Building a Generation of Physician Advocates: The Case for Including Mandatory Training in Advocacy in Canadian Medical School Curricula.

There is an increasing focus on the social accountability of physicians as individuals, and of medicine itself. This has led to increasing emphasis on physician advocacy from a wide variety of institutions. The physician advocacy concept is now part of the Health Advocacy competency mandated by the Royal College of Physicians and Surgeons of Canada. Despite its growing prominence, physician advocacy remains poorly integrated into current medical undergraduate curricula. The authors recommend how and why curricular reform should proceed; they focus on Canadian medical education, although they hope their views will be useful in other countries as well.The authors discuss conflicting definitions of physician advocacy, which have previously hampered curriculum development efforts, and suggest a way of reconciling the conflicts. They review current gaps in advocacy-related curricula, suggest that these can be addressed by incorporating practice-based and skills acquisition elements into current didactic teaching, and offer several strategies by which an advocacy curriculum could be implemented, ranging from small modifications to current curriculum to developing new competencies in medical education nationally.The authors present a case for making an advocacy curriculum mandatory for every Canadian medical trainee; they argue that teaching trainees how to fulfill their professional responsibility to advocate may also help them meet the social accountability mandate of medical school education. Finally, the authors explain why making the development and implementation of a mandatory, skill-based curriculum in advocacy should be a priority.