The Medical-Legal Partnership Approach to Teaching Social Determinants of Health and Structural Competency in Residency Programs

Acad Med. 2017 Mar;92(3):292-298. doi: 10.1097/ACM.0000000000001494.


Medical-legal partnerships (MLPs) embed civil legal services lawyers into health care settings and interprofessional health care teams delivering care to low-income or otherwise vulnerable patients and communities. MLPs present the opportunity to instill in residents a practical understanding of the social determinants of health and provide them with concrete tools to address them. MLP training helps residents develop structural competency and build the skills necessary to address barriers to health at the patient, institutional, and population levels. Through a case study, this Perspective explores how residents can address health-harming legal needs working in partnership with interprofessional health care teams that include lawyers, and illustrates how such MLP experiences can relate to competency-based Milestones that are applicable to training residents in all specialties.

MeSH terms

  • Attitude of Health Personnel
  • Delivery of Health Care / standards*
  • Education, Medical / standards*
  • Humans
  • Internship and Residency / standards*
  • Interprofessional Relations
  • Lawyers / psychology*
  • Physicians / psychology*
  • Poverty / psychology
  • Professional Competence / standards*
  • Public-Private Sector Partnerships
  • Social Determinants of Health / standards*
  • United States
  • Vulnerable Populations / psychology