Changing the face of medicine: Why social accountability and Sustainable Development Goals are so important?

This article was exclusively written for The European Sting by Ms. Maria Eduarda Mesquita, a final year medical student in Brazil and currently specializing in Health Education. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

            In 1995, the World Health Organization published a document proposing that medical schools should be obliged to prioritize health concerns of the community they have a mandate to serve. They established that improving community health isn’t an act medical schools do out of good faith or charity, but an obligation. Twenty five years later, we are still far from reaching social accountable schools. An improvement can however be expected with the implementation of Sustainable Development Goals (SDGs). 

To appropriately undertake  this discussion, we have to clarify the concepts of Social Responsibility, Responsiveness and Accountability. Social Responsibility means to recognise and be aware of community problems. Social responsiveness further addresses how to respond to those problems, .. SA, however, goes far beyond both. It means to engage with the community, discuss and implement solutions , while placing  education at a spotlight. SA perceives education as a participative and transformative process, as Paulo Freire, a brazilian education patron, defines it..

            When thinking of doctors, we usually picture a  white rich cis heterosexual male, and this view could make it difficult for the community to think of that position as somehting achievable. Medicine has had a long history of privilege, and only a select  few have been able  to be admitted and pay for college. Even in countries that possess free public schools, accessibility remains a problem. The SDGs 1 and 4, no poverty and quality education, propose a different path.They ensure problems that would otherwise divert students to work, such as food insecurity, no longer pose such a barrier.. In addition, once basic education is secure, hhigher education will become much more accessible. .

            When we think about health care promotion, no one truly understands a population better than one of its own members, diversity is therefore a way to improve representation and healthcare quality. For that reason, supporting underrepresented genders, people of color and LGBTQI+ people in medical schools is essential, as well as increasing the presence of students from rural areas and of low socioeconomic status, as SDGs 5 and 10 propose.

            Simply recognizing the lack of minorities amongst medical doctors is not enough. There will be no change unless we take action about it. Institutional problems require institutional actions, and not only a statement of the medical schools about just  how much they support equity.

            Furthermore, we should evaluate our schools’ social accountability, to identify weaknesses and discuss how we can improve, with the SDGs being a valuable guide in that journey. The possibilities of actions to be implemented are endless, but some of the more pressing changes revolve around implementation of scholarships to people of low socioeconomic status, policies to provide  support for students to use their gender identities as they wish, as well as their chosen names. Afterwards we will need to create mechanisms to diminish dropout rates of students in vulnerable positions.Such actions will, not only benefit these populations, but will help improve the quality of care provided to the whole community and to strenght healthcare and educational systems.

About the author

Maria Eduarda Mesquita is a final year medical student in Brazil and currently specializing in Health Education. She works as Latin America and Caribbean Regional Liaison at the Gender Equity Initiative in Global Surgery (GEIGS). She’s an active member of both the International Federation of Medical Students Associations(IFMSA) and of the International Student’s Surgical Network (InciSioN).