Fundamental Cause Theory as a Missing Lens in Medical Education.
Abstract
Medical education increasingly incorporates social determinants of health, yet recognizing social conditions does not necessarily enable students to explain why health inequalities persist. Fundamental Cause Theory (FCT) offers an educational framework for addressing this curricular gap by linking socioeconomic conditions, flexible resources, and persistent inequalities. Its integration into medical education could develop competencies such as distinguishing proximal pathways from fundamental causes, analyzing how resources shape access to prevention and treatment, and critically differentiating downstream from upstream responses. FCT could be incorporated into existing public health, community medicine, and clinical reasoning activities through case-based and community-engaged learning. Assessment could focus on students’ ability to construct theoretically informed explanations of health inequalities rather than merely identify social determinants. However, there is currently no direct empirical evidence demonstrating the educational effectiveness of teaching FCT. Therefore, its curricular integration should be considered a theoretically grounded educational proposal requiring rigorous evaluation in medical education research.
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