identities. As medical sociologists, we should consider identifying with one or more of the four major subfields. The consistent use of shared labels will eventually help to crystalize our disciplinary structure and to better demonstrate our contributions. It is insufficient to simply identify the subfields that represent research conducted in medical sociology. Identifying with major subfields reinforces the structure of the field by consistently signifying the nature of our work. This recommendation in no way limits the ways in which researchers might identify themselves or their work. For example, in some circumstances, it may make sense to claim expertise in health care or medicalization. Our recommendation is that researchers also recognize where their interests fit into a broader disciplinary structure that distills our major subfields and key contributions to the sociological study of health and medicine.
Recommendation #3. Consider consistent graduate program identities. One potential strategy is for graduate programs to consider identifying as comprehensive or focused. Comprehensive graduate programs would represent the field as a whole. Focused graduate programs would represent one or more specific subfields. Precise program identities would contribute to more efficient graduate programs by dictating hiring decisions (who to hire), graduate recruitment strategies (who to recruit), and graduate curriculum (which courses and area examinations). For example, comprehensive programs could choose to require area examinations that cover the field whereas focused programs could require area examinations that correspond to selected subfields. Doing so would align examinations with faculty expertise, which is consistent with the American Sociological Association’s Code of Professional Ethics.
Recommendation #4. Reconsider the role of Sociology in Medicine. Although we have excellent graduate programs in Social Epidemiology, Social Psychology of Health and Illness, and Sociology of Medicine, Sociology in Medicine is currently unrepresented in the graduate landscape. What role should Sociology in Medicine have in graduate education? Each year our graduates go on to work in medical schools, hospitals, government organizations, and health research firms. Non-academic job placements are likely to become even more common as the academic job market shrinks. We encourage conversations around the question of dedicating graduate courses or entire graduate programs to training graduate students to work in inter-disciplinary, inter-professional, and applied contexts. “Medical sociology’s usefulness beyond its informative and educational function” has been called into question because our graduate programs are “still rather didactic and merely educational, not applied” (Constantinou 2015). Recent job ads for positions in institutions of medicine specify “a PhD in Psychology or Sociology with a specialty in Health Psychology or Medical Sociology.” However, postings that encourage applications “from candidates in all disciplines… including the social and behavioral sciences…” are more and more common. Complicating this picture is a market that increasingly highlights skill sets rather than disciplinary background.
We also encourage conversations about how we can best support the long-term careers of sociologists placed in institutions of medicine. We may need to develop ways of embedding our graduates in ongoing training programs that are formed and nurtured not by medicine, but by sociology. When our graduates become disconnected from Sociology, the students we train so well may not remain sociologists for long. The Medical Sociology section of the American Sociological Association might consider devoting additional sessions and activities to applied medical sociology to maintain connections with sociologists in practice settings. Discussions along these lines could eventually facilitate the placement of even more graduate students in sparse hiring climates and increase our status across the health sciences. Success in these areas could lead to more resources being devoted to sociology programs in general.
CONCLUSION
In this paper, we argued that the sociological study of health in the US has failed to identify a contemporary disciplinary structure (an “island of meaning”) that adequately represents the field. Instead of defining medical sociology conceptually, we defined its structure in terms of four major subfields: Social Epidemiology, Social Psychology of Health and Illness, Sociology of Medicine, and Sociology in Medicine. While recognizing an underlying unity driven by common training in sociological theory and research, we reviewed the unique contributions of each subfield. Specifically, medical sociology examines (1) the social causes of health-related outcomes and behaviors, (2) the social psychological processes that mediate and moderate the social causes and social consequences of health, (3) issues linked with health care delivery and health care experiences, medical knowledge, and health social movements, including social inequality, social institutions, and health policy/law, and (4) problems within institutions of medicine, including medical treatment, health professions, and the marketing of health care. We also recommended efforts toward a more refined and directed conceptualization of the field, including the establishment of a more explicit disciplinary structure that is supported by consistent research identities, relevant graduate program, and greater attention to Sociology in Medicine. Ultimately, we argued for a more efficient and representative organization of the field that more clearly demonstrates our contributions to the study of health. This is not the final statement on the organization of medical sociology. Our hope is to reintroduce these discussions as a matter of regular discourse. Much has changed since Straus (1957), and even more developments are on the horizon.
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