University of Pittsburgh

Preventive Medicine

Prevention: Tobacco Cessation, Obesity

Background

Preventive medicine and health maintenance are essential aspects for 21st century medical practice. With this in mind, this content was identified as one of the key learning domains in the Learning Objectives for the Medical Student Curriculum.

Goals

Specific objectives of the UPSOM curriculum are that students become knowledgeable about the principles and practice of preventive medicine, and that they develop skills to eeffectively educate and counsel patients and families using sound principles for changing patients' behaviors in order to promote and improve their health.

Implementation

The preventive medicine theme permeates the curriculum, beginning during the first and second years in the Clinical Experiences courses. In the classroom, students learn about the principles of immunization, substance abuse, and other topics. During the clinical component of the course, much of which is with primary care preceptors, students gain first-hand experience with how practicing physicians approach prevention.

Substance abuse, sexual practices, and other potentially difficult to discuss topics are addressed during the first year Medical Interviewing course, as students develop their skills while interacting with standardized patients.

Content relevant to prevention is also integrated within the second year Organ System Block courses. For example, the impact of cholesterol reduction on vascular disease is addressed in the Body Fluids Homeostasis-Cardiovascular course. Tobacco cessation and health and wellness are addressed in the Body Fluids Homeostasis–Pulmonary course.

Many topics in preventive medicine are covered within the third year clinical clerkships. Tobacco cessation, alcohol use, immunization, effective disease screening and anticipatory guidance are among the topics covered in the Combined Ambulatory Medicine and Pediatrics Clerkship and the Family Medicine Clerkship. Student experiences with tobacco, alcohol, and obesity counseling are recorded in the clerkship Learning Logs. In the Pediatric Inpatient Medicine Clerkship and the Obstetrics and Gynecology Clerkship, well and preventive care and disease screening are emphasized.

Please refer to the overlapping theme, Substance Abuse, for additional information on current approaches, the tobacco cessation curriculum, and on the SBIRT curriculum.

The concept of preventive care can be quite broadly interpreted to include a spectrum of topics, including many that extend across traditional boundaries from medicine to dental medicine and public health. The Healthy People 2010 Objectives demonstrate how comprehensive this theme can be.

Impact

The topic of preventive medicine has been broadly integrated across the UPSOM curriculum. It is included in a number of courses and is addressed in a wide range of formats, including classroom instruction and discussions, reading materials, interactions with standardized patients, and clerkship experiences with preceptors and patients. This is ensuring that students are becoming well versed in the principles and practice of preventive medicine and that they are developing skills to effectively educate and counsel patients to promote and improve their health. Though managing the expense of comprehensive preventive health care has not yet been achieved by our society, our physicians now must deliver that care. The inclusion of preventive medicine topics across the curriculum is preparing students to meet this challenge.