Medical and Public Health Education Public Health Practice and Academic Medicine: Promising Partnerships Regional Medicine Public Health Education Centers—Two Cycles Rika Maeshiro rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr The partnering of the academic medicine and public services in academic settings). Although not identi- health communities to improve the health of popula- cal to the Core Functions or Essential Services of public tions seems natural; however, collaboration between health, “education, research, and service” to improve the two groups has not been standard practice. This health appear to be shared objectives in the portfo- series of articles will highlight examples of what are lios of public health practice and academic medicine. hopefully a growing number of successful partnerships This month’s column will review recent collaborations between academic medicine and public health practice aimed at improving medical student education in pop- that are intended to improve health status. Readers are ulation health, focusing particularly on the establish- encouraged to contribute their experiences in public ment of Regional Medicine–Public Health Education health practice–academic medicine partnerships from Centers (RMPHECs). the perspectives of public health practitioners and/or Incorporating prevention- and population-based medical educators. health into the medical curriculum has been a challenge The Association of American Medical Colleges to US medical education for decades. Advocates for im- (AAMC) is a nonprofit association dedicated to improv- proving public health content in medical education be- ing the nation’s health by enhancing the effectiveness lieve that a better-informed physician workforce will of academic medicine. When the AAMC was founded respond more effectively to the needs of their patients, in 1876 to help reform medical education, the asso- their communities, and their public health colleagues, ciation represented only medical schools. Currently, the AAMC represents the accredited allopathic med- ical schools in the United States (125) and Canada (17); Corresponding author: Rika Maeshiro, MD, MPH, Association of American nearly 400 major teaching hospitals, including 98 af- Medical Colleges, 2450 N Street, NW, Washington, DC 20037 (e-mail: filiated health systems and 68 Veterans Affairs medi- [email protected]). cal centers; 94 academic and professional societies that Editors Note: I am very pleased to announce that starting with this July issue of represent 109,000 faculty members; and the nation’s the Journal of Public Health Management and Practice, we have a new column: Medical and Public Health Education. The column editor is Rika Maeshiro, MD, 67,000 medical students and 104,000 physicians in res- MPH, Assistant Vice President for Public Health and Prevention, Association of idency training programs. AAMC’s three main mis- American Medical Colleges (AAMC). This column will focus on future physicians, sion areas mirror those of our constituents: Medical a critical element for the public health workforce, and the interaction between Education (educating the physician and medical sci- medical practitioners and public health. AAMC is increasingly active in enhancing entist workforce); Medical Research (discovering new the population health and preventive curriculum for medical students. This has the dual potential of increasing the number of practicing physicians who are oriented medical knowledge and developing innovative tech- to population-based prevention and also increasing the number of students who nologies for the prevention, diagnosis and treatment will consider preventive medicine as a career choice. We are particularly fortunate of disease); and Patient Care (providing healthcare that Rika Maeshiro has agreed to edit the column. Contributions from our readers for this column are welcome and can be directed to [email protected] qqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq J Public Health Management Practice, 2006, 12(5), 493–495 Rika Maeshiro, MD, MPH, is Assistant Vice President for Public Health and C 2006 Lippincott Williams & Wilkins, Inc. Prevention, Association of American Medical Colleges, Washington, DC. 493 494 ❘ Journal of Public Health Management and Practice translating into improved population health. Recent ef- portunity. As in the pilot RMPHEC activity, a critical forts at the AAMC to enhance population health con- and required component of the current program is the tent in medical school education began in 1998, when partnering of medical schools with public health prac- the second Medical School Objectives Project Report, titioners in local or state health departments. Collab- Contemporary Issues in Medicine: Medical Informatics and orating with additional community or public health Population Health,1 recommended that all medical stu- entities, such as area health education centers, centers dents receive training in epidemiology; biostatistics; for public health preparedness, community-based or- disease prevention/health promotion; healthcare or- ganizations, and schools of public health, was also en- ganization, management, and financing; and environ- couraged. Despite a short 4-week deadline, 47 of 125 mental and public health as part of their population eligible schools (more than 33%) submitted applica- health education. In 2000, the AAMC entered into a tions, and several more had expressed interest but could cooperative agreement with the Centers for Disease not meet the timetable. The proposals came from a Control and Prevention (CDC), in which one explicit wide spectrum of medical schools: public and private, objective was to improve the teaching of prevention and research-intensive and community-focused, large and public health at academic medical centers. The AAMC small schools, and from across the country. also contributed to the development of the Clinical Pre- In their proposals, schools were required to de- vention and Population Health Curriculum Framework2 re- scribe their current educational activities in popula- leased in 2004 through the multidisciplinary Healthy tion health, public health, prevention, and prepared- People Curriculum Task Force sponsored by the Asso- ness and to identify preexisting collaborative efforts ciation for Prevention Teaching and Research (formally between the medical school and public health entities. the Association of Teachers of Preventive Medicine) Schools then identified gaps in their educational pro- and the Association of Academic Health Centers. This gram. Selection criteria included evidence of active par- Framework identifies topics in four components (Evi- ticipation of a medical school and public health entity; dence Base of Practice; Clinical Preventive Services— senior administrative support from participating insti- Health Promotion; Health Systems and Health Policy; tutions; evidence that the proposal would provide ed- and Community Aspects of Practice) that are consid- ucational experiences for all medical students (ie, not ered “core” to the education of all health professions. only those with preexisting interests in public health); Over the last two decades, the annual Graduation Ques- and the feasibility of successful implementation. Staff tionnaire (GQ) has reflected improvement in medical from the AAMC and the CDC reviewed all applica- school graduates’ perception of their instruction in the tions. Unfortunately, the amount of funding was not preventive care topics, but according to the GQ and sufficient to award all of the many qualified and inno- the Liaison Committee on Medical Education’s (the ac- vative proposals. Eleven schools were funded by May crediting body for allopathic medical schools) annual 2006: survey, educational progress has been slower on topics Case Western Reserve University School of Medicine related to health systems/health policy, global health Harvard Medical School and environmental health. Mercer University School of Medicine To help accelerate the adoption of effective popu- Southern Illinois University School of Medicine lation health education in medical schools, in 2003, Stanford University School of Medicine through the CDC cooperative agreement, the AAMC The Brody School of Medicine at East Carolina established seven pilot Regional Medicine–Public University Health Education Centers (RMPHEC), which were de- University of California, Davis School of Medicine scribed previously in this journal.3 Although the pi- University of Colorado School of Medicine lot program was originally envisioned as a multi- University of New Mexico School of Medicine year project, funding beyond the first year was not University of Rochester School of Medicine and available, and the pilot program ended after 1 year. Dentistry Convinced that these Centers were a valuable and ef- University of Vermont College of Medicine fective method of encouraging changes in medical ed- ucation, the AAMC and the CDC embarked on a sec- The awarded schools represented well the pool of ond phase of this project in early 2006, using funds diverse institutions that had applied for this opportu- that had been left over from prior years’ cooperative nity. The principal investigators included new grantees agreement activities. A Call for Proposals was devel- as well as veterans from the pilot RMPHEC program. oped that requested applications from schools to “fully They include faculty members, associate deans, as well integrate population health into the