Acute, chronic, and terminal illnesses all have powerful social, cultural, behavioral, economic, and relational dimensions. Persons do not get sick or well alone, and doctors do not practice medicine in a void. The College of Physicians and Surgeons (P&S) of Columbia University is determined to improve its teaching of evidence-based knowledge and methods from the social and behavioral sciences that illuminate the human experiences of health and illness and equip future doctors to influence health-related behaviors of patients and colleagues. It must become evident to all P&S graduates that a physician cannot practice effective medicine without a nuanced and muscular understanding of health beliefs, cultures of illness, mind-body connections, social structures of health care, clinical relationships, and self-awareness. This project adopts three strategies to reach these goals: 1) intensive faculty development to improve clinician-educators'ability to convey content material and practical skills in social and behavioral medicine to students;2) inclusion of social scientists and behavioral scientists among those who teach these aspects of health care to students and faculty;3) enhanced visibility of social and behavioral scientists at the medical center as researchers, teachers, and mentors/role-models for medical students contemplating careers in these fields. The existing Clinical Practice course at P&S will, with support, be bolstered with human and financial resources to integrate currently fragmented curricular material, to extend required curriculum into third and fourth years of medical school, and to draw upon the extensive social and behavioral science resources of Columbia University currently not used at all in medical student teaching. The envisioned teaching will improve medical students'ability to bring about behavioral change in their patients, their capacity to form authentic and ethical relationships with patients and colleagues, their competence to practice medicine reflectively, and their commitment to their own health. This project will galvanize the medical center to recognize and face the complex weave of human motivations, desires, and habits that constitute health and illness behavior. By encouraging healthy behaviors in their patients and reflective practice among themselves, P&S physicians will improve the health of the public and the vitality of the profession.
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