Shaking Off Our Lassitude: Creating a Global Health Service-Learning Program Founded in Social Medicine


  • Francis Xavier Coughlin Boston University School of Medicine


global health, social medicine, medical elective


This paper describes the creation and implementation of a global health service-learning elective. The elective was supported by Brown University and Rhode Island Hospital. It was designed for fourth year medical students and internal medicine residents during the winter of 2012, based in Santiago, Dominican Republic. The aim of the course was to create a structured global health elective with principles based in social medicine and social justice. Following a service-learning paradigm, one half of the course was a clinical experience, based in a large, urban teaching hospital, a primary care clinic, and a rural health promotion program. The other half of the course was a structured compilation of assigned readings, lectures, films, field visits, and reflection sessions that placed the clinical experiences into a national and international context. The course analyzed systemic causes of poverty as well as the role of structural violence in creating poor health. Finally, using Rudolf Virchow’s call for physicians to be the “natural attorneys of the poor” as a foundation, we explored the role of the physician-advocate in terms of social justice and solidarity with the poor.





Social Medicine in Practice