Careers In Preventive Medicine

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Careers In Preventive Medicine

• Physicians With Populations
• As Their Patients

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HEADLINES OF THE DAYWhat do these headlines
have in common?

• FDA Picks Drug To Fight Bioterrorism
• New York Reports Another Case Of West Nile Virus
• Astronaut Says Hes Still Wobbly After Months Of
  Weightlessness

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They all are shaped by leadersin Preventive
Medicine
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Preventive Medicine Protects Americans Throughout
the Day
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Preventive Medicine

• A medical specialty since 1948, offering
  board-certification in the specialty areas of
• General Preventive Medicine and Public Health
• Occupational Medicine
• Aerospace Medicine

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What Is Preventive Medicine? Preventive Medicine
Is the Specialty for Physicians

• Committed to disease and injury prevention and
  health promotion
• With a strong record of leadership and
  accomplishment in public health
• Driven to improve preventive and primary care
  services to underserved and high-risk populations
• Interested in protecting people from
  environmental health hazards
• Dedicated to improving the health of employees
• Concerned about aerospace health and medicine

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Aims of the Specialty of Preventive Medicine

• Promote and preserve health and longevity in
  individuals and populations
• Use epidemiology to find high-risk groups in
  populations
• Prevent and limit disease and injury
• Enhance quality in healthcare systems
• Facilitate early diagnosis with screening and
  education
• Improve the quality of life

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Skills of the Preventive Medicine Physician

• Biostatistics
• Epidemiology
• Environmental and Occupational Health
• Planning, Administration, and Evaluation of
  Health Services
• Practice of Prevention in Clinical Medicine
• Health Policy and Management

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Number of Physicians Board-Certified in
Preventive Medicine
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Role of Preventive Medicine in Todays Society
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Preventive Medicine Is Helping People Live Longer
La Rue is an active 84-year old
Her mother died at 64
Her grandmother died at 45
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Preventive Medicine Will Shape Healthcare in the
21st Century
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Americans Increasingly Rely on Preventive
Medicine Specialists
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Two major goals of Healthy People 2010

• Increase quality and years of healthy life
• Eliminate health disparities

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Leading Health Indicators
Ten Major Public Health Issues

• Physical activity
• Overweight and obesity
• Tobacco use
• Substance abuse
• Responsible sexual behavior

• Mental health
• Injury and violence
• Environmental quality
• Immunization
• Access to health care

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Healthy People 2010
Actual Causes of Death
Data from 1990
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People in Preventive Medicine

• Public health admin/ management
• Policy
• Informatics
• Environmental Medicine
• Business/industry

• Research/academia
• Aerospace Medicine
• Occupational Medicine
• Clinical Preventive Medicine
• International Medicine

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Antronette K. Yancey, MD, MPH, FACPMDirector of
Chronic Disease Prevention Health PromotionLos
Angeles County Department of Health Services

• Education
• MD Duke Univ. School of Medicine, Durham, NC,
  1982
• MPH University of California, Los Angeles, 1991
• Post Graduate Training
• Residency Psychiatry (Internal Medicine), Duke
  University Medical Center, 1982-84
• Residency Preventive Medicine/MPH, UCLA, 1990-91
• Chief Resident in Preventive Medicine, 1991

• Career Highlights
• Board of Directors (1993-2000) and Chair,
  Minority Affairs Committee (1993-96), National
  Marrow Donor Program - created more diverse and
  inclusive registry of potential bone marrow
  donors
• Director of Public Health, City of Richmond, VA -
  designed and implemented ROCK! Richmond, healthy
  eating and active living campaign, 1996-98

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Preventive Medicine holds the hope for a
healthier future for all Americans. A. Yancey

• Current Job Activities Developed and oversees
  division with a 15 million budget, staff of
  75-85, and 60-70 contracts with community-based
  organizations. Assesses chronic disease and
  injury prevalence of countys 9.7 million people.
  Designs approaches for reducing risk and
  enhancing resilience. Implements intervention
  strategies in collaboration with government,
  community-based and professional organizations,
  businesses, and community leaders. Currently
  launching Fuel Up/Lift Off! L.A. (FULOLA), a
  community-level fitness and wellness program
  social marketing campaign.

