A curriculum in health systems and public health for internal medicine residents

Medical educators and accreditation organizations recognize that healthcare professionals in the future will depend on working knowledge of the larger contexts and systems of health care, including population and public health. Little published guidance on medical education in health systems and public health exists, particularly for graduate medical education.

This study describes the evaluation of a curriculum in health systems and public health which was successfully implemented in an internal medicine residency training program.

A pilot program consisting of a week-long didactic curriculum for senior residents, including ten half-day seminars. Two cycles of the pilot curriculum were implemented in September and November, 2007.

The participants were third-year residents in an internal medicine training program at a large, urban academic medical center.

The 1-week curriculum was fully implemented and evaluated in the academic years 2008-2010. It included seminars on health policy and economics, health insurance, technology and cost assessment, legal medicine, public health, community-oriented primary care, and local health department initiatives.

Residents evaluated the quality and impact of the seminars and overall curriculum, retrospectively assessed their knowledge of topics presented before and after the seminars, and rated the seminars that were most valuable to them.

The seminars were highly rated by the participating residents, and the curriculum was judged by them to be valuable in their clinical activities and professional development.

Key lessons learned included the importance of accessing resources external to the residency program and the challenge of making learning in health systems and public health active and relevant to clinical practice.