Preventive Medicine

							Introduction to Preventive Medicine & Public Health Training

INTORDUCTION TO

GRADUATE MEDICAL EDUATION AT GRIFFIN HOSPITAL
YALE UNIVERSITY SCHOOL OF MEDICINE YALE UNIVERSITY SCHOOL OF PUBLIC HEALTH

WHY GRIFFIN?
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INNOVATIVE TEACHING PROGRAM STRONG UNIVERSITY AFFILIATION DEDICATED FACULTY PLANETREE MODEL OF CARE FORTUNE MAGZINE BEST PLACES TO WORK PUBLIC HEALTH AND PREVENTIVE MEDICINE FRIENDLY ATMOSPHERE BEAUTIFUL FACILITY NIGHT FLOAT SYSTEM

Benefits Package
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Competitive Salary 2003 PGY1 $ 39,172 Medical, dental, & Disability insurance White coats Meal tickets Free Up-to-Date access Free MKSAP Free pocket PC/Handheld computer Dedicated on call and learning center Paid Board Review courses Sponsored international Health Electives Free Parking Annual Graduation Book Allowance 1 month paid vacation

Answers to commonly asked questions
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VISA
– Sponsor both H and J visa – Do not pay for attorney fees

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Board Pass rate
– Internal Medicine – Preventive Medicine 100% 100%

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Out of Match offers
– We go through NRMP match

How many positions?
– – – – Internal Medicine TY Prelim IM Combined IM/PM 2 8 4 3

Leading Causes of Death

Death Rate for Infectious Diseases

Ten Great Public Health Achievements United States 1900 - 1999
MMWR 4/2/99/48(12);241-243.
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Vaccination Motor-vehicle safety Safer workplaces Control of infectious diseases Decline in deaths from coronary heart disease and stroke

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

Our Job is not Finished yet
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Public health faces new challenges
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New infections (such as W. Nile) Chronic disease (Obesity and Diabetes) Cancers Bioterrorism Behaviors (smoking, eating) Health access

Actual Causes of Death

Environmental Conditions Favoring the Spread of Infectious Disease
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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

Demographic Conditions Favoring the Spread of Infectious Disease
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Population growth and movement due to man made and natural disasters

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Global travel
Human behaviors such as intravenous drug use and risky sexual behaviors

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Prevention
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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.

Preventive Medicine Competencies
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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

Overview of Combined Program
Year 1: 11 months Clinical Rotations Geriatrics, Ambulatory Medicine Year 2: 2 months 4 months Clinical MPH coursework Rotations (Fall semester) Year 3: 2 months 3 months Public Health Clinical Rotations Rotations Integrated Rotations Year 4: 6 months Clinical Rotations Integrated Rotations

5 months Clinical Rotations

2 months Clinical Rotations

4 months MPH coursework (Spring semester)

5 months Clinical Rotations Adolescent Medicine

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

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Preventive Medicine/ Public Health Rotations

Preventive Medicine/ Public Health Rotations
Major areas:  Public Health Department Rotations  Research electives  Occupational Medicine electives  Health Management & Administration  Clinical Preventive Medicine

Public Health/Community Health
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The Connecticut State Department Of Public Health
– oBehavioral Health Risk Factor Surveillance Survey (BRFSS)

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The Department of Public Health of the Lower Naugatuck Valley
» West Nile Virus Surveillance » Out break Investigation

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The Department of Public Health, City Of Stamford
» Patterns and Characteristics of Tick bites » Risk factor for Melanoma in Lifeguards

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The Department of Public Health, New Haven Local Public Health Agencies
» Valley United Way » Women Health Center

Research Opportunities Griffin Hospital
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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

Research Rotations Other 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
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Connecticut State General Assembly
Resident rotated through Connecticut State Capitol and Legislative Office with the Chair of Public Health Committee.

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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

International Health/ Human Rights
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Griffin Center for Health and Human Rights
East Timor Project
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Latent TB and living conditions in East Timor
Prevalence of psychiatric morbidity in Adolescent detention Centers

Colorado Adolescent Detention Centers
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 Others: Uganda, Brazil, Russia are possible.

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Project Amazonas- Peruvian Amazon
 Health Risk Behaviors in Peruvian Amazon

 Physicians for Human Rights  Yale office of International Health
» Zimbabwe Project

Skill Sets of Combined Program Graduates
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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

Benefits of combined training
Better job opportunities
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Internal medicine
– Primary care – Hospitalist – Sub-specialty training

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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

AccomplishmentsNational Level
Prevention 98
» Best research poster award

Prevention 00
» Best Poster award » 4 posters presented

Preventive Medicine 2001
» 3 posters presented

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Preventive Medicine 2002
» 5 posters accepted for presentation

Accomplishments- State level
American College of Physician-CT » 1999
Winner, Oral presentation  Winner 2nd prize, poster presentation
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» 2000
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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

Thank you.

Preventive Medicine Curriculum
Distributed.