Unknown unknowns: can bringing patients' lived experience of long term conditions into curriculum design help our future doctors offer more holistic, socially accountable care?

Understanding the holistic impact of long-term conditions (LTCs) on a patient, due to their high prevalence, morbidity, mortality and cost, is an important part of the primary care undergraduate medicine curriculum. Increasingly, we set learning outcomes for our students anticipating what the patient would want them to know. But are our expectations congruent with what patients would want them to know? In this leading article, we propose that patient involvement in curriculum design remains inadequate. We base our argument on (1) an existing strong theoretical premise that increasing patient incorporation enhances the delivery of medical education, (2) recommendations from major health organisations, our regulator and leading healthcare educationalists and (3) a growing body of evidence that what is important to physicians may not reflect what is important to patients. We advocate that patient involvement in curriculum design will result in a better understanding of how LTCs affect their physical, psychological and social health and of their journey through health care and community support services. This learning is essential, but unfortunately often overlooked, if we are to ensure that students in their future roles plan patient care using an empathic, holistic, patient-centred and socially accountable approach.