[Representation of Social Determinants of Health in German Medical Education]. / Soziale Determinanten von Gesundheit als Lehr- und Prüfungsinhalte im Medizinstudium.

ABSTRACT

OBJECTIVE: The World Health Organization (WHO) has emphasized the need for a health workforce trained in recognising, understanding and acting on the social determinants of health (SDH). However, little is known about how current medical education prepares graduates to meet this challenge. This study analyses the extent to which content on SDH is incorporated in the German medical curriculum. METHOD: This work is based on a qualitative and quantitative content analysis of 3 key document groups, outlining what medical schools are expected to teach and defining what medical students are expected to know on graduation. RESULTS: The assessment reveals important gaps in the representation of SDH in key frameworks for German medical education. Only between 4 and 27% of the analysed document-elements contained reference to any SDH-related issues, with 0-3% of those elements containing explicit references to SDH. While some aspects were widely covered (e. g. topics of occupational health), other topics such as health inequalities or determinants outside of the health care system were not or hardly represented. CONCLUSIONS: A stronger and more explicit representation of SDH during medical education could help to prepare the new health workforce for current and future challenges in our globalised world. The current reform process of the National Competency-Based Catalogue of Learning Objectives for Medicine should strive to fill the gaps, e. g. by putting more emphasis on aspects of poverty and health, health inequalities and issues of access to healthcare.