Social determinants: Why are they so difficult to address?

“He who knows only his own side of the case knows little of that.”
John Stuart Mill, On Liberty. 1869

By Greg Gruener

At a lecture I recently attended with our students, the guest speaker’s topic was on health disparities and the data presented was, as most of us in the healthcare field know, pretty conclusive.  I have to admit that I knew and had seen this same information in prior lectures, articles, and had gone over it in small group discussions.  I also knew that health disparities existed because of various social determinants.  While the subsequent discussion moved along, I was left at the reflective starting line since I finally grasped the fact that being caused by social determinants, health disparities could only be completely addressed by changing those same determinants.  This is not news for most people in healthcare as their organizations and schools, unlike business, law, etc., have been charged (and are accredited) with addressing those determinants.  So, despite being immersed in the data, why had it taken me so long to have this aha moment?  Here is my explanation for a cognitive lapse, as informed by Donald Rumsfeld…

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Promoting Social Justice in Medical Education

A profile of Dean Linda Brubaker, MD, MS, Dean and Chief Diversity Officer, Loyola University Chicago Stritch School of Medicine

Professor Linda Brubaker brings an enthusiasm for medical education, social justice, and her medical specialty fields of female pelvic medicine and reconstructive surgery (urogynecology) to her several roles at Loyola’s Stritch School of Medicine (SSOM). As a medical scholar, researcher, educator, journal editor, and clinician who sees patients every week, author of nearly 300 journal articles and book chapters, and principal investigator on five federally-funded research grants, she is uniquely suited to leading a medical school in the application of Jesuit educational values…

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A Cut Above- A reduction in the number of cadavers and instructors actually improves the teaching of medical gross anatomy

By Michael Dauzvardis

Time: midnight
September, 2011
Place: gross anatomy lab
Music playing softly in the background: Your Body is a Wonderland, by John Mayer

“I’ve been at it for 4 hours and still can’t find the greater occipital nerve!” barks Joe, a first year medical student meticulously dissecting the posterior neck region on his cadaver— which he has nick-named Marvin.

Emily, one of Joe’s four dissection partners, quips “Perhaps that’s what killed Marvin—the congenital lack of a left greater occipital nerve!” 

“Hilarious, “Joe retorts “Remind me to laugh.”

At that instant, Joe, in a moment of frustration, slips and forcibly plunges his scalpel into the neck musculature– striking bone.

Emily cautiously points, smiles, and adds “Oh—I didn’t know the greater occipital nerve was hollow.”

Joe, with his overzealous dissection technique, had managed to cut through both the greater occipital nerve and occipital artery.

“You’ll make a fine psychiatrist” taunts Emily.

Joe sets down his scalpel, rips off his gloves, and sulks out of the lab…

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Presence and Vulnerability in Medical Education

By Sunny Nakae

In my MSW program I took a diversity and social justice course.  The class was very engaged and often intense; we became well acquainted as we shared our stories.  Mid-way through the semester the instructor assigned us to read an article from our local newspaper about living with HIV.  The article, unbeknownst to the instructor, happened to feature an individual in our class.  Everyone was acutely aware as we shuffled into the classroom that day. We did not know what to expect…Read More »

Instructions for Authors

Content: Reflective MedEd welcomes submissions from educators and students in medical schools and related health professions.  We also welcome contributions from the perspective of patients, and scholars in the humanities, social sciences, and public policy.  In short, we seek entries from anyone whose insights regarding educational method and content or the social and interpersonal context of medicine can assist in developing future physicians who respect their patients in the fullness of their humanity and can be leaders for social justice in medicine and society.  Thus, we welcome a wide variety of types of narratives and ask that they be written in a clear, direct, conversational style…Read More »

Welcome to the Ralph P. Leischner, Jr., MD, Department of Medical Education

The department brings together Loyola Stritch’s efforts regarding “teaching to teach and learning to learn.” We are part of the new era in academic medicine that gives the same priority to our educational mission as our research and service missions. We aim to turn out a diverse physician workforce who treat patients according to the highest standards of care, are community leaders who promote social justice in health care and society, and who have the research, advocacy, and quality improvement skills to be effective change agents. It is the mark of a Stritch alumnus to reflect upon his or her ongoing personal and professional development as her vocation unfolds.  Such a physician is usually not formed by accident but benefits from a supportive community of mission-driven educators who constantly strive to improve their abilities to serve such medical students.  The department contributes to the building of this community…Read More »