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Stephanie Zaza, MD, MPHChief, Community Guide
BranchCenters for Disease Control and Prevention
(CDC)

• Education
• MD Northeastern Ohio College of Medicine, 1990
• MPH Johns Hopkins Univ. Baltimore, MD 1995
• Post Graduate Training
• Residency Gen. Preventive Medicine and Public
  Health, CDC, Atlanta, Georgia, 1993-95
• Epidemic Intelligence Service CDC, 1991-93
• Internship, General Surgery Swedish Hospital
  Medical Center, Seattle, Washington, 1990-91

• Career Highlights
• Primary care policy fellowship, Health Resources
  and Services Admin., 2000
• Named director of the CDC Community Guide
  project, 1999
• American College of Preventive Medicine, Rising
  Star Award, March 1999

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We are truly changing the way public health and
prevention will be done in this country.S. Zaza

• Current Job Activities Provides leadership in
  developing, disseminating, implementing and
  evaluating the Guide to Community Preventive
  Services Systematic Reviews and Evidence-Based
  Recommendations. Leads not only the development
  of high quality systematic literature reviews
  about what are effective interventions in public
  health, but also works with numerous partners
  within and outside of the federal government to
  integrate effective services into public health
  practice.

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Helga E. Rippen, MD, MPH, PhDDirector of Medical
InformaticsPfizer Health Solutions Inc

• Education
• MD University of Florida (with honors), 1993
• MPH The Johns Hopkins University, 1995
• PhD Biomedical Engineering, Duke University,
  1986
• Post Graduate Training
• Residency Preventive Medicine Residency, The
  Johns Hopkins University, 1986
• Transitional Internship Georgetown University,
  1984

• Career Highlights
• Establishing the Health Information Technology
  Institute, Mitretek Systems, 1993-1996
• Developing criteria to assess the quality of
  health information on the Internet and
  Information Quality Tool, 1999
• Co-chairing the development of an international
  Code of Ethics for health information on the
  Internet, 2000

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I believe that information technologies will be
a critical tool in improving the health of our
nation and that Preventive Medicine should lead
the way in their development and assessment. H.
Rippen

• Current Job Activities Leading the development
  of Pfizer Health Solutions Inc (PHS) products.
  Helping to formulate an informatics strategy for
  PHS that best supports the needs of the health
  care sector. Developing an innovative,
  Internet-based, disease management program that
  provides tools for outcomes analysis. Impacting
  the field of health/medical informatics through
  participation in non-profit Boards,
  presentations, and lectures. Chairs or
  co-chairs the Internet Healthcare Coalition
  IEEE-USA Medical Technology Policy Committee and
  Preventive Medicine 2001 Informatics track.
  ACPMs alternate delegate to the AMA Young
  Physicians Section.

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Philip J. Landrigan, MD, MSc, DIHChairman,
Department of Community and Preventive
MedicineMount Sinai School of Medicine

• Education
• MD Harvard Medical School, 1967
• MSc Occupational Medicine, University of London,
  1977
• Diploma of Industrial Health (England), 1977
• Post Graduate Training
• Residency Childrens Hospital Medical Center,
  Boston, 1968-70
• London School of Hygiene and Tropical Medicine,
  1976-77

• Career Highlights
• Directing Mount Sinais Center for Childrens
  Health and the Environment, 1998-present
• Chairing the Committee on the Scientific Issues
  Surrounding the Regulation of Pesticides in Diets
  of Infants and Children, National Academy of
  Sciences, 1988-92
• Service in the Global Smallpox Eradication
  Campaign in northern Nigeria

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Toxic chemicals in the environment are now
recognized to cause some fraction of
neurological, developmental, and behavioral
disorders in children. The implications for
prevention are enormous. P. Landrigan

• Current Job Activities Ethel H. Wise Professor
  and Chair of the Department of Community and
  Preventive Medicine and Director of Environmental
  and Occupational Medicine at the Mount Sinai
  School of Medicine in New York City. Holds a
  Professorship in Pediatrics at Mount Sinai, and
  is a member of the Institute of Medicine of the
  National Academy of Sciences. Editor-in-Chief of
  the American Journal of Industrial Medicine.
  Directs the Center for Childrens Health and the
  Environment and the Mt. Sinai-Irving J. Selikoff
  Center for Occupational and Environmental
  Medicine, one of 10 federally-funding pediatric
  environmental health specialty units in the U.S.

