Preventive medicine: what do future practitioners really need? Are they getting it in medical school?

The purposes of our study were (1) to determine preventive medicine topics most relevant to clinical practice, and (2) to determine if medical education affects medical students' attitudes regarding preventive medicine. Our method of study was two surveys. The first survey asked practicing physicians to rank the 23 topics identified in the Healthy People 2000 monograph and determine their usefulness in clinical practice. The second survey assessed medical students' attitudes about preventive medicine. Practitioners ranked tobacco, cancer, and diabetes as most relevant to the actual clinical practice of medicine. There were no correlations between practitioners' gender, age, or region and their rankings of topics. In terms of specialties, surgeons felt preventive medicine was less important than did family practitioners. Medical students' attitudes about preventive practices became significantly more positive as they progressed through medical school. Survey scores also improved significantly in second year students after their preventive medicine course. Students planning to be surgeons were less positive about preventive medicine. There is a continuing need for prevention education in medical school curricula, especially about tobacco, cancer, diabetes, and nutrition. Epidemiology and disease reporting might best be presented as "how to read the literature."