American Journal of Preventive Medicine
Experiences during medical schoolReuniting Public Health and Medicine: The University of New Mexico School of Medicine Public Health Certificate
Introduction
The professions of medicine and public health in America became increasingly fragmented in the 20th Century.1 Medicine focused on its newfound curative potential and sophisticated technologies applied at the individual level, while public health emphasized the population-based perspectives of prevention, health systems, and health policies. In her landmark address to the Association of American Medical Colleges (AAMC)102nd annual meeting in 1992, June Osborn, MD, then Dean of the University of Michigan School of Public Health, issued a prescient call to reintegrate the two professions to produce a rational system of health care after reform.2 Since that time, there have been important initiatives involving many medical schools attempting to integrate public health into their medical school curricula. One was the Rockefeller Foundation and Pew Charitable Trusts–supported Health of the Public Program3 and the other, the current AAMC/CDC-supported Regional Medicine–Public Health and Education Centers (RMPHECs).4 Lessons from these initiatives have informed current curricular planning at the University of New Mexico. The current environment of healthcare reform favoring investments in prevention and community-based approaches strengthens the case for the integration of public health and medicine.
Section snippets
Background
In 2003, the University of New Mexico School of Medicine (UNMSOM) adopted the goal of an integrated Public Health Certificate for all medical students as one of its top strategic priorities. This effort supports the core strategic goal of the UNM Health Sciences Center: “Working with community partners, UNM Health Sciences Center will help New Mexico make more progress in health and health equity than any other state by 2020.”5
The goal of the certificate program is to educate a physician
Implementation
Integrating a public health program into all phases of the UNMSOM curriculum required merging two distinct and sometimes rival disciplines. Brief descriptions of the curricular components are provided below.
Methods utilized included (Figure 1):
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identifying public health competencies and determining appropriate didactic and practical experiences that would allow the medical students to achieve mastery during their medical curriculum;
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meeting Liaison Committee for Medical Education and Council of
Outcomes
Students in the integrated certificate of public health courses and rotations rate each course in an online evaluation on standard items like course organization, objectives, content, and assessment using a 5-point Likert rating scale with 1=strongly disagree and 5=strongly agree. In the first-year Health Equity Course, students' mean ratings for four items were 4.06 for increased understanding of public health concepts based on course assignments, 4.23 for increased knowledge and understanding
Discussion
Providing excellent medical services alone is important but not a sufficient condition to improve community health. The impact on community health of all medical students receiving a Public Health Certificate will be enhanced if students observe their residents and faculty applying these skills, and if they experience an integration of public health and medicine in clinical practice.
The UNM Health Sciences Center has therefore begun introducing public health training into residency,17
Conclusion
In 2003 the IOM issued its landmark report on the education of public health professionals, “Who Will Keep the Public Healthy?”20 The report recommends that schools of medicine and public health develop collaborations as a means of overcoming the 20th-century schism between the two professions.21 The UNMSOM Public Health Certificate Program is an innovative approach to restoring medicine and public health to their historic Hippocratic unity.
References (21)
Medicine and public health: the power of collaboration
(1997)The nature of public health after reform
Acad Med
(1993)- et al.
Health of the publicThe academic response. Health of the Public Mission Statement Working Group
JAMA
(1992) Responding to the challenge: population health education for physicians
Acad Med
(2008)School of Medicine
Strategic Plan
(2010–2015)Liaison Committee on Medical EducationFunctions and structure of a medical school: standards for accreditation of medical education programs leading to the M.D. degree
(2008)- et al.
Innovative health care disparities curriculum for incoming medical students
J Gen Intern Med
(2008) - et al.
Unnatural causes: is inequality making us sick?
(2008) Public Health in America
- et al.
Building foundations for effective library skills in medical education: library/biometry projects in the first month of medical school
Cited by (17)
Public health practice and clinical practice
2023, Principles and Application of Evidence-based Public Health PracticeRevolutionized Public Health Teaching to Equip Medical Students for 21st Century Practice
2020, American Journal of Preventive MedicineCitation Excerpt :The literature describing innovation in public health education may help to address the mismatch between the current limitations in public health learning and the skills needed by future medical graduates. Recent examples include learning public health through specific clinical cases,18,19 integration of learning through entire degrees,20–24 field or service learning experiences,24–26 specific topic teaching content (e.g., social determinants, climate change),27,28 and the development of a public health curriculum for all medical degrees in the United Kingdom.29,30 It is not clear, however, what the most effective approach to delivering a clinician with the requisite public health skills is, or what the long-term impact of these innovations may be.
Vision 2020 measures University of New Mexico's success by health of its state
2015, American Journal of Preventive MedicineCitation Excerpt :Meanwhile, the UNM School of Medicine implemented an innovative public health curriculum to prepare physicians for a greater role in population health. All medical students now must complete a 15-credit public health certificate, which is integrated into basic and clinical science experiences.14 Vision 2020 has driven several initiatives aimed at expanding traditional clinical roles to serve communities outside the clinic or hospital.
Integration of public health into medical education: An introduction to the supplement
2011, American Journal of Preventive MedicinePublic health and medicine: Where the twain shall meet
2011, American Journal of Preventive Medicine