Preventive Medicine - Public Health Residency Program
Director: Angela Dearinger MD, MPH
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 at each PGY-2 and PGY-3 level. The residency program has two tracks available, traditional Public Health -General Preventive Medicine and Cancer Prevention. The program combines academic and practicum phases of training, allowing these activities to be intermingled over two years. Practicum experiences in PGY-2 are more observational; while, PGY-3 practicum experiences are more direct. Earning the MPH degree is a requirement for completion of the residency. The MPH courses are offered within the University of Kentucky's College of Public Health. The College 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 and knowledge needed to protect, promote and maintain the health of populations – resulting in the prevention of disease, disability and death. Working in clinical and administrative settings, the resident becomes well-versed in how systems of healthcare are managed to address the health needs of diverse populations. In this two-year combined residency, class instruction will be carefully matched with practicum experience to maximally reinforce new expertise gained. 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 resident activities. Residents, faculty and the program itself are rigorously evaluated with revisions made when indicated. The vision of this residency is to graduate knowledgeable, effective, and well-rounded public health and preventive medicine specialists.
The academic component of the residency includes:
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:
NOTE: General requirements of incoming Preventive Medicine residents include:
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. Each resident will spend six months at each of the following practicum sites: a state public health agency, a local health department, a VA medical center, and the University of Kentucky Medical Center. The objectives for each practicum site may be met over a series of rotations occurring during PGY2 and/or PGY3.
All of the preceptors have had many years of public health management experience in addition to careers as clinicians. Dr. Angela Dearinger has extensive clinical experience and is triple board certified in Pediatrics, Internal Medicine and Preventive Medicine. She also directs the Kentucky Public Health Research Network, one of the first public health practice- based research networks (PBRN) in the country. Dr. F. Douglas Scutchfield is internationally known for his expertise in public health services and systems research. As 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, but 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. Ray Garman has worked in a variety of occupational health settings. He has a special interest in pulmonary medicine and injuries of the hand. Dr. David Mannino, Chair of the Department of Preventive Medicine and Environmental Health, has international recognition as an expert in pulmonary medicine.
In this combined residency, core competencies are addressed in PGY-2 while the resident is taking core and required classes (See "Academics tab"). Residents have 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 General Preventive Medicine 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. During practicum rotations, residents-
With funding from the American Cancer Society (ACS), we offer a Preventive Medicine Cancer Track where residents focus on population- based cancer prevention and control. The Cancer Prevention resident experience includes time at the Kentucky Cancer Registry, the Markey Cancer Center and the Rural Cancer Prevention Center. These practicum rotations emphasize-
At each of the practicum sites, preceptors assure that residents identify ancillary, management, and administration tools. 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, the resident has additional experiences in public health practice, clinical preventive medicine, epidemiology, and health administration and management. Each of these areas reinforces 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, employee health clinics, and family medicine clinics. 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 the capstone project or a specially assigned project, the resident designs and conducts 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 implement wellness interventions, 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.
Over the course of a typical two-year residency, classes are 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's 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 residents' coursework depends significantly on their own interest beyond the core degree requirements. Residents may concentrate in Health Services Management, Biostatistics, Epidemiology, Health Behavior, or Preventive Medicine and Environmental Health. Residents who have more managerial interests may take courses in management, economics, and organizational behavior. Residents may take advanced courses in biostatistics, such as regression and correlation. 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 electives in one of the five concentration areas. In addition, a three hour public health overview course (CPH 663), three hours of field practicum experience, and capstone project are required. All students are required to take three semester hours of research.
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:
CPH 609 Practicum Field and CPH 608 Public Health Capstone Project MPH course requirements are typically completed with "selectives" in the residents' chosen area of concentration, such as Health Services Management. The choice of concentration is dependent on the professional interests and goals of the resident.
Examples of Selective Courses:
The resident's capstone project will be research focused and will possibly be submitted as a manuscript to a peer reviewed journal.
Residents are provided with the following resources:
Applications are accepted from any physician who has completed an ACGME accredited clinical training year (PGY1) 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:
Inquiries should be directed to Deana Bellis. Authors of letters of recommendation should mail them directly to the Program Coordinator at the following address:
Preventive Medicine Residency Program Coordinator
College of Public Health
111 Washington Avenue, Suite 220
Lexington, KY 40536-0003