A Two-Year Experience of Community-Based Medical Education in the Department of Social Medicine at Shahid Sadoughi University of Medical Sciences

Abstract

Dear editor

Medical education, if it is to effectively address the health needs of society, requires a stronger integration of classroom-based learning with the real-life environments in which individuals and communities live. Although the concept of the social determinants of health is incorporated into medical curricula, developing students’ capacity to understand and address these determinants requires experiential learning through field-based education and direct engagement with diverse social contexts. In this educational experience, medical interns in the Department of Social Medicine at Shahid Sadoughi University of Medical Sciences, Yazd, participate in a field visit to neighborhoods implementing the Health-Promoting Neighborhoods (HPN) program. Prior coordination is made with the university’s Deputy of Health, following which the interns attend a Neighborhood Health Promotion Council meeting. The council consists of representatives from the local community and members of the healthcare team who serve as members of the Neighborhood Health Promotion Council. During the visit, the interns observe and review the neighborhood profile, which provides an overview of the neighborhood’s demographic, social, health, and other relevant characteristics. During the session, the medical interns are introduced to the five leading causes of death in the region, as well as the major factors contributing to the occurrence and spread of common diseases and social health problems. The human resources, infrastructure, equipment, and other capacities of the neighborhood are also presented to the interns. The interns review the neighborhood’s priority health problems, the process used to identify and prioritize these problems, and the operational plans developed to address each of them. Subsequently, a field visit to the neighborhood is conducted to familiarize the interns with the interventions implemented to address the identified problems. During this visit, the interns directly observe the measures undertaken by community members and the local healthcare team. This field experience was designed to broaden medical students’ understanding from the individual patient–clinic perspective to a community-oriented perspective. It aimed to familiarize students with the social and environmental determinants of health, highlight the importance of community outreach and communication, and demonstrate the role of community engagement in gaining public support for the implementation of health promotion programs. Ultimately, the experience sought to empower medical students to respond effectively to the real health needs of the community, in line with the principles of community-oriented and socially responsive medical education.