may be influenced more by their observation of how a supervising physician handles patients with depressive symptoms than by anything they hear in a lecture or read in a textbook. The teaching that occurs in this format is sometimes referred to as the “hidden curriculum,” which can be described as the implicit message continually being conveyed to students through a supervisor’s or a role model’s example, rather than the person’s spoken words. It also involves the imprinting of attitudes and values onto impressionable students by their more-experienced educators (Ludmerer, 1999).

The lack of standardized course content and teaching methods in the behavioral and social sciences leads to the variability among medical schools noted above, which is a further impediment to data collection and analysis. The Liaison Committee on Medical Education (LCME), the accrediting body for U.S. and Canadian medical schools, tracks a number of special topics of relevance to the behavioral and social science content of medical school curricula. However, as is true for other special topic areas, it does not specify how the behavioral and social sciences should be taught, the number of hours a school should devote to these disciplines, or what topics should be covered. It merely states that the curriculum must include behavioral and socioeconomic subjects in addition to basic science and clinical disciplines (LCME, 2003). As a result, each medical school has great flexibility in designing an appropriate program for itself. The lack of a standard program design, however, hampers the systematic analysis of curricular content across medical schools, and makes it impossible to ensure that the most essential and empirically supported behavioral and social science content is included in medical school curricula.

Use of the national database for medical school curricula of the Association of American Medical Colleges (AAMC) does not resolve these difficulties. AAMC’s Curriculum Management and Information Tool (CurrMIT) database is the most comprehensive tool available for collecting and analyzing the content of medical school curricula. It is a voluntary system designed to allow medical schools to examine the full spectrum of their course offerings, track key trends, support new innovations, and compare local curricula with those of other medical schools (AAMC, 2003b). Schools have flexibility in the way they enter their data, depending on program needs. As a result, data entry formats vary from school to school, as do the degree to which the information is updated and the level of detail entered (e.g., only 67 schools have provided course titles).

The CurrMIT database lists 142 accredited medical schools (126 in the United States and 16 in Canada). Of these 142 schools, 55 have entered data reporting that the school offers a course in behavioral or social science (AAMC, personal communication, June 2003).

Because LCME requires medical school curricula to include behavioral and socioeconomic subjects (LCME, 2003), it can be assumed that all accredited medical schools in the United States teach behavioral and social science topics in some form. The CurrMIT database may not identify all schools with behavioral



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