The preparation of a syllabus in social medicine: McKeown revisited

Daniel Goldberg


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.


teaching, education, medical students, fundamental causes, Virchow

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Editorial Offices:

Department of Family and Social Medicine
Albert Einstein College of Medicine/Montefiore Medical Center
Bronx, New York, 10461

Asociación Latinoamericana de Medicina Social (ALAMES)/Latin American Social Medicine Association:
ALAMES, Southern Cone Region, Cassinoni 1440 – 802, CP 11200 Montevideo, Uruguay.
ALAMES, Mexico Region, San Jerónimo 70 – 1, Col. La Otra Banda, CP 01090, México, D.F.