“Action expresses priorities”—Mahatma Gandhi”

Curricula addressing health policy and systems-based practice have increasingly been prioritized in both undergraduate and graduate medical education. Current ACGME milestones for internal medicine residency require trainees to understand and effectively navigate components of a complicated healthcare system. The most aspirational milestone calls for trainees to improve systems and influence health policy at the local, regional, or national level.1 To prepare trainees to become both effective physicians and leaders, educators must craft curricula that provide both dedicated didactics and hands-on experiences in health policy and advocacy. To further this goal, we presented a workshop with strategies to develop these programs at SGIM 2022 in Orlando, Florida.

Learning objectives and educational experiences should be tailored to the level of trainee, while considering available time and institutional resources. For example, one internal medicine residency program offers a longitudinal elective across the last two years of post-graduate training, culminating in an advocacy day at their state capitol or Washington, DC. Another medical school program features an intensive week-long elective for students, which also includes a trip to their state capitol or Washington, DC.

Advocacy education is enhanced when course directors leverage connections with their government relations departments and faculty from other disciplines. Most academic medical centers have government relations professionals who can guide advocacy projects and help facilitate meetings with various stakeholders. Local and institutional experts in policy, law, and business can teach learners core topics. Successful programs ultimately incorporate foundational learning in law and policy as well as opportunities for trainees to meaningfully engage in advocacy. Such opportunities empower physicians in training to lead change in the healthcare system as they progress through their careers.


  1. The Accreditation Council for Graduate Medical Education. Internal Medicine Milestones. https://www.acgme.org/globalassets/PDFs/Milestones/InternalMedicineMilestones.pdf. Updated November 2020. Accessed February 15, 2023.



ACLGIM, Advocacy, Health Policy & Advocacy, Leadership, Administration, & Career Planning, Medical Education, Social Determinants of Health

Author Descriptions

Dr. Pollard Sullivan (kathleen.sullivan@vumc.org) is an assistant professor of medicine in the Division of General Internal Medicine and Public Health at Vanderbilt University Medical Center in Nashville, Tennessee.  Dr. Pasha (pasha.amirala@mayo.edu) is an assistant professor of medicine in the Division of General Internal Medicine at Mayo Clinic in Rochester, Minnesota.