Division of Toxicology and Environmental Medicine, Environmental Medicine and Education Services Branch, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA.
Am J Prev Med. 2011 Oct;41(4 Suppl 3):S296-301. doi: 10.1016/j.amepre.2011.06.007.
Although environmental factors contribute to more than 25% of all global disease, and toxic agents ranked fifth in underlying causes of U.S. deaths in 2000, environmental medicine education is largely omitted in the continuum of U.S. medical education. The paucity of specialists trained in environmental medicine (i.e., occupational medicine and other preventive medicine specialties and subspecialties), coupled with the lack of adequate general medical education on how to prevent, diagnose, refer, or treat patients exposed to hazardous substances in the environment, contributes to lost opportunities for primary prevention or early intervention to mitigate or minimize environmentally related disease burden. Survey findings of graduating medical students over the past few years have identified environmental health as a medical school topic area that can be improved. This article reflects a panel presentation on the challenge of including environmental health in general medical education. It was given at the 2010 "Patients and Populations: Public Health in Medical Education" conference cosponsored by the CDC and the American Association of Medical Colleges. A variety of educational strategies, models, and educational resources are presented that illustrate how recommended competency-based environmental health content can be integrated into medical education to better prepare medical students and physicians without specialized expertise in environmental medicine to provide or facilitate environmental preventive or curative patient care.
尽管环境因素导致了全球超过 25%的疾病，但在 2000 年美国的死亡原因中，有毒物质仅排在第五位。然而，环境医学教育在美国医学教育的连续体中基本被忽略。接受过环境医学（如职业医学和其他预防医学专业和亚专业）培训的专家稀缺，加上缺乏足够的普通医学教育，无法预防、诊断、转介或治疗接触环境中有害物质的患者，这导致错失了初级预防或早期干预的机会，无法减轻或最小化与环境相关的疾病负担。过去几年，对即将毕业的医学生的调查结果表明，环境健康是医学院校可以改进的一个领域。本文反映了一个小组对将环境健康纳入普通医学教育的挑战的专题介绍。该小组在 2010 年由疾病预防控制中心和美国医学院协会共同主办的“患者和人群：医学教育中的公共卫生”会议上进行了介绍。本文提出了各种教育策略、模式和教育资源，说明如何将推荐的基于能力的环境健康内容整合到医学教育中，以更好地培养没有环境医学专业知识的医学生和医生，为患者提供或促进环境预防或治疗护理。