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Mirza I. Rahman, MD, MPHDirector, Medical
ServicesUS Human Health, Merck Co., Inc., West
Point, PA

• Education
• MPH Columbia School of Public Health, NY, 1994
• MD Stony Brook School of Medicine, NY, 1990
• Residency Training
• Public Health General Preventive Medicine,
  Stony Brook School of Medicine, NY, 1993-95
• Family Practice, Stony Brook School of Medicine,
  NY, 1990-93

• Career Highlights
• Establishing the Health Information Technology
  Institute, Mitretek Systems, 1993-1996
• Developing criteria to assess the quality of
  health information on the Internet and
  Information Quality Tool, 1999
• Co-chairing the development of an international
  Code of Ethics for health information on the
  Internet, 2000

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Bridging the gap that often characterizes the
relationship between Industry and the Preventive
Medicine community is important, so that together
we can move forward in the cause of promoting
health and preventing disease. M. Rahman

• Current Job Activities
• Develops and edits the Disease Modules section
  of Merck Medicus, a new Internet initiative by
  Merck Co., Inc.
• Serves as the Merck US Medical Scientific
  Affairs liaison to the Manufacturing Division.
• Is involved in the review of promotional
  materials for a number of the companys products
  as a member of the Medical-Legal Board.
• Teaches a course on Post-Marketing Safety
  Surveillance in the Quality Assurance /
  Regulatory Affairs Graduate Program at the Temple
  University School of Pharmacy.

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Dominic Chow, MD, MPHCo-Investigator, Hawaii
AIDS Clinical Research ProgramUniversity of
Hawaii, Honolulu, HI

• Education
• MD SUNY Health Science Center at Brooklyn, 1993
• MPH Johns Hopkins School of Hygiene and Public
  Health, 1998
• Post Graduate Training
• General Preventive Medicine Residency, Johns
  Hopkins School of Hygiene and Public Health,
  1997-98
• Resident and Chief Resident, Medicine/Pediatrics
  Residency, Yale, 1993-97

• Career Highlights
• Conducting outcomes research in clinical trials
  with the implication of impacting health policy
  and management
• Teaching residents and medical students about
  prevention and how prevention can be put into
  daily practice

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My training in Preventive Medicine has enabled
me to investigate how the results from our
clinical trial will affect standard medical
practice. Outcomes research on clinical trials
have implications on health policy and
management. D. Chow

• Current Job Activities As Deputy Director of the
  Combined Internal Medicine and Pediatrics
  residency program, teaches residents how to put
  prevention into daily practice. The cradle to
  grave model of internal medicine/pediatrics
  training allows for extensive opportunities to
  promote health during the course of patients
  lives. As a Co-Investigator at the Hawaii AIDS
  Clinical Research Program, is involved with
  health outcomes research within the national AIDS
  Clinical Trials Group, specifically investigating
  the resource use and cost-effectiveness of HIV-1
  resistance testing during antiretroviral failure,
  comparing sequencing versus phenotyping
  resistance testing.

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Colonel Paul S. Stoner, Jr., MD, MPHChief,
Flight Medicine ClinicLyndon B. Johnson Space
Center

• Education
• MD Temple University School of Medicine, 1982
• MPH The Harvard School of Public Health, 1994
• Post Graduate Training
• Residency Aerospace and Occupational Medicine,
  Brooks Air Force Base, Texas, 1984

• Career Highlights
• Participating in both Operations Desert Shield
  and Desert Storm as an operational flight surgeon
  assigned to an Air Transportable Hospital in
  Riyadh, Saudi Arabia, 1991
• Serving as the Medical Group commander as part of
  an Air Expeditionary Force deployment to the
  Southwest Asian country of Qatar.
• Working as the Chief of the Flight Medicine
  Clinic at the Johnson Space Center, 1998-present

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Devising health programs for the improved health
of populations will be the most prudent means to
advance the health and well being of our
society. P. Stoner, Jr.

• Current Job Activities Colonel (Dr.) Paul S.
  Stoner, Jr. is the United States Air Force
  aerospace medicine liaison officer at the Johnson
  Space Center in Houston, Texas. He works to
  bolster the interface and interaction between the
  Air Force and the National Aeronautics and Space
  Administration. As the Chief of the Flight
  Medicine Clinic, he supervises and participates
  in the routine medical care provided to US
  astronauts and their families. He is also
  responsible for the selection and annual physical
  examinations of the astronauts. Colonel Stoner
  is designated as a chief flight surgeon in the US
  Air Force with more than 1,000 flying hours in
  over 25 different operational aircraft.
• . .

