U.S. Medical Studentsʼ Rotations in Epidemiology and Public Health at State and Local Health Departments

Abstract

Elective rotations in health departments expose medical students to public health practice and career opportunities in applied epidemiology and preventive medicine. State and county epidemiologists and health officers can serve as excellent role models for medical students. In 2000-2001, the authors identified such electives by consulting medical schools' Web sites and by contacting state epidemiologists, teachers of preventive medicine, and medical school associate deans. The authors found that electives were offered in nine state and five local health departments; these are described in detail. Those electives usually focused on infectious diseases, involved students in outbreak investigations when possible, lasted four or more weeks, were open to other students and medical residents, and were overseen by a health department preceptor with a medical school faculty appointment and a commitment to train students. Some electives included more didactic components, encouraged the student to publish a manuscript, or were coordinated by a preventive medicine residency director. The authors observe that health departments can benefit from training enthusiastic medical students via such electives; these students bring fresh ideas to the departments. Medical school catalogs, Web sites, and word of mouth are important means for promoting these electives. Ideally, in the future every medical school will offer a state or local health department elective so that all medical students will become aware of epidemiology and public health career options. The electives reported in this article can help guide additional medical schools and health departments as they initiate such rotations.

Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud

“…There have been many efforts to integrate public health concepts into medical education, in the form of classroom teaching,9–11 field experiences,12–15 dual Doctor of Medicine/Master of Public Health degree programs,16–18 and residency rotations 19–21. However, our literature review revealed only two published programs that mention social determinants of health as a thematic focus,19,21 and few undergraduate medical education programs that incorporate teaching about the social determinants of health into their curriculums 22–24…”

Public Health and Family Medicine: An Opportunity

“…A fourth-year public health practice elective could then focus on intermediate level skills and knowledge. 7 The family practice residency curriculum should review and insure the mastery of the basic level and incorporate the intermediate and advanced levels. This could be accomplished by including the content in didactics, insuring that the family practice clinic and faculty model these practices, and by developing an enhanced community medicine experience that includes these topics.…”

Integrating Public Health Into Undergraduate Medicine in North America: A Systematic Review

“…Studies reported on a combination of public (n=13) [ 9 , 10 , 16 , 19 , 20 , 25 , 26 , 28 , 32 , 37 , 40 , 42 , 44 ], global (n=9) [ 7 , 14 , 15 , 18 , 24 , 27 , 29 , 31 , 39 ], population (n=9) [ 11 , 13 , 23 , 34 , 38 , 41 , 43 , 45 , 46 ], community (n=6) [ 17 , 21 , 30 , 33 , 35 , 36 ], and epidemiological (n=1) [ 22 ] health interventions. Definitions of each of these were found to be highly overlapping; when reported, objectives of projects, although targeting different “types of public health,” were similar and often included social determinants of health (e.g., poverty, language skills, provider bias, and racism), population-level approaches to medicine, public policy, global burdens of disease, and pandemic preparedness.…”

“…The first of these interventions included one-off workshops, simulation exercises, or clerkship electives (50.0%, n=19/38) [ 7 , 10 , 13 - 15 , 17 , 19 , 21 - 23 , 26 , 27 , 29 , 31 , 32 , 37 , 39 - 41 ]. These interventions were often characterized as being stand-alone, time-limited, and isolated in the curriculum, with the rest of the four years being largely unchanged.…”