Public health physicians - An endangered species

Background: Questions have arisen regarding the competency levels of the va rious professions within the public health sector, including those of physi cians. Protection of the nation's health requires that physicians on the pu blic health team be competent practitioners of both medicine and public hea lth. Physicians practicing in this arena are required to possess a vast arr ay of knowledge, skills, and attitudes to be effective contributors in the field. Methods: Using focus groups of key informants in public health, the context of practice, inventory of required competencies, current competencies, and identified gaps in these competencies, measures to address the situation w ere identified and discussed. Results: Recommendations from the focus groups include: use of distance-bas ed learning, development of educational materials and programs, use of the American College of Preventive Medicine as a facilitator, improved remunera tion, changes to the certification process, utilization of mentoring progra ms, introduction of new marketing strategies, use of professional publicati ons, and increased governmental/agency support. Contributors to this endeav or are identified. Conclusions: While we strive to improve the physician workforce entering th e field, creative strategies for continued lifelong learning are urgently n eeded to facilitate ongoing development of physicians in the current public health workforce. This situation presents a major research agenda for publ ic health practice. Identification of the essential knowledge, skills, and attitudes for public health physicians is the first step toward narrowing g aps in required competencies.