The Evolving Role of Public Health in Medical Education

Abstract

Medical education in the twentieth century was largely influenced by the Flexner Report, with significant proportions of instruction dedicated to the molecular underpinnings of the pathologic pathways and minimal mention of the socio-ecological determinants of health. When examining the predominant diseases of the twenty first century landscape, widening health disparities, and significant changes in the United States healthcare system, it is imperative to view wellness and sickness in a broader public health context rather than a singular focus of the biomedical model. While undergraduate opportunities to study public health are on the rise in the United States, there is a parallel urgency for medical curricula to recognize the importance of the complex interrelated socio-ecological root causes of health, well-being, and illness. In order to reduce the risk of non-communicable diseases and increase health equity, it is necessary for medical education to integrate core public health knowledge and competencies. Contemporary health challenges require a public health approach, in addition to clinical skills, for physicians to provide equitable care. The COVID-19 pandemic further underscores the necessity to mitigate the effects of socio-ecological determinants of health. Seven key recommendations are presented from a training to practice timeline emphasizing the important linkages between medical education, socio-ecological influences on health, and public health. As the health challenges in society and communities shift, so too must training of future physicians. There is a need and an opportunity for medicine and public health to address the shared health challenges of our global society.

Integrating clinical and public health knowledge in support of joint medical practice

“…Closer ties between clinical medicine and public health have been advocated more recently [ 1 , 2 ] as well as in the past. Writing for the practitioners and academics who feel themselves responsible for teamwork and professionalism in their services and also for accessibility of care in the community, we argue for the effective epistemological integration of these two disciplines.…”

Knowledge, Attitudes, and Social Responsiveness Toward Corona Virus Disease 2019 (COVID-19) Among Chinese Medical Students—Thoughts on Medical Education

“…The majority of medical personnel are obviously deficient in the knowledge and skills of responding to emergencies. They can only temporarily train and learn protective skills in the face of an outbreak, which increases the risk of infection (6,35). In the early stage of the response to the epidemic, we had to reflect on the unexpected casualties caused by the insufficient public health literacy of front-line medical personnel.…”

“…Importantly, the pandemic sounded a wake-up call for us and posed new challenges to medical education, such as insufficient emphasis on public health emergency preparedness, unsophisticated interdisciplinary cooperation mechanism, and insufficient guidance in medical ethics (5). In other words, it put forward higher and stricter requirements for disease prevention and control in the future, especially for public health security and emergency response capacity of infectious diseases (5,6).…”

Rapid Clinical Promotion Model of Standardized Training for Public Health Physicians in China

“…In recent years, the relationship between clinical medicine and public health has become increasingly close. 1 , 2 Because risks and sometimes pathologies are multiple, the goal-oriented approach of medical practice encourages and assists individuals to achieve their maximal health potential in line with individually defined goals. 3 And public health physicians need to be well informed about topical clinical procedures, interpersonal communication, and philosophy, as well as mastering the relevant behavioral skills.…”

“…Unified thinking: (1) It was necessary to cultivate the important role of standardized "medicalprevention integration and medical-prevention coordination" public health physicians in public health cause, who should master basic clinical knowledge and skills (2). It was necessary to stimulate enthusiasm for learning, and further clarify that medical literacy was the basic role of public health physicians, basic clinical knowledge and skills was a basic requirement for public health physicians to carry out their work.…”