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Janet Fujikawa, DO, MSMedical Director,
Occupational Health Services,Lockhead Martin
Mission Systems, Gaithersburg, MD

• Education
• DO Kirksville College of Osteopathic Medicine,
  Kirksville MO, 1983
• MS Epidemiology Preventive Medicine,
  University of Maryland, 1990
• Post Graduate Training
• Occupational Medicine Fellowship, Johns Hopkins
  Hospital, 1991-93
• Resident, Preventive Medicine Residency Program,
  University of Maryland, 1988-90
• Intern, Family Practice, Naval Hospital, Camp
  Pendleton, Oceanside CA, 1983-84

• Career Highlights
• Developing wellness programs, such as Health
  Fairs and Wellness Libraries
• Commander, Medical Corps, United States Naval
  Reserves

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With people living and working longer and an
increased interest in the prevention of injury
and illness, there will be a need for trained and
caring professionals in the different areas of
Preventive Medicine. J. Fujikawa

• Current Job Activities Supports approximately
  10,000 Lockheed Martin employees and supervises
  four clinics in four different states with nurses
  and consultants. Is involved with Workers
  Compensation, medical leave case management,
  applicant drug screens, international business
  travel issues, wellness programs (monthly health
  promotions, Health Fairs, flu shots), Automated
  External Defibrillators (AED), ergonomics,
  Americans with Disabilities Act (ADA) and Family
  and Medical Leave Act (FMLA), and new program
  development and implementation.

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Tamara Lewis, MD, MPA, MPHMedical Director,
Community Health and PreventionIntermountain
Health Care, Salt Lake City UT

• Education
• MD University of Utah School of Medicine, 1989
• MPA Brigham Young University Marriott School of
  Management, Provo, UT, 1991
• MPH Medical College of Wisconsin, 1998
• Post Graduate Training
• Internal Medicine Internship, LDS Hospital,
  1989-90

• Career Highlights
• Attaining full smoking cessation counseling and
  pharmacotherapy coverage for all IHC enrollees
• Developing a teen tobacco quit line (1-800
  number)
• Establishing health status goals as IHC corporate
  goals
• Securing expanded funding for Utah State
  Immunization Information System

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In order to combat the diseases of wealthy
nations (heart disease, cancer, and injuries), we
need to focus on the heart of poor health choices
and habits and develop the skills for effective
behavior change and the tools for effective
individual and population communication. T. Lewis

• Current Job Activities Develops corporate health
  status goals, prevention guidelines, health needs
  appraisals, health promotion strategies,
  prevention programs, computerized medical
  records, Care Process Models, and
  cost-effectiveness analyses integrates
  prevention into clinical practice design and
  partners with Health Plans Quality Improvement
  (HEDIS), Healthy Communities, and community
  coalitions also serves as Medical Director for
  IHC Healthy Balance, Intermountain Health Cares
  employee wellness program.

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Carlos Aristeguieta, MD, MPHSenior Program
AssociateManagement Sciences for Health,
Arlington, VA

• Education
• MD Universidad Autónoma de Centro América, San
  José, Costa Rica, 1992
• MPH Johns Hopkins School of Hygiene and Public
  Health, 1996
• Postgraduate Training
• General Preventive Medicine/Public Health Johns
  Hopkins School of Hygiene and Public Health,
  1995-97
• Family Medicine University of Miami, Jackson
  Memorial Hospital, 1992-95

• Career Highlights
• Trained health workers in Latin America in the
  design of interventions to promote the rational
  use of antimicrobials and reduce the risk of
  antimicrobial resistance.
• Worked toward measles eradication with the Pan
  American Health Organization and the Ministries
  of Health and other counterparts in Haiti and the
  Dominican Republic.

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Physicians trained in Preventive Medicine will
become key players in fostering the health of
populations around the world, advocating and
assuring policies and actions that lead to the
best possible outcomes. The opportunities are
enormous. C. Aristeguieta

• Current Job Activities Develops research
  initiatives in evidence-based, rational use of
  antibiotics in Latin America and the Caribbean.
  Promotes rational drug use in the Region, with
  emphasis on antibiotics. Developed a workshop on
  the rational use of antibiotics for the Region
  based on the course by the International Network
  on the Rational Use of Drugs (INRUD).

