Academic Medicine: Structural Competency Special Issue

New Medicine for the U.S. Health Care System: Training Physicians for Structural Interventions.

Hansen HMetzl JM.
Acad Med. 2017 Mar;92(3):279-281. doi: 10.1097/ACM.0000000000001542.

Structural competency provides a language and theoretical framework to promote institutional-level interventions by clinical practitioners working with community organizations, non-health-sector institutions, and policy makers. The special collection of articles on structural competency in this issue of Academic Medicine addresses the need to move from theory to an appraisal of core educational interventions that operationalize the goals of and foster structural competency. In this Commentary, the authors review the role of clinical practitioners in enhancing population-level health outcomes through collaborations with professionals in fields outside medicine, including the social sciences and law. They describe the core elements of structural competency in preclinical and clinical education, as illustrated by the articles of this special collection: perceiving the structural causes of patients’ disease, envisioning structural interventions, and cultivating alliances with non-health-sector agencies that can implement structural interventions. Finally, the authors argue that preparing trainees to form partnerships will empower them to influence the social determinants of their patients’ health and reduce health inequalities.

Article references:
Integrating and Assessing Structural Competency in an Innovative Prehealth Curriculum at Vanderbilt University.
Metzl JM, Petty J.
Acad Med. 2017 Mar;92(3):354-359.

Queer Frontiers in Medicine: A Structural Competency Approach.
Donald CA, DasGupta S, Metzl JM, Eckstrand KL.
Acad Med. 2017 Mar;92(3):345-350.

The Political Future of Social Medicine: Reflections on Physicians as Activists
Geiger, H. Jack
Academic Medicine . 92(3):282-284, March 2017.

The Medical–Legal Partnership Approach to Teaching Social Determinants of Health and Structural Competency in Residency Programs
Paul, Edward G.; Curran, Mallory; Tobin Tyler, Elizabeth
Academic Medicine . 92(3):292-298, March 2017.

Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care
Bourgois, Philippe; Holmes, Seth M.; Sue, Kim; More
Academic Medicine . 92(3):299-307, March 2017.

Integrating Theory, Content, and Method to Foster Critical Consciousness in Medical Students: A Comprehensive Model for Cultural Competence Training
Dao, Diane K.; Goss, Adeline L.; Hoekzema, Andrew S.; More
Academic Medicine . 92(3):335-344, March 2017.