In response to growing recognition of the role played by behavioral and social factors in health and disease, the National Institutes of Health and The Robert Wood Johnson Foundation asked the Institute of Medicine to conduct a study of medical school education in the behavioral and social sciences. The study included a review of the approaches used by medical schools to incorporate the behavioral and social sciences into their curricula, development of a prioritized list of behavioral and social science topics for future inclusion in those curricula, and an examination of ways in which barriers to the incorporation of behavioral and social science topics can be overcome.

The committee finds that existing databases provide inadequate information on behavioral and social science curriculum content, teaching techniques, and assessment methodologies in U.S. medical schools and recommends development of a new national behavioral and social science database. It also recommends that medical students be provided with an integrated behavioral and social science curriculum that extends throughout the 4 years of medical school. The committee identifies 26 topics in six behavioral and social science domains that it believes should be included in medical school curricula. The six domains are mind-body interactions in health and disease, patient behavior, physician role and behavior, physician-patient interactions, social and cultural issues in health care, and health policy and economics.

To help overcome multiple barriers to the incorporation of the behavioral and social sciences into medical school curricula, the committee recommends that the National Institutes of Health or private foundations establish behavioral and social sciences career development and curriculum development awards. Moreover, concerned that the U.S. Medical Licensing Examination currently places insufficient emphasis on test items related to the behavioral and social sciences, the committee recommends that the National Board of Medical Examiners ensure that the exam adequately covers the behavioral and social science subject matter recommended in this report.

Contents

• The National Academies
• Committee on Behavioral and Social Sciences in Medical School Curricula
• Independent Report Reviewers
• Preface
• Acknowledgments
• Executive Summary
  • ROLE OF BEHAVIORAL AND SOCIAL FACTORS IN HEALTH AND DISEASE
  • WHY PHYSICIANS NEED EDUCATION AND TRAINING IN THE BEHAVIORAL AND SOCIAL SCIENCES
  • STATEMENT OF TASK
  • CURRENT STATE OF THE BEHAVIORAL AND SOCIAL SCIENCES IN CURRICULA OF U.S. MEDICAL SCHOOLS
  • CONCLUSIONS AND RECOMMENDATIONS
• 1. Introduction
  • ROLE OF BEHAVIORAL AND SOCIAL FACTORS IN HEALTH AND DISEASE
  • PURPOSE OF THE STUDY
  • STUDY ORIGIN AND TASKS AND ORGANIZATION OF THE REPORT
• 2. Current Approaches to Incorporating the Behavioral and Social Sciences into Medical School Curricula
  • THE BEHAVIORAL AND SOCIAL SCIENCES IN CURRENT MEDICAL SCHOOL CURRICULA
  • BARRIERS TO SYSTEMATIC ANALYSIS OF THE BEHAVIORAL AND SOCIAL SCIENCES IN MEDICAL SCHOOL CURRICULA
  • INVENTORY OF CURRENT BEHAVIORAL AND SOCIAL SCIENCE CONTENT IN MEDICAL SCHOOL CURRICULA
  • NEED FOR AN IMPROVED DATABASE ON THE STATUS OF BEHAVIORAL AND SOCIAL SCIENCE INSTRUCTION IN U.S. MEDICAL SCHOOLS
• 3. The Behavioral and Social Sciences in Medical School Curricula
  • MIND–BODY INTERACTIONS IN HEALTH AND DISEASE
  • PATIENT BEHAVIOR
  • PHYSICIAN ROLE AND BEHAVIOR
  • PHYSICIAN–PATIENT INTERACTIONS
  • SOCIAL AND CULTURAL ISSUES IN HEALTH CARE
  • HEALTH POLICY AND ECONOMICS
• 4. Strategies for Incorporating the Behavioral and Social Sciences into Medical School Curricula
  • BARRIERS TO INCORPORATING THE BEHAVIORAL AND SOCIAL SCIENCES INTO MEDICAL SCHOOL CURRICULA
  • STRATEGIES FOR CURRICULUM CHANGE
• References
• Appendixes
  • A Methods
  • B Committee and Staff Biographies

This study was supported by Award No. N01-OD-4-2139, Task Order No. 112, and Grant No. 046078 between the National Academy of Sciences and the National Institutes of Health, Office of Behavioral and Social Science Research and The Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.