Clinical Informatics Becomes a Board-certified Medical Subspecialty Following ABMS Vote

September 22, 2011
AMIA to offer prep courses for clinicians who sit for Board Exam

Washington, DC—Today, AMIA—the association for informatics professionals—announces the success of a multi-year initiative to elevate clinical informatics to an American Board of Medical Specialties (ABMS) subspecialty certified by an examination administered by the American Board of Preventive Medicine and available to physicians who have primary specialty certification through the American Board of Medical Specialties. Joining such subspecialties as pediatric anesthesiology, medical toxicology, sports medicine, geriatrics medicine, and cardiovascular disease, clinical informatics (CI) certification will be based on a rigorous set of core competencies, heavily influenced by publications on the subject that were developed by AMIA and its members, many of whom have pioneered the field and supported CI’s new status as an ABMS-recognized area of clinical expertise. The goal for the first board exam is to have it available in Fall 2012, with the first certificates awarded early in 2013. To prepare physicians who wish to sit for this examination, AMIA is developing preparatory materials both as online and in-person courses starting Spring 2012.

"It is entirely appropriate and timely to certify clinical informatics as a specialized area of training and expertise in an era when more and more clinicians are turning to data-driven, computer-assisted clinical decision support to provide care for their patients," said AMIA’s Board of Directors Chair Nancy M. Lorenzi, PhD, of Vanderbilt University Medical Center. “Clinical informatics blends medical and informatics knowledge to support and optimize healthcare delivery."

Medical students and residents don't know about the preventive medicine residency

Over the years, I've spoken with a number of medical students and residents who knew nothing about the preventive medicine residency.

These medical students and residents are not familiar with the ACPM - American College of Preventive Medicine or the American Board of Preventive Medicine (ABPM). You can become board certified in preventive medicine. Medical students and residents are also not familiar with the Preventive Medicine Residency & Fellowship programs offered by the CDC. They don't realize that they can get an MPH while they go through a preventive medicine residency.

The American Board of Medical Specialties (ABMS) recognizes preventive medicine as a specialty and here's a list of preventive medicine general and subspecialty certificates:

General Certificate(s)

• Aerospace Medicine*
• Occupational Medicine*
• Public Health and General Preventive Medicine*

Subspecialty Certificates

• Medical Toxicology
• Undersea and Hyperbaric Medicine

To learn more about preventive medicine, start with the American College of Preventive Medicine (ACPM) and the American Board of Preventive Medicine (ABPM).

Government public health opportunities because of ARRA

Looking for a public health job? You can find some here on the NonClinicalJobs.com Job Board.

Communities Putting Prevention to Work (CPPW) is an initiative developed by the HHS. It's a part of the American Recovery and Reinvestment Act of 2009 or ARRA. The goal of the HHS initiative – Communities Putting Prevention to Work – is to reduce risk factors and prevent/delay chronic disease and promote wellness in both children and adults. The initiative was launched by HHS in a press briefing held on September 17, 2009.

$372.8 million, funded by the American Recovery and Reinvestment Act of 2009, has been awarded nationally to 44 communities, including cities, states, towns, and tribes. $120 million will support States and Territories in promoting wellness and preventing chronic disease through state-wide policy and environmental change for chronic disease prevention and to increase tobacco cessation through expanded quit lines and tobacco cessation media. $32.5 million will support state chronic disease self-management programs.

If you're thinking about a career in public health, get involved with your local public health organization as they leverage these stimulus funds to develop a robust CPPW initiative that focuses on wellness and disease prevention. Click here to view a list of grantees by state.

In the Philadelphia area, you may want to get to know Giridhar Mallya, MD, MSHP, Director of Policy and Planning, Philadelphia Department of Public Health and Project Director for CPPW.

Dr. Mallya will be giving a talk titled, "Creating Healthy Communities: Tobacco Use, Nutrition, and Physical Activity"

Wednesday June 16, 2010 from 6:30 PM - 8:00 PM (ET)

The College of Physicians of Philadelphia
19 South 22nd Street
Philadelphia, PA 19103

You can learn about Dr. Mallya's upcoming lecture here.

