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Training Physicians For Public Health Careers
these programs can be funded (Consolidated Appropriations Act, 2005, Public Law 108-447, Conference Report 108-792). This report is the result of the deliberations of the committee assembled to address that charge.
A critical task for the committee was the development of a vision of the future public health physician workforce to guide the committee’s work. The committee’s vision has three components. First, the committee envisions a future in which sufficient numbers of well-trained public health physicians work with other public health professionals to address population issues such as health promotion and disease prevention, chronic and infectious diseases, safe food and water supplies, sanitation, and environmental exposures. Second, the committee envisions a future in which sufficient numbers of well-trained public health physicians are available to provide the scientific and clinical input along with the leadership and management necessary to link and coordinate the efforts of the many participants of a strong public health system. Third, in the face of public health emergencies, the committee envisions a future in which there will be sufficient numbers of well-trained public health professionals, including physicians, to plan for and prevent these emergencies or to respond to them. Such emergencies would include disasters such as hurricanes, bioterrorism, and emerging or reemerging infections such as pandemic influenza or multiple-antibiotic-resistant tuberculosis.
Who are public health physicians? The committee has adopted the following definition: public health physicians are physicians “whose training, practice and world view are based in large part on a population focus rather than individual practice, that is, on assuring the availability of essential public health services to a population using skills such as leadership, management, and education as well as clinical interventions” (Gebbie and Hwang, 1998).
WHAT SHOULD PUBLIC HEALTH PHYSICIANS KNOW?
The health challenges of the 21st century (e.g., the increasing burden of chronic diseases, persistent and emerging infectious diseases, and disaster response) require the medical and public health communities to work in concert. Additionally, given the increased understanding of the multiple determinants of health, physicians must be aware of not only the biological risk factors but also the behavioral and environmental factors that can affect health in order to tailor interventions for individual treatment. Training physicians in population-based medicine as well as clinical medicine holds strong promise for augmenting the quality and effectiveness of clinical practice. However, the integration of these population health content areas into an already crowded medical school curriculum necessitates the development of creative approaches to curriculum