BOX 7-1

LCME Undergraduate Medical Education Accreditation Standards That Address Psychosocial Health Services

  • ED-7. It [the curriculum] must include current concepts in the basic and clinical sciences, including therapy and technology, changes in the understanding of disease, and the effect of social needs and demands on care.

  • ED-10. The curriculum must include behavioral and socioeconomic subjects, in addition to basic science and clinical disciplines.

  • ED-13. Clinical instruction must cover all organ systems, and include the important aspects of preventive, acute, chronic, continuing, rehabilitative, and end-of-life care.

  • ED-19. There must be specific instruction in communication skills as they relate to physician responsibilities, including communication with patients, families, colleagues, and other health professionals [emphasis added].

SOURCE: LCME, 2006a.

dards intentionally are broad in scope to afford schools flexibility in the way they meet them.4

Each medical school defines its own curricular objectives (LCME, 2006a). In 1996, however, AAMC initiated the Medical School Objectives Project (MSOP) (AAMC, 1998) “to reach general consensus within the medical education community on the skills, attitudes, and knowledge that graduating medical students should possess” (AAMC, undated). The MSOP guidelines state, in part, that graduates must demonstrate “knowledge of the important non-biological determinants of poor health and of the economic, psychological, social, and cultural factors” that contribute to the development or continuation of ill health (AAMC, 1998:8). Yet neither the LCME standards nor the MSOP guidelines specify explicitly how to teach these subjects, how many hours should be devoted to their study, or what topics related to psychosocial health services should be covered. The extent to which the MSOP guidelines are being fulfilled is unclear.

A national survey of U.S. medical schools5 conducted between 1997 and 1999 found that the concepts and measurement of such psychosocial factors as stress and social support were taught by 80 to 93 percent of schools (most often in required courses), but that psychosocial topics represented on average 14 percent of curricula (range from 1 to 60 percent), and


Personal communication, Robert Eaglen, PhD, LCME/AAMC, October 10, 2006.


46 percent response rate.

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