Introduction to Preventive Medicine

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Introduction to Preventive Medicine Public
Health Training
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• INTORDUCTION TO
• GRADUATE MEDICAL EDUATION
• AT
• GRIFFIN HOSPITAL
• YALE UNIVERSITY SCHOOL OF MEDICINE
• YALE UNIVERSITY SCHOOL OF PUBLIC HEALTH

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Answers to commonly asked questions

• VISA
• Sponsor both H and J visa
• Do not pay for attorney fees
• Board Pass rate
• Internal Medicine 100
• Preventive Medicine 100
• Out of Match offers
• We go through NRMP match
• How many positions?
• Internal Medicine 2
• TY 8
• Prelim IM 4
• Combined IM/PM 3

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Leading Causes of Death
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Death Rate for Infectious Diseases
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Ten Great Public Health Achievements -United
States 1900 - 1999MMWR 4/2/99/48(12)241-243.

• Vaccination
• Motor-vehicle safety
• Safer workplaces
• Control of infectious diseases
• Decline in deaths from coronary heart disease and
  stroke

• Safer and healthier food
• Healthier mothers and babies
• Family planning
• Fluoridation of drinking water
• Recognition of tobacco use as a health hazard

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Our Job is not Finished yet

• Public health faces new challenges
• New infections (such as W. Nile)
• Chronic disease (Obesity and Diabetes)
• Cancers
• Bioterrorism
• Behaviors (smoking, eating)
• Health access

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Actual Causes of Death
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Environmental Conditions Favoring the Spread of
Infectious Disease

• Globalization of the food supply
• Development projects that alter the habitat of
  disease carrying insects and animals
• Increased human contact with the wilderness
  habitat that may harbor unknown infectious agents
• Increased use of antimicrobial agents and
  pesticides hastening resistance

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Demographic Conditions Favoring the Spread of
Infectious Disease

• Population growth and movement due to man made
  and natural disasters
• Global travel
• Human behaviors such as intravenous drug use and
  risky sexual behaviors

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Prevention

• Primary Prevention - preventing the occurrence of
  disease and injury, for example by immunizations.
• Secondary Prevention - early detection and
  intervention, by reversing, halting or retarding
  the progression of a condition.
• Tertiary Prevention - minimizing the the effects
  of disease and disability by surveillance and
  maintenance to prevent complications.

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What is Preventive Medicine?

• Preventive medicine physicians work with large
  population groups as well as with individual
  patients to promote health and understand the
  risks of disease, injury, disability and death.

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Preventive Medicine Competencies

• Epidemiology
• Biostatistics
• Environmental and occupational medicine
• Planning, administration, evaluation of health
  services
• Social and behavioral aspects of health and
  disease
• Practice of prevention in clinical medicine
• Research Methods Clinical Trial
• Grant Writing

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Overview of Combined Program
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Preventive Medicine Activities

•  1.  Preventive Medicine Lectures   
• First Friday of each month
• 2. Preventive Medicine journal Clubs 
• 2nd Friday of each month
• 3. Preventive Medicine Seminars/Peer Teaching 
• 3rd Friday of each month
• 4. Research Conferences  
• 4rth Friday of each month
• Preventive Medicine/ Public Health Rotations

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Preventive Medicine/ Public Health Rotations

• Major areas
• Public Health Department Rotations
• Research electives
• Occupational Medicine electives
• Health Management Administration
• Clinical Preventive Medicine

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Public Health/Community Health

• The Connecticut State Department Of Public Health
• o Behavioral Health Risk Factor Surveillance
  Survey (BRFSS)
• The Department of Public Health of the Lower
  Naugatuck Valley
• West Nile Virus Surveillance
• Out break Investigation
• The Department of Public Health, City Of Stamford
  
• Patterns and Characteristics of Tick bites
• Risk factor for Melanoma in Lifeguards
• The Department of Public Health, New Haven
• Local Public Health Agencies
• Valley United Way
• Women Health Center

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Research Opportunities Griffin Hospital

• Women Health Center
• Department Of Preventive Medicine
• Department of Internal Medicine
• Geriatric Assessment Center
• Griffin Center for Health Human Rights
• Yale-Griffin Prevention Research Center
• Rapid Diagnostic Breast Cancer Center

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Research RotationsOther institutions

• Yale School of Epidemiology
• State Dept. of Public Health
• Center of Outcome Research and Evaluation
• City Health Departments
• CT Injury Prevention Center
• Yale Occupational Medicine Program

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Occupational Medicine

• Yale Occupational Medicine Program
• Sikorsky Aircraft
• Griffin Occupational Medicine program (new)

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Health Management

• Connecticut State General Assembly
• Resident rotated through Connecticut State
  Capitol and Legislative Office with the Chair of
  Public Health Committee.
• Opportunity to work on Hospital Committees and
  task force
• Clinical Pathways
• Griffin Hospital Quality Management dept.
• Griffin Hospital Continuing care dept.
• Legislative Electives at State Capital
• Managed care Insurance company experience

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International Health/ Human Rights

• Ø Griffin Center for Health and Human Rights
• East Timor Project
• Latent TB and living conditions in East Timor
• Colorado Adolescent Detention Centers
• Prevalence of psychiatric morbidity in Adolescent
  detention Centers
• Others Uganda, Brazil, Russia are possible.
• Project Amazonas- Peruvian Amazon
• Health Risk Behaviors in Peruvian Amazon
• Ø Physicians for Human Rights
• Ø Yale office of International Health
• Zimbabwe Project

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Skill Sets of Combined Program Graduates

• Internal medicine training
• Preventive Medicine Training
• MPH degree
• Familiarity with Evidence-Based Medicine
• Understand public health, epidemiological
  principles
• Able to read scientific literature
• Ability to pursue Academic carriers
• Ability to pursue research and grants

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Benefits of combined training

• Better job opportunities
• Internal medicine
• Primary care
• Hospitalist
• Sub-specialty training
• Public health
• Federal government
• CDC
• NIH
• WHO
• International health work
• NGOs
• Managed care/health insurance
• Hospital or group practice management (such as
  hospitalist groups)
• Academic faculty

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Accomplishments- National Level

• Prevention 98
• Best research poster award
• Prevention 00
• Best Poster award
• 4 posters presented
• Preventive Medicine 2001
• 3 posters presented
• Preventive Medicine 2002
• 5 posters accepted for presentation

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Accomplishments- State level

• American College of Physician-CT
• 1999
• Winner, Oral presentation
• Winner 2nd prize, poster presentation
• 2000
• Winner Oral Presentation
• 2001
• Winner 2nd prize oral presentation
• Winner 1st prize, research poster
• Winner, 3rd prize, research poster

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Accomplishments- State level

• American College of Physician-CT
• 10/2002
• Winner 1st prize oral presentation
• Winner 1st prize, research poster
• Winner, 1st prize, Clinical poster

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• Thank you.

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Preventive Medicine Curriculum

• Distributed.