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  Griffin Hospital

Combined Internal/Preventive Medicine Program

Four-year Combined Program in General Internal Medicine/Preventive Medicine (IM/PM)

Introduction

The importance of preventive and population-based principles in clinical practice is widely acknowledged. The challenge of imparting these skills in either undergraduate or postgraduate medical education has, however, not been fully met. Such skills are provided comprehensively by preventive medicine residency programs, but at the expense of clinical training. Sequential residencies in primary care and preventive medicine, the currently available means of obtaining thorough preparation in both clinical and population-based principles, represent an inefficient, generally unappealing, and non-integrated approach.

Dr. James Jekel
James F. Jekel, MD, MPH
Chairman & Associate Program Director (PM)
Dr. Haq Nawaz
Haq Nawaz, MD, MPH,
Program Director
Send email: haqnawaz@pol.net
Dr. Dorthea Wild

Dorothea Wild, MD, M.P.H., Dr. Med.
Associate Program Director
Email Dr. Wild:
dwild@griffinhealth.org

In response to these concerns, and in an effort to make preventive medicine training appeal to a wider audience, we have developed and implemented a residency program fully integrating internal and preventive medicine. The program meets, and generally exceeds, the requirements of both specialty boards over a 4-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 board eligibility. The model we describe is ideally wed to the demands of the modern health care environment in the US.

Program Structure:

Griffin Hospital, in conjunction with the Yale University School of Public Health, offers a unique, 4-year training program combining Internal Medicine with Preventive Medicine (IM-PM). Residents in this program obtain a masters degree in public health (MPH) from the Yale University School of Public Health fully subsidized by Griffin Hospital. The program cultivates expertise in clinical decision making and patient care, while developing skills in research methodology, teaching, community-based health promotion and epidemiology. Training includes on-site experience in a variety of health care settings, including both state and local departments of public health. Upon completion of training, successful graduates will be eligible for boards in both internal medicine and preventive medicine, and will be well prepared for careers in primary care clinical practice, managed care organizations, and academia.

Affiliations

The Program requires an array of inter-institutional affiliations to support a diversity of clinical, academic, and practicum rotations. The IM/PM residency at GH is affiliated with:

  • the Yale University School of Public Health
  • the Yale University School of Medicine
  • Yale-New Haven Hospital
  • Yale University Occupational Medicine Program
  • the Connecticut Department of Public Health
  • the Departments of Public Health of the Lower Naugatuck Valley
  • the Departments of Public Health, city of Stamford
  • the Departments of Public Health, city of Stratford
  • the Departments of Public Health, city of New Haven
  • the Departments of Public Health, city of Bridgeport (Pending)
  • the Connecticut State General Assembly
  • The Center for Outcome Research & Evaluation at Yale (CORE)
  • the Yale Health Plan (a staff model HMO)
  • the Connecticut Planned Parenthood
  • the Yale-Griffin Prevention Research Center
  • the Center for Science in the Public Interest
  • the Women Health Access Program
  • the Center of Excellence in Women Health
  • Yale Injury Prevention Program
  • the Assocation of Teachers of Preventive Medicine
  • the American College of Preventive Medicine

Aspects of training not addressed through institutional affiliation may be addressed through faculty affiliations. As an example, the chairperson for the Connecticut State Legislature Health Care Subcommittee is a member of the PM residency advisory committee, and serves as a rotation preceptor.

Overview of Progam Structure

Year 1:

11 months- Clinical Rotations

Geriatrics, Ambulatory Medicine

Year 2:
2 months

Clinical Rotations

4 months

MPH coursework (Fall semester)

5 months

Clinical Rotations

Year 3:

2 months

Public Health Rotations

3 months

Clinical Rotations

Integrated Rotations

2 months

Clinical Rotations

4 months

MPH coursework
(Spring semester)

Year 4:

6 months

Clinical Rotations

Integrated Rotations

5 months

Clinical Rotations

Adolescent Medicine

 

Typical Rotation Schedule

*Note: This is an exmaple of a typical schedule and may different for each resident.

PGY-1 PGY-2 PGY-3 PGY-4
Gen Med Gen Med Gen Med Gen Med
Gen Med ICU Gen Med Gen Med
Gen Med MPH Night Float ICU
Gen Med MPH Telemetery Night Float
ICU MPH Elective Practicum
Telemetery MPH Ambulatory Practicum
Telemetery Gen Med Practicum Practicum
Night Float Telemetery MPH Practicum
ER Gen Med MPH Practicum
Elective Geriatrics MPH Practicum
Ambulatory Fight Float MPH Practicum
Vacation Vacation Vacation Vacation