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Starting Your Career in Preventive Medicine
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Paths for Entering the Specialty ofPreventive
Medicine

• Full residency program directly following medical
  school and a transitional year
• Academic and practicum components of residency
  program after completing clinical training in
  another medical specialty
• Combined training with another medical specialty

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Training in Preventive Medicine
Medical School (4 years)
Preventive Medicine Residency Training (3
years) Clinical postgraduate training
Masters in Public Health or equivalent
Residency Practicum
Specialty Board Exam
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Where Can You Find Preventive Medicine Training
Programs?

• 76 ACGME-accredited programs in U.S.
• Schools of medicine/university medical centers
  (63)
• Schools of public health (14)
• Military/federal (5)
• State or local health departments (8)
• Hospitals/health care organization (8)
• Train approximately 350 residents yearly

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Distribution of Residents In Preventive Medicine
Programs
Public Health (13)
General Preventive (37)
Aerospace (9)
Occupational (41)
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Funding Sources for Preventive Medicine Training
Programs

• Federal
• HRSA
• VA
• NIOSH
• CDC
• HCFA
• NIH
• DoD
• NASA

• State/Other
• Health agencies
• Schools of public health
• University medical centers
• Foundations
• National health organizations
• Private industry

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Preventive Medicine Core Knowledge Content Areas

• Health services administration
• Biostatistics
• Epidemiology
• Clinical Preventive Medicine
• Behavioral aspects of health
• Environmental health

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Seeking Out Preventive Medicine Experiences in
Medical School

• Join the ACPM-MSS!
• The Medical Student Section (MSS) of ACPM aims to
  raise the awareness of and interest in Preventive
  Medicine among medical students.
• Network of communication
• AJPM e-journal subscription
• Mentoring Program
• PMIGs
• ACPM Annual Meetings
• http//www.acpm.org/medstudents.htm

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Seeking Out Preventive Medicine Experiences in
Medical School

• Contact local Preventive Medicine resources, such
  as
• Departments of community/preventive medicine
• Schools of public health
• Health departments
• Arrange Preventive Medicine elective rotations
• Relevant courses or rotations
• Community-based organizations
• Independent research

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Types of Projects Available to Medical Students
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For more information, contact

• The American College of
• Preventive Medicine
• Leadership in the Science, Policy, and Practice
  of Preventive Medicine
• www.acpm.org
• 202-466-2044

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Other Resources

• American Board of Preventive Medicine
  www.abpm.org
• Association of Teachers of Preventive Medicine
  www.atpm.org
• American College of Occupational and
  Environmental Medicine www.acoem.org
• Aerospace Medical Association www.asma.org
• Associations of Schools of Public Health
  www.asph.org
• American Medical Student Association www.amsa.org
• American Medical Association (Fellowship and
  Residency Interactive Electronic Database
  www.ama-assn.org/cgi-bin/freida/freida.cgi

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Other Resources (cont.)

• Health Resources and Services Administration /
  Bureau of Health Professions www.bhpr.hrsa.gov
• Association of Preventive Medicine Residents
  www.acpm.org/apmr.htm
• American Public Health Association www.apha.org
• Accreditation Council on Graduate Medical
  Education www.acgme.org
• The Office of Disease Prevention and Health
  Promotion www.odphp.org
• Healthy People 2010 www.healthypeople.org

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Sources of Information

• American College of Preventive Medicine
• Healthy People 2010 http//www.health.gov/healthyp
  eople/
• American Journal of Preventive Medicine. 2000.
  Vol. 18 (1).
• Accreditation Council for Graduate Medical
  Education (ACGME).
• CDCs Ten Great Public Health Achievements -
  United States 1900 - 1999 www.cdc.gov/epo/mmwr/pre
  view/mmwrhtml/00056796.htm

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Acknowledgements

• Office of Disease Prevention and Health Promotion
  / US Department of Health and Human Services
• ArtToday, www.arttoday.com
• A special thanks to those ACPM volunteer members
  who helped to prepare this information,
  especially Ani Hyslop, Lorraine Yeung, Sindy
  Paul, Dorothy Lane, and Erica Frank.