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Background:

Advocacy is an integral component of a physician’s professional responsibility and can help physicians shape the increasingly complex modern medical system and fulfill their social contract. Despite this, advocacy training in undergraduate medical education (UME) remains inconsistent, often elective, and lacks standardized competencies or requirements from accrediting bodies such as the Liaison Committee on Medical Education (LCME). A clearer understanding of existing advocacy curricula is needed to support the development of more consistent and evidence-based training across UME.

Objective: 

To characterize current practices and common elements of UME advocacy curricula in the United States and Canada—including content areas, topics, and teaching methods—to inform the development of a standardized curricular framework.

Methods: 

We conducted a systematic review following PRISMA guidelines to identify articles that described UME advocacy curricula developed in the United States and Canada. A medical librarian conducted systematic searches in PubMed, Embase, PsycINFO, and ERIC. Inclusion criteria were English-language manuscripts describing UME curricula with explicit advocacy training. Two reviewers independently screened studies with a third resolving conflicts. Data extraction and thematic analysis are ongoing.

Results:

Of 4,934 articles screened, 123 articles met inclusion and exclusion criteria for full-text review and data extraction. To date, 28 articles have undergone detailed review, describing 27 curricula at medical schools. Preliminary data show that the most common learning methods included experiential learning (59%), didactics (55%), small group discussion (41%), and independent or group projects (39%). Community partnerships (59%) were the most commonly described advocacy approach, followed by community service-learning (38%) and legislative advocacy (28%). The most common educational topics were social determinants of health (48%), healthcare finance (41%), health equity (38%), health system structural complexities (38%), and specific vulnerable populations (38%). Educator-reported best practices included adequate faculty involvement (52%) and community-focused efforts (48%). Educator reflections frequently described longitudinal, experiential, and community-based learning approaches.

Conclusion:

Preliminary findings demonstrate substantial variability in UME advocacy curricula, with a predominance of experiential and community-engaged approaches, indicating frequent use of community-immersive strategies in existing curricula. These patterns may inform the development of a more consistent and structured framework for advocacy curricula in undergraduate medical education.