Elena I. Gore, M.P.H.
2013 M.D. Candidate, Medical University of South Carolina
There has long been an awareness of the role of prevention in improving health and health care in our country. In fact, many of the leading causes of death in this country are due to preventable diseases. Thus, it is important for the field of medicine to be a part of the prevention as well as the treatment of disease. Accordingly, The American Board of Preventive Medicine (ABPM), established in 1948, works to certify qualified physicians with specific knowledge of preventive medicine and to enhance standards of practice within preventive medicine. Though preventive medicine seems somewhat self-explanatory in its title, the depth and variety of clinical practice within the field merits further elucidation.
According to ABPM, preventive medicine is a recognized specialty that physicians can pursue as a career. Physicians within this specialty focus on the health of individuals, communities, and defined populations. They work to protect, promote, and maintain health and well-being while preventing disease, disability and death. Preventive medicine specialists work in various settings including private, academic, and government institutions, state and local health departments and multi-national, non-government organizations. Within these settings, there is also diversity in the types of positions preventive medicine specialists can hold. The American College of Preventive Medicine (ACPM) notes that preventive medicine specialists work as chief medical officers, directors of health departments, and policy makers.
Despite all the diversity in this specialty, there are key commonalities in knowledge and skills that all practitioners in this field must obtain. According to ABPM, these include: biostatistics, epidemiology, environmental and occupational medicine, planning and evaluation of health services, management of health care organizations, research into causes of disease and injury in population groups, and the practice of prevention in clinical medicine.
There are a variety of ways to obtain certification in preventive medicine. ABPM describes several pathways for certification in a preventive medicine specialty. The Residency Pathway is for people who graduated medical school after January 1, 1984 and are either not certified by the ABPM or certified by the ABPM in one specialty and are now completing a residency practicum in another ABPM specialty area. Applicants for certification must also complete 1) a clinical year at an institution accredited by the ACGME, the Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians of Canada, 2) an academic year during which a course of graduate study culminates in a Master of Public Health degree or equivalent masters or doctoral post graduate degree, and 3) a residency practicum year in the preventive medicine specialty. During the academic year, the coursework must include biostatistics, epidemiology, health services management and administration, and environmental health.
An additional way to obtain preventive medicine certification is via the Special Pathway. This is for persons who are currently certified in one preventive medicine specialty and seek certification in a second preventive medicine specialty. These persons must have been practicing essentially full-time in the specialty area they seek for at least two of the past five years.
There are several combined residency programs in internal medicine and preventive medicine and one combined family medicine and preventive medicine program. There are also numerous preventive medicine residency programs that are not combined but require completion of at least one year of a primary care residency, with preference given to those who complete the entire residency. More information on accredited residency programs can be found at http://www.acgme.org/adspublic/.
The ABPM recognizes three specialty areas within the field of preventive medicine: Aerospace medicine, occupational medicine, and public health and general preventive medicine.
• Aerospace medicine practitioners are concerned with the health, well-being, safety, and performance of persons involved in air and space travel
• Occupational medicine physicians focus on the health of workers as it relates to their work environments, including physical, chemical and social aspects
• Public health and general preventive medicine physicians work to promote, prevent, and manage the health of communities and defined populations in a variety of settings
There are also two subspecialties within preventive medicine: Medical Toxicology and Undersea Hyperbaric Medicine. According to the American Board of Emergency Medicine (ABEM), Medical Toxicology is a subspecialty with certification offered by ABEM and the American Board of Pediatrics (ABP). According to the American College of Medical Toxicology (ACMT) physicians who pursue this subspecialty focus on “the diagnosis, management and prevention of poisoning and other adverse health effects due to medications, occupational and environmental toxins, and biological agents.” Undersea and Hyperbaric Medicine subspecialty certification can be obtained through the ABPM and the ABEM. Physicians in this subspecialty focus on the use of high environmental oxygen pressure and the prevention of injury and illness due to exposure to elevated ambient pressure.
Specialists in the field of preventive medicine work in a broad range of medical specialties and careers. Preventive medicine combines clinical skills with those of public health professionals to allow clinicians to use their understanding of community and population health to better care for individuals. As this country moves to meet goals of healthier lifestyles and healthier people, preventive medicine specialists are poised to be skilled and capable leaders who possess the knowledge and expertise to help reduce preventative deaths while improving quality of life.
For more information, please visit the following websites:
American Board of Preventive Medicine
Aerospace Medical Association
American College of Medical Toxicology
American College of Preventive Medicine
Society for Academic Emergency Medicine
Filed Under: Global Health
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