hand, the doctor may recognize the fundamental attribution error at play and ask about the patient’s social determinants, only to find that the patient is working two jobs or is being discouraged by family members. These encounters are realistic educational moments that the MCAT might have used to encourage pre-medical students to think critically THE TRIPLE HELIX Spring 2016