Department of Preventive Medicine and Environmental HealthPreventive Medicine - Public Health Residency ProgramDirector: Dr. Douglas Scutchfield
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- Overview
- Competencies
- Academics
- Resources for Residents
- Application Process
The University of Kentucky’s Department of Preventive Medicine and Environmental Health offers a General Preventive Medicine - Public Health residency program with four positions – two each at the PGY-2 and PGY-3 levels. The Program combines academic and practicum phases of training – allowing practicum and academic activities to be intermingled over two years. Practicum experiences in PGY-2 are more observational; whereas, PGY-3 practicum experiences are more direct and include independent provision of preventive services. Attaining the MPH degree is a requirement for completion of the residency. The MPH courses are offered within the University of Kentucky College of Public Health which is a fully-accredited school of public health and an active participant in the Association of Schools of Public Health. The College is committed to Translating Research and Education into Policy and Practice.
The Program provides its graduates with the skills, knowledge and attitudes to protect, promote, and maintain the health of defined populations – resulting in prevention of disease, disability and death. Working in clinical and administrative settings, the resident becomes well-versed in how systems of healthcare can be manipulated and maintained to optimally address the health needs of a variety of populations and across the spectrum of the specialty. In this two-year combined residency, class instruction will be carefully matched with practicum experience so that they will maximally reinforce each other. The residency program emphasizes a deliberate selection process, a wide range of quality instructional courses, thoughtful design of educational plans for each resident, and in-depth tracking of the activities of each resident, in fulfillment of the learning objectives of their educational plan. Residents, faculty and the program itself are rigorously evaluated, and revisions made where indicated. The products of this residency are informed, effective, and well-rounded professionals.
The academic component of the residency includes:
- coursework in Health Services Administration, Public Health Practice, Managerial Medicine, Environmental Health, Biostatistics, Epidemiology, Health Behavior, and Clinicical Preventive Medicine.
- extra-curricular didactic experiences is to expose the resident to real-world applications of the pricniples of preventive medicine, and to think critically about how health and quality of life can abe optimized for both individuals and populations. These activities include:
- A capstone research project
- didactic activities - Journal Club, grand rounds, state/national meetings, and self learning.
The practicum experience is designed to be flexible in providing core and specialty competencies in a variety of settings that represent a spectrum of health concerns and issues including:
- how different organizational structures are required to address the different settings in which preventive medicine and public health are practiced
- how the approach to delivering population or individual preventive services must be adapted to population characteristics and settings.
NOTE: General requirements of preventive medicine residents include:
- their PGY-1 experience must include at least 11 months of direct patient care
- they must be licensed by the Kentucky Board of Medical Licensure
- they must be able to attend evening classes, make day trips to offsite rotations, and provide outpatient clinical care in public health settings
- they must have basic computer skills
The Program Director and each resident collaborate in designing a unique practicum experience. In doing so, they choose among experiences offered at community health centers, worksite wellness programs, state and local health departments, health maintenance organizations, outpatient clinics, and community organizations. These exposures will provide the resident with experience in planning and delivering both individual and population-based preventive services. The default practicum rotation will be six months at a state public health agency, six months at a local health department, six months at a VA medical center, and six months at the University of Kentucky Medical Center. The six months allotted to each site will not necessarily be consecutive. The objectives for each practicum site may be met over a series of rotations occurring during PGY2 and/or PGY3. Residents are expected to have a Kentucky medical license, to practice clinical public health, and have basic computer skills.
All of the preceptors have had many years of public health management experience in addition to careers as clinicians. Dr. Scutchfield’s experience in epidemiologic assessments, residency training, teaching, health services management, and publishing is vast. Because the Department already has an Occupational Medicine residency, the preceptors in this specialty will not only mentor the residents in the core occupational and environmental health competencies, they will also be able to provide selected residents with an in-depth experience in this field should that be required by that resident’s Educational Plan. Dr. McKnight, Chair of the Department of Preventive Medicine and Environmental Health, has national and international recognition as an expert on agricultural health and safety. Dr. Garman has worked in a variety of occupational health settings. He has a special interest in pulmonary medicine and injuries of the hand. Dr. Prince is an expert in independent medical exams, physiologic monitoring for toxic exposures, and travel medicine. At the state health department, Dr. Humbaugh has been a private practitioner and an epidemiologist in a variety of settings, including the CDC. At the local health department, Dr. Rice Leach has had a long career of managing large urban health departments.
- Approach to Core Competencies
- Approach to Competencies Specific to Preventive Medicine – Public Health
In this combined residency, core competencies are addressed in PGY-2 while the resident is taking some of the core and required classes (See "Academics tab"). Residents has the opportunity to use the knowledge foundation, acquired during classes to develop skills and undertake responsibilities in real life situations. Many of the class experiences are specifically designed to give the residents background and experience in the core competency areas. The practicum builds upon this with multiple opportunities to meet each of the competencies and core requirements at a variety of the practicum sites.
