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An Integrated Residency in Internal and Preventive Medicine

Katz, David L. MD MPH; Nawaz, Haq MD MPH; Ahmadi, Ramin MD MPH; Jekel, James F. MD MPH; DeLuca, Vincent A. MD; Cashman, Suzanne DSc; Fulmer, Hugh S. MD MPH

Institutional Issues: Articles

The importance of preventive and population-based principles in clinical practice is widely acknowledged. The challenge of imparting these principles in either under-graduate or postgraduate medical education has, however, not been fully met. The necessary skills are provided comprehensively by preventive medicine residency programs, but at the expense of clinical training. Sequential residencies in primary care and preventive medicine, the currently available means of obtaining thorough preparation in both clinical and population-based principles, represent an inefficient, generally unappealing, and non-integrated approach.

In response to these concerns, and in an effort to make preventive medicine training appeal to a wider audience, the authors developed and implemented a residency program fully integrating internal and preventive medicine. The program meets, and generally exceeds, the requirements of both specialty boards over a four-year period. The program provides extensive training in clinical, preventive, and public health skills, along with case management and cost-effective care, conferring the MPH degree and leading to dual board eligibility. The model is ideally wed to the demands of the modern health care environment in the United States, is extremely attractive to applicants, and may warrant replication both to train academic and administrative leaders and to raise the standards of preventive and public health practice in primary care.

Dr. Katz is director, Preventive Medicine Residency Program and the Yale-Griffin Prevention Research Center, Department of Preventive Medicine, Griffin Hospital, Derby, Connecticut, and director of medical studies in public health and assistant clinical professor of epidemiology and public health and medicine, Yale University School of Medicine, New Haven. Dr. Nawaz is assistant director, Preventive Medicine Residency Program, Department of Preventive Medicine, Griffin Hospital; assistant research director, Yale-Griffin Prevention Research Center; and lecturer in public health, Yale University School of Medicine. Dr. Ahmadi is assistant chairman of graduate medical education and assistant director, Internal Medicine Residency Program, Griffin Hospital; and assistant clinical professor of medicine and lecturer in public health, Yale University School of Medicine. Dr. Jekel is associate director, Preventive Medicine Residency Program, and chairman, Department of Preventive Medicine, Griffin Hospital; and professor emeritus of epidemiology and public health, Yale University School of Medicine. Dr. DeLuca is chairman of graduate medical education and director, internal medicine residency program, Griffin Hospital; and clinical professor of medicine, Yale University School of Medicine. Dr. Cashman is associate professor, Department of Family Medicine and Community Health, University of Massachusetts Medical School, and Dr. Fulmer is director, Center for Community Responsive Care, Boston, Massachusetts.

Correspondence and requests for reprints should be addressed to Dr. Katz, Preventive Medicine Residency Program, Griffin Hospital, 130 Division Street, Derby, CT 06418; e-mail:〈katzdl@pol.net〉.

© 2000 Association of American Medical Colleges