Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts, USA.
Am J Prev Med. 2011 Oct;41(4 Suppl 3):S270-5. doi: 10.1016/j.amepre.2011.06.010.
Graduate and undergraduate medical training are incorporating public health curricula into their programs to enable future physicians to participate in public health activities and improve the health of the communities. This paper highlights two approaches to a community health curriculum implemented at the Cambridge Health Alliance Internal Medicine Training Program from 2008-2010. Between 2008 and 2009, the residency program incorporated a longitudinal curriculum for first-year residents. The goal of the curriculum was to expose residents to basic community health research models while giving them time to participate in a 1-year practicum with the Cambridge Public Health Department. Strengths included increasing resident knowledge about the local public health department and providing residents with an opportunity to work with staff and patients in that setting. Limitations of such a design included staff time constraints for coordinating with community partners as well as resident dissatisfaction with being involved in only select portions of an evolving project. This curriculum was therefore revised into a 1-month ambulatory block consisting of didactics and a practicum with the local YWCA in September 2010. Residents felt that this design yielded more time in didactics than in the practicum. Both designs offer important learning points in terms of practically incorporating public health activities in a tightly scheduled residency-training program. The current paper highlights the importance of partnering with a community organization such as a public health department or the YWCA. Emphasis is placed on the contributions that residents can make to these organizations while they learn how to integrate clinical and community health activities.
研究生和本科生的医学培训正在将公共卫生课程纳入其课程中,以使未来的医生能够参与公共卫生活动并改善社区的健康状况。本文重点介绍了 2008 年至 2010 年剑桥健康联盟内科培训计划中实施的两种社区卫生课程方法。在 2008 年至 2009 年期间,住院医师培训计划纳入了针对第一年住院医师的纵向课程。该课程的目标是使住院医师接触到基本的社区卫生研究模型,同时为他们提供与剑桥公共卫生部合作进行为期 1 年实习的机会。该课程的优势包括增加住院医师对当地公共卫生部门的了解,并为住院医师提供在该环境中与工作人员和患者合作的机会。这种设计的局限性包括协调与社区合作伙伴的工作人员时间限制,以及住院医师对仅参与不断发展项目的部分内容的不满。因此,该课程在 2010 年 9 月修订为为期 1 个月的门诊课程,包括讲座和与当地 YWCA 的实习。住院医师认为,这种设计在讲座中提供了比实习更多的时间。这两种设计在实践中都为在紧张的住院医师培训计划中纳入公共卫生活动提供了重要的学习要点。本文重点介绍了与公共卫生部门或 YWCA 等社区组织合作的重要性。强调了住院医师在学习如何整合临床和社区卫生活动的同时可以为这些组织做出的贡献。