Beyond Flexner: A novel framework to implement the social mission of medical education

Abstract

Purpose: Medical schools are uniquely positioned to contribute to the changing healthcare climate by increasing diversity in the healthcare workforce and addressing social determinants of health. The purpose of this study was to develop a framework for promoting social mission in medical education and develop case studies of medical schools that exemplify social mission. Materials and Methods: The research team and Advisory Committee first used an iterative process to identify eight core modalities as essential elements in the social mission of medical education. Each modality was supported by a literature review. Six schools were selected for their commitment to enhancing health equity. Interviews and focus groups were then conducted with school leadership, key faculty, students, and residents to learn about the social mission activities of the school and to evaluate the school’s commitment to the eight core modalities. Results: All schools selected for case studies integrated and actively engaged with all eight modalities: school mission, cultivation of the pipeline, student admissions, curricular structure and content, location of clinical experience, tuition management, mentorship, and postgraduate engagement. Each modality was utilized to advance the school’s social mission, demonstrating these modalities as a useful framework for promoting the social mission of medical education. Conclusion: The social mission modalities were developed to provide a tool for institutions to discuss, promote, or measure their social mission. This is ever-more important in the current healthcare climate and should be incorporated not only in medical education but also in all health professions education to build a culture of health.