The preparation of a syllabus in social medicine: McKeown revisited

Abstract

This article revisits Thomas McKeown’s classic 1957 article regarding the difficulties involved in teaching, and preparing a syllabus in, social medicine. The present article assesses McKeown’s perspective for the teacher designing a syllabus in social medicine for contemporary medical learners in the U.S. The three principal goals that McKeown identifies for such a syllabus—coherence, realizable learning objectives, and accessible presentation— remain just as important and perhaps just as elusive today. The article surveys some of the difficulties involved in positioning social medicine themes and content within dominant conventions in U.S. medical curricula. The article focuses especially on difficulties posed by a wide and interdisciplinary evidence base, the perceived irrelevance of priorities and interventions important in virtually any informed concept of social medicine, and how these priorities and interventions can be presented within the framework expected by and familiar to medical learners in the U.S.