Learning social medicine in the Bronx: An orientation for primary care residents

Background: Primary care educators face the challenge of teaching the social context of health and disease to clinicians. Description: Since 1975, the Residency Program in Social Medicine has trained clinicians to practice in urban underserved communities. During Orientation Month, 1st-year residents are relieved of inpatient duties and participate in learning activities addressing social and cultural aspects of health. Learning objectives include understanding patients' social context, their community, and the role of physicians as professionals. Recent innovations include incorporating an overall theme, weekly case studies, "triple jump" exercises, community mapping projects, patient-led community tours, and theme-specific visits to community institutions (e.g., prisons). Evaluation: Residents complete weekly formative evaluations, a summative evaluation, and narrative reflections. Faculty complete an evaluative questionnaire. Conclusions: Orientation is a highly rated and valued part of our curriculum. Its success derives from ongoing curricular innovation and evolution, a departmental commitment to social medicine, and positive community response to our learners' interest and energy.