What makes a medical school socially accountable in Latin America? A report from a Latin American panel based on a qualitative approach

Abstract

Background: Latin America is a region with huge health inequalities and a tremendous growth in the number of medical schools during the last decades. The role of the medical schools in reducing health inequality has not been systematically explored.

Methods: A qualitative framework method was used to explore the meaning, barriers, and facilitators of the concept of the social accountability of medical schools in Latin America. Twenty nine Latin American academic leaders from seven countries participated in an expert panel discussion. The Atlas ti.7 software was used to analyze the information.

Results: Social accountability was identified as a core dimension of the mission of medical schools. The panel identified a gradient of three dimensions associated with social accountability. First, a formative dimension related to student selection, curricular structure and community based learning initiatives. Second, a societal dimension associated with institutional mission, community partnerships, and social research projects. Third, a political dimension related with involvement in health policies and primary care engagement. Lack of accreditation standards was identified as a main barrier to improve social accountability.

Conclusions: Latin American leaders consider that medical schools should develop specific formative, societal, and political initiatives in order to be socially accountable.

Acknowledgments

The authors would like to acknowledge Maximiliano José Díaz Gutiérrez, Hernán José García Fernández, Carolina Ximena López Sotomayor, María Paz Martínez Rubio, Estrella Muñoz Venegas and Ignacio Téllez Guzmán for their support on specific aspects of the research process as well as to all focus group participants.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

No conflicts of interest to report. It just need to be stated that authors are part of the School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile.

Glossary

Social accountability

(See MedEdWorld www.mededworld.org)

Notes on contributors

Klaus Püschel is the Director of the School of Medicine, Pontificia Universidad Católica de Chile (PUC). MD, Specialist in Family Medicine, Master in Public Health/Preventive Medicine, Master in Bioethics. He was the head of the Family Medicine Department for about 6 years and is Full Professor at PUC.

Arnoldo Riquelme, MD, is a Specialist in Internal Medicine and Gastroenterology. He holds a Master in Medical Education (University of Dundee, Scotland). He is a clinician and an academic working at the Department of Gastroenterology and the Centre for Medical Education, School of Medicine, Pontificia Universidad Católica de Chile. He is currently the Director of the Health Sciences Academic Unit (Unidad Docente Asociada de Ciencias de la Salud), Faculty of Medicine, at the same university.

Philippa Moore, MD, academic at the Department of Family Medicine, Pontificia Universidad Católica de Chile. She is a Family Physician with studies in UK and Chile. One of her areas of interest is doctor–patient communication. She is part of the Unit of Communication and Relationship in Health Care at PUC.

Viviana Rojas, is a Psychologist with broad experience in qualitative research. She has been involved in various health related projects.

Andrés Perry, is a MD student at the School of Medicine, Pontificia Universidad Católica de Chile. He is very interested in social aspects of Medical Schools.

Jaime C. Sapag, Associate Professor, Division of Public Health and Family Medicine, Pontificia Universidad Católica de Chile. MD, Family Physician, MPH, PhD. He has been trained in Chile, USA, and Canada. Mental Health in Primary Care is one of his areas of interest. He has strong experience in Global Health.

Additional information

Funding

This work was supported by School of Medicine, Pontificia Universidad Católica de Chile.