In addition to time spent in rotation at the University of Kentucky, the typical resident experience includes a total of 18 months (including class time) at the Veterans Affairs Medical Center (VAMC), a local health department, and a state health department. The two health departments can account for 12 months of rotation. During practicum rotations, residents -
- identify the organization and management structure at the site, as well as how the health programs are administered and evaluated.
- become involved in population health, employee health, safety and health, and management meetings. In addition to the management and administration training this provides, this also gives them practice with communication and presentation skills to a variety of group settings.
- become familiar with (and involved in) the processes of identifying and allocating resources in a variety of industrial, academic, and government settings. This is done in the context of using epidemiologic tools to identify healthcare and organizational needs, and measuring effectiveness.
- acquire an understanding of the health, and social culture of an organization, employee groups, and/or communities involved.
- prepare reports and give oral presentations. Emphasis is made throughout the program in identifying group needs and expectations, and communicating in a way to respond with professionalism and integrity.
At each of the practicum sites, preceptors assure that residents identify ancillary, management, and administration tools, particularly computer support in managing health and safety programs. They describe tracking and reporting programs used, as well as any information systems utilized by the site. These systems often assist in the generation of reports required by public health agencies, OSHA and other regulations and laws. Residents become familiar with the practical applications of these health and environmental laws and regulations and their application in a variety of settings. Privacy and patient advocacy are emphasized from both regulatory and ethical perspectives. In addition to their roles in public health practice, fitness/risk, and medical surveillance, residents also become involved with health promotion and more general preventive efforts at the sites. They often design and/or implement specific public health screening programs for groups (such as health risk assessments). They also advise individual patients regarding their risk factors and ways to enhance their health. Regular didactic sessions for PGY-2 and PGY-3 residents are designed to address all of the core competencies. These sessions provide a forum for resident and faculty interaction on research reports related to the evidence base for preventive medicine practice.
In addition to practicum experiences to deliver the core competencies, the PM-PH resident has additional experiences in public health practice, clinical preventive medicine, epidemiology and health administration and management. Each of these areas reinforce medical knowledge, interpersonal communication, practice-based learning and improvement, professionalism, and systems-based practice. During PGY-2, the resident becomes familiar with and observes each of these areas. In PGY-3, the resident has a more in-depth involvement, including some independent mastery experiences.
During the rotations at the health departments, the resident becomes familiar with the function of public health leaders and how they assure that the essential functions of public health are being met. The resident has the opportunity to observe how public health leaders interact with staff, civic leaders, regulators, federal agencies, and policy makers. The resident becomes familiar with processes whereby public health activities are funded and the mechanisms for allocating resources to meet the public’s needs for health-related services, monitoring, regulation and research. In addition, the resident is assigned a special project related to at least two of the ten essential public health functions. The resident has direct contact with patients in preventive medicine settings, and is also involved with preventive medicine from an administrative perspective. Direct clinical experience comes from participation in travel medicine clinics, well-child clinics, and employee health clinics. These experiences provide competencies in primary prevention. Participation in the chronic disease clinics at the VA Medical Center provide secondary and tertiary prevention competencies. In addition, residents are asked to assist in administrative projects that consider how closely preventive care follows the evidence base. In doing so, the resident gains a working knowledge of the recommendations of the US Preventive Services Task Force, the process of guideline development, conducting searches to establish an evidence base, and access to guidelines (such as www.guidelines.gov). The resident also becomes familiar with the determinants of physician/provider preventive practice behavior change, and may become involved in a project to implement an intervention to improve clinical preventive practices.
Drawing from either the capstone project or a specially assigned project, the resident designs and conduct an epidemiologic outcome study that draws on the academic competencies, and relates them to real-life situations. Planning for this project is incorporated into the resident’s orientation so that, as academic and core competencies are being met, the resident can identify situations that could become a part of the epidemiologic outcome study. The proper use of statistical methods is an essential part of this activity.
Depending on the interests of the resident, there are a wide range of opportunities for developing competencies in medical management and medical administration. Using core competencies in management and administration, each resident is required to participate in some aspect of upper-level management involving at least one of the following: use of electronic medical record data to take administrative action; design and implementation of wellness interventions in an incarcerated population; construction and use of an electronic database to track population health variables; participatory approach to strategic planning to address public health concerns; budgeting that matches strategic plans with resources available; use of organization financial data to inform organization’s activities; participatory action research approach to addressing public health concerns; clinical preventive services medical record audit leading to recommendations for change in clinical practice; facilitating discussions with clinical providers leading to consensus adoption of local preventive services guidelines; analysis of large datasets (such as MEDPAR) to formulate policy recommendations; addressing disparities in preventive health care; marketing preventive health services; and interactions with state and local legislators regarding public health issues. A template is used for tracking the PMPH competencies as they are attained.
Academic Requirements and Offerings
Since this is a combined preventive medicine residency program there is no “academic phase” per se. Over the course of a typical two-year residency, classes are judiciously intermingled with practicum experiences. The Program Director works with the resident to identify “self learning” exercises in advance of formal classes where doing so enhances the learning opportunities of a particular practicum experience.
