Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Am J Prev Med. 2011 Oct;41(4 Suppl 3):S251-5. doi: 10.1016/j.amepre.2011.06.002.
Public health situations faced by family physicians and other primary care practitioners, such as severe acute respiratory syndrome (SARS) and more recently H1N1, have resulted in an increased interest to identify the public health competencies relevant to family medicine. At present there is no agreed-on set of public health competencies delineating the knowledge and skills that family physicians should possess to effectively face diverse public health challenges. Using a multi-staged, iterative process that included a detailed literature review, the authors developed a set of public health competencies relevant to primary care, identifying competencies relevant across four levels, from "post-MD" to "enhanced." Feedback from family medicine and public health educator-practitioners regarding the set of proposed "essential" competencies indicated the need for a more limited, feasible set of "priority" areas to be highlighted during residency training. This focused set of public health competencies has begun to guide relevant components of the University of Toronto's Family Medicine Residency Program curriculum, including academic half-days; clinical experiences, especially identifying "teachable moments" during patient encounters; resident academic projects; and elective public health agency placements. These competencies will also be used to guide the development of a family medicine-public health primer and faculty development sessions to support family medicine faculty facilitating residents to achieve these competencies. Once more fully implemented, an evaluation will be initiated to determine the degree to which these public health competencies are being achieved by family medicine graduates, especially whether they attained the knowledge, skills, and confidence necessary to effectively face diverse public health situations-from common to emergent.
家庭医生和其他基层医疗从业者所面临的公共卫生状况，如严重急性呼吸系统综合症（SARS）和最近的 H1N1 流感，使得人们越来越关注确定与家庭医学相关的公共卫生能力。目前，还没有一套公认的公共卫生能力来描述家庭医生应该具备的知识和技能，以有效应对各种公共卫生挑战。本研究采用多阶段、迭代的方法，包括详细的文献回顾，作者制定了一套与基层医疗相关的公共卫生能力，确定了跨越四个层次的能力，从“医学后”到“增强”。家庭医学和公共卫生教育-从业者对拟议的“基本”能力的反馈表明，需要突出更有限、可行的“优先”领域。这组重点公共卫生能力已开始指导多伦多大学家庭医学住院医师培训计划课程的相关部分，包括学术半天；临床经验，特别是在患者就诊期间识别“可教时刻”；住院医师学术项目；和选择公共卫生机构实习。这些能力也将用于指导家庭医学-公共卫生入门教材和师资发展课程的开发，以支持家庭医学教师帮助住院医师实现这些能力。一旦更全面地实施，将启动评估，以确定家庭医学毕业生在多大程度上实现了这些公共卫生能力，特别是他们是否获得了有效应对各种公共卫生情况（从常见到突发）所需的知识、技能和信心。
