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.
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 |