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Prev Med. 2020 Mar 14;134:106060. doi: 10.1016/j.ypmed.2020.106060. [Epub ahead of print]

Preventive medicine's equivalence problem.

Author information

Health Resources and Services Administration, Rockville, MD 20857, United States of America. Electronic address:
University of Maryland, School of Public Health, College Park, MD, United States of America.


The structure of preventive medicine residency training in the U.S. warrants serious examination. U.S. public health and general preventive medicine residencies have suffered a 17% decline in the number of residency programs since 2000, and current residency programs are, on average, half-empty. The required clinical year is not unique to preventive medicine, a basic, undifferentiated MPH for preventive medicine doesn't distinguish the preventive medicine specialist, and practicum year requirements are overly broad and not necessarily specific to the specialty, leaving the specialty vulnerable to equivalence by most other specialties. Strategies including creation of an additional preventive medicine-specific clinical year, developing a new public health degree for the specialty, and more specific practicum rotations, as well as potentially changing the specialty's name and altering the annual structure of training, are proposed along with an equivalence test.


Graduate medical education; Preventive medicine; Public health; Residency; Training

Conflict of interest statement

Declaration of competing interest The views expressed in the article are solely the opinions of the authors and do not necessarily reflect the official policies of the U.S. Department of Health and Human Services (HHS) or the Health Resources and Services Administration (HRSA), nor does mention of the names of HHS or HRSA imply endorsement by the US government. Paul Jung and Boris D. Lushniak are both Fellows of the American College of Preventive Medicine. Dr. Lushniak is a Regent on the Board of the American College of Preventive Medicine.

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