Health Equity in Graduate Medical Education: Exploring Internal Medicine Residents' Perspectives on a Social Determinants of Health Curriculum

Background. There is a clear mandate for resident training in social determinants of health (SDOH) and health equity stemming from patients' needs and program accreditation requirements. Objective. To explore residents' perspectives on the impact of an SDOH curriculum. Methods. In 2017, we developed an SDOH curriculum for 38 PGY-2 Internal medicine residents at our institution. Half of the residents completed semi-structured interviews and online reflections. We conducted a thematic analysis of the transcripts to identify common themes in their perspectives on the curriculum and its impact. Results. Residents valued the curriculum and were motivated to change their practice. Participants cited lack of time and resources as important barriers limiting advocacy to the patient level. Conclusions. Graduate medical education training in SDOH is critical. By addressing the learner-defined barriers to advocacy and incorporating curricular elements learners have identified, residency programs can structure their SDOH curriculum to optimize the impact for patients and trainees.