Resident coursework is typically completed at the University of Kentucky College of Public Health which is a fully-accredited school of public health and an active participant in the Association of Schools of Public Health. The College is commited to Translating Research and Education into Policy and Practice. The residents’ coursework depends significantly on their own interest beyond the core degree requirements. Residents who have more managerial orientations may take courses in management, economics, and organizational behavior. Residents may take advanced courses in biostatistics, such as regression and correlation. Residents are required to take only one epidemiology course, but elective courses in advanced epidemiology are also offered. All MPH instructors are members of the University of Kentucky graduate faculty.
The MPH degree requires a minimum of 42 credit hours. All students must complete 15 semester hours of required core coursework and at least 15 hours of specialty work in one of the five concentration areas. In addition, a three hour public health overview course (CPH 663) and three hours of field practicum experience are required. All students are required to take at least one 3-hour elective.
The MPH core course requirements provide a broad overview of the disciplines of public health and the basic principles of public health practice. Specialty coursework develops the skills and knowledge upon which to build or enhance a career in public health. Selective courses are available in each of the five concentration areas: Epidemiology, Environmental Health, Biostatistics, Health Behavior, and Health Services Management. The culminating experience is a research-based capstone project that requires a formal written product and a final examination presentation.
Required Core Courses:
- CPH605 Epidemiology
- STA580 Basic biostatistics
- CPH601 Occ/Env Health I
- CPH650 Mgmnt Public Health Orgs
- CPH604 Public Health & Disease Prevention
Required non-core Courses:
- Advanced Public Health Practice and Administration (CPH663)
- Public Health Finance and Accounting (HSM 635), and
- Research Methods for Health Behavior/Public Health (CPH646 or CPH647)
The MPH course requirement is typically completed with “selectives” in Health Services Management (HSM), and at least one elective which can be in the field of Health Behavior, Toxicology, Epidemiology, Biostatistics and in other centers within the University (public administration, environmental design, etc). Instead of HSM, residents may choose one of the other concentration areas listed above (e.g. epidemiology) if it is more appropriate to their professional interests.
Elective Courses:
- HSM614 Managerial Epidemiology
- CPH617 Occupational & Environ Epidemiology
- TOX 509 Concepts of Toxicology
- CPH653 Public Health Law & Policy
- CPH758 Special Topic: Evid-Bsd Strat Planning
- CPH646 Maternal & Child Health
- CPH646 Ecology & Health Behavior
- CPH646 Health & Culture
- CPH711 Chronic Disease Epidemiology
- CPH718 Cancer Epidemiology
- MED616 Biology and Treatment of Cancer
The resident’s capstone project will be research focused and will dovetail with the practicum learning objective of submitting a manuscript to a refereed journal.
Residents are provided with the following resources:
- desks equipped with computer and electronic devices and programs to facilitate state-of-art communications
- administrative assistant services
- a discretionary fund of $1,000 per year to attend a professional conference. Additional funds are available for travel, lodging, and per diem as needed for expenses incurred during off-site rotations.
- departmental libraries at the administrative and clinic sites.
- The Medical Center Library (MCL) is located nearby. It is a member of the University of Kentucky campus library system of 15 libraries. Total print volumes owned by the MCL is 239,000 and total non-print volumes is 34,000. Electronic book and journal titles owned by the MCL is 3,500 but total electronic book and journal titles accessible by our users is 92,000 (including thousands of titles on medicine, social sciences and human behavior). Any journal not available is obtained by purchase or made available electronically via document delivery. Off campus access is available through a proxy server.
- The University of Kentucky Young Library (main library) which houses some 3.5 million texts.
- Public Health grand rounds, and many other conferences/rounds throughout the medical center and the University.
Applications are accepted from any physician who has completed an ACGME accredited clinical training year (PG1) that has provided at least six months of direct patient contact. The standard Residency Program Application form should be used. The application should also accompany the following:
- Electronic Residency Application Service
- One-page personal statement
- Curriculum vitae
- Medical school transcript
- Copy of Medical School Diploma
- Dean’s letter from medical school (optional)
- Certificate of completion of PG1 clinical year (and subsequent years, if applicable)
- Copy of board certification, where applicable
- Upon request, three letters of recommendation, one of which will be from the Program Director at the end of preliminary (clinical) year, and will include the following:
- a statement that the applicant completed 12 months of PGY1 training, at least 6 of which were direct patient care
- completion of the Global Resident Competency Rating Form
- Copy of current licensure and DEA certificate
- Copy of USMLE, FLEX, or other nationally recognized assessment examination results
Inquiries should be directed to Deana Bellis, Associate Director, Residency Program. Authors of letters of recommendation should mail them directly to the Program Coordinator at the following address:
Deana Bellis
Residency Program Coordinator
College of Public Health
121 Washington Avenue, Suite 220
Lexington, KY 40536-0003
Phone: 859-218-2100
Fax: 859-257-9862