An integrated residency in internal and preventive medicine

The importance of preventive and population-based principles in clinical pr actice is widely acknowledged. The challenge of imparting these principles in either under graduate or postgraduate medical education has, however, no t been fully met. The necessary skills are provided com prehensively by pre ventive medicine residency programs, but at the expense of clinical trainin g. Sequential residencies in primary care and preventive medicine, the curr ently available means of obtaining thorough preparation in both clinical an d population-based principles, represent an inefficient, generally unappeal ing, and non-integrated approach. In response to these concerns, and in an effort to make preventive medicine training appeal to a wider audience, the authors developed and implemented a residency program fully integrating internal and preventive medicine. Th e program meets, and generally exceeds, the requirements of both specialty boards over a four-year period. The program provides extensive training in clinical, preventive, and public health skills, along with case management and cost-effective care, conferring the MPH degree and leading to dual boar d eligibility. The model is ideally wed to the demands of the modem health care environment in the United States, is extremely attractive to applicant s, and may warrant replication both to train academic and administrative le aders and to raise the standards of preventive and public health practice i n primary care.