Deputy Director of Health

Here's an interesting public health job position titled, "Deputy Director of Health." Here's some more information:

Description:
The position of Deputy Director in a large urban health department is quite challenging. On the one hand, the Deputy must be able to “fill in” for the Director when the Director is out-of-town, on vacation or working on another issue. As a result, the Deputy plays a role in all of the major programs in the department. To do this, the Deputy Director must achieve working knowledge of many areas of public health programming. Additionally, the Deputy must have deeper responsibility with regards to several programs in the Department. The Deputy will spend some time becoming oriented to several programs before being given full administrative responsibility. The first program area over which the Deputy will assume deeper responsibility will be Division of Communicable Disease Prevention and Control. This is the area of the health department that requires the most physician input and has the greatest visibility in the community. This division houses four different types of clinics and associated communicable disease control programs The Deputy Director has both administrative and medical responsibilities. The medical responsibilities include, but are not limited to the establishment and periodic review of health and medical policies, conduct of epidemiologic investigations, provision of advice and consultation to practicing physicians and others within the community relative to management of cases of public health importance and supervising the work of other physicians and other professional staff within the department. The administrative responsibilities consist of acting for, and in place of the County Health Director in all matters of public health administration. The work is performed in accordance with the general policies and objectives prescribed by the Monroe County administration and with applicable State and Federal law and guidance. The Deputy Director will be asked to speak to the media about local public health issues when the Director is not available. The Deputy Director may be asked to sit on boards and advisory bodies in the community. The Deputy may be asked to attend statewide and national meetings related to local public health programs. As the current Department Director is nearing retirement age, appointment as Deputy Director at this time may be viewed by applicants as a step toward appointment as Department Director.

Compensation:
$115,115-$145,436.

Qualifications:
Candidates for Deputy Director must be physicians licensed to practice in the State of New York. In addition, it is preferred that the candidate hold a Masters Degree in Public Health or Epidemiology (or a closely related field) or be eligible or certified by the American Board of Preventive Medicine in either Preventive Medicine or Public Health. Candidates must have two years of administrative experience in a health related organization or government agency. Alternatively, the candidate may have certification by one of the American Boards as a diplomate in Internal Medicine, Pediatrics, Geriatrics, Family Medicine and/or one of their respective subspecialties plus two year full-time or its part-time/volunteer equivalent experience in supervision, management, research or practice in one of the following areas: communicable disease control, chronic disease control, epidemiology or general public health.

Notice how the job description indicates a preference for an MPH, but this is not a mandatory requirement. Many physicians have the misconception that they are unable to work in the public health field unless they have an MPH. Click here for all the details about this current public health job posting.

Careers in Preventive Medicine

What type of careers can you pursue if you complete a preventive medicine residency? Well, let's look at one example. If you visit the University of Maryland Preventive Medicine Residency (PMR) Program website, you'll see a section called "Positions Held by Graduates." Here's what you'll see on that page:

• Federal
• Project Officer, National Heart, Lung and Blood Institute
• Epidemiologist, National Center for Health Services Research
• Project Evaluation, Food and Drug Administration
• Director of Refugee Health, U.S. Public Health Service
• Branch Chief, >National Institute of Allergy and Infectious Diseases


• Public Health
• Director, Division of Epidemiology and Disease Control, Maryland State Health Department
• Health Officer, Department of Health, Charles County, Maryland
• Director, Department of Public Health, Waterbury, Connecticut
• AIDS Medical Consultant, Baltimore County Health Department
• Chief, Center for Community Epidemiology, Maryland State Health Department


• Private Industry
• Occupational Medicine, ARMCO Steel Corporation, Pennsylvania
• Associate Director of Epidemiology, Merck, Sharpe and Dohme
• Director of Epidemiology, Abbott Laboratories


• Clinical Preventive Medicine
• Department of Family Medicine, Spartanburg S.C. Regional Medical Center
• Internal Medicine, Johns Hopkins Health Plan, Baltimore, Maryland
• Primary Prevention Program, Group Health Association, Washington, D.C.
• Medical Director, CMC Eastpoint, Baltimore, Maryland


• Academic Medicine
• Assistant Chief, Community Medicine, Baylor College of Medicine
• Associate Professor, Preventive Medicine and Community Health, University of Rochester School of Medicine
• Associate Professor, Epidemiology and Preventive Medicine and Pediatrics, University of Maryland School of Medicine
• Assistant Professor of Epidemiology, University of South Carolina

The nice thing about a preventive medicine residency is that you'll come out with an extra degree: an MPH. You're saving on tuition, plus you're receiving a salary as a resident, so it's actually a really great deal. Remember that several preventive medicine residency programs do not participate in ERAS, so you'll have to do some research to learn more about them. Speaking of ERAS, here's what you'll see on their site regarding Preventive Medicine:

Preventive Medicine specialties focus on the health of individuals, communities and defined populations. Preventive Medicine's three specialty areas share common core competencies, but emphasize different populations, environments or practice settings: 1) Public Health/General Preventive Medicine (PH/GPM), 2) Occupational and Environmental Medicine (OEM), and 3) Aerospace Medicine (AM).

PH/GPM manages population-based & individual prevention in clinical, academic, public health, and private settings. http://www.acpm.org.

OEM deals with populations & individuals, by promoting health & productivity, prevention & treatment of illness and injury in workers & in people with environmental exposures. http://www.aoec.org.

AM promotes the health and well-being of crew and passengers involved in air & space travel. http://www.asma.org.

Multiple career options through preventive medicine

So many medical students are unaware of preventive medicine. They don't even recognize that it's on the American Board of Medical Specialties (ABMS) list. There's no mandatory requirement to go through preventive medicine rotations during medical school, so most students don't get exposed to this specialty. Here's some data from the ABPM (American Board of Preventive Medicine) about preventive medicine:

Preventive medicine has three specialty areas with common core knowledge, skills, and competencies that emphasize different populations, environments, or practice settings:

• aerospace medicine,
  
• occupational medicine, and
  
• public health and general preventive medicine.

The ABPM also offers fellowships in preventive medicine as well. Currently, there are two subspecialties (but I imagine this list will grow in the future):

• Medical Toxicology
  
• Undersea Hyperbaric Medicine

To learn more about preventive medicine, visit the American Board of Preventive Medicine (ABPM) website here: http://www.theabpm.org

MPH during residency?

One question that often comes up is: "Should I get an MPH (Master of Public Health) while I'm going through residency?"

• If you're in a preventive medicine residency, you're probably getting an MPH through your residency program.
• If you're in a fairly "busy" residency, you probably won't have time for the MPH coursework during residency. You could take one year off and do an intensive one-year MPH.
• If you're in a rather "cush" residency, then I suppose you could take a few MPH courses and start your MPH degree. However, you probably won't finish the MPH before your residency is over.
  

Remember: you can always get your MPH after you complete your residency. If you take one or two courses each semester, it's really not too bad.

A Taste of Chapter 1 from My Book

I'd like to share bits and pieces of my book as I write different sections. I'm currently writing Chapter 5 and I'm using stories to illustrate some examples of non-clinical career options for medical school graduates. Here's a very rough draft segment of Chapter 1:

During medical school, one of my close friends (I’ll call her Sandy) decided that clinical medicine wasn’t right for her. She attended a prestigious undergraduate university, had stunning MCAT scores, and a perfect GPA. During medical school, she took some time off to get involved in research and she published several papers. Her attending thought that she was going to be a superstar physician. However, she didn’t enjoy the patient encounter and she struggled emotionally with the burdens associated with clinical care. She couldn’t sleep at night because she was so concerned about her patients in the