From the Patient’s Point of View: An Anthropological Response to Medicine’s Social Responsibility in Canadian Medical Education

In Canada, where both health care and medical education are publicly funded, medical curricula reflect educators’ social responsibilities to their communities and patients. During curriculum renewal in the 1990s and 2000s, MD programs responded to these social obligations by developing and implementing Problem-Based Learning (PBL) and Evidence-Based Medicine (EBM). At the University of British Columbia, this wave of curriculum change was an opportunity to include anthropological perspectives and ethnographic methodologies in the MD program in a set of two new required, multi-disciplinary courses in Doctor, Patient, and Society. These courses brought together medical anthropology, epidemiology, community health, and medical ethics. Anthropology, community medicine, and medical ethics, in combination with PBL provided a more community and patient-centered orientation to complement epidemiology and EBM. By enabling students to conduct anthropological, ethnographic research in communities, and interview patients in their homes, students confronted the tension between epidemiological evidence and individual patient experiences. This ethnographically-based, patient and person-oriented approach helps prepare students for clinical interactions with patients who are also community members. It also equips them to meet the growing demands for personalized chronic care, and prepares them for emerging clinical fields including targeted cancer therapies and genomic medicine.