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Residency Training

In general, following a PGY-1 internship year, the PGY-2 year is dedicated to academic experience in public health, leading to a graduate degree (usually an MPH). The PGY-3 year is for practicum experience and consists of field rotations. There is quite a bit of variety in how programs are structured, and MPH training also varies based on the focus of various training programs. Some programs emphasize international health and policy training while others focus on biostatistics and epidemiology.

Different programs contribute different amounts of funding during the academic component of residency training. Some programs offer full resident salary in addition to paying for the full MPH program tuition. Other programs offer a partial resident salary, and some programs may require a contribution to the MPH program tuition bill.  Residency program funding has been a long-standing issue for Preventive Medicine, since it is the only medical specialty that is funded primarily by HRSA Title VII; clinical training programs are primarily funded by Medicare. Preventive Medicine training programs continue to be significantly underfunded, and year-to-year solvency is not always guaranteed.  It is important to inquire about the financial health of any residency program that interests you.

Careers

Preventive Medicine is an extraordinarily broad field, and the skill set that residents acquire is somewhat dependent on the focus of their particular residency training program. This is appealing compared with the relatively narrow focus of some clinical disciplines. A resulting concern, however, is how Preventive Medicine specialists fit into the physician job market.

There are two slide shows, from the American Board of Preventive Medicine (ABPM) and the American College of Preventive Medicine (ACPM), that discuss career options in Preventive Medicine, and both are worth viewing. Preventive Medicine specialists are employed in a wide variety of positions, including public health agency leaders, medical directors, and clinical preventive medicine practitioners. Preventive Medicine physicians may work in clinics providing immunizations, tobacco cessation, or tuberculosis management. They may participate in public health preparedness activities for bioterrorism events, community health status monitoring, and outbreak investigation. They work on programs promoting food safety and curbing community violence and STD's.

There is current concern that many Preventive Medicine specialists do not seek board certification from the American Board of Preventive Medicine. The reasons for this are not completely known, but it is possible that the high rate of double boarding plays a role. Many Preventive Medicine specialists who are board-certified in a clinical medical specialty may not wish to seek an additional official board certification.  There is also concern that Preventive Medicine board certification is not required for many of the jobs best suited to Preventive Medicine specialists; the value of board certification may be low in the job market. A current Job Market Initiative coordinated by the American Association of Public Health Physicians (AAPHP) and the American College of Preventive Medicine (ACPM) addresses some of these concerns.

A common question is whether "stand alone" training in Preventive Medicine is sufficient for becoming a competent and employable board-certified physician.  Like most questions in Preventive Medicine, you will get a different answer depending on whom you ask.  Preventive Medicine specialists who are also board-certified in a clinical discipline may encourage double boarding; likewise, clinical preventive medicine practitioners may feel that full residency training in another specialty is important.  If you ask a Preventive Medicine specialist who is involved in leading a public health agency, or works on health policy, he or she may feel that additional residency training contributes little.  This is an ongoing debate within Preventive Medicine, so you will need to use your own judgment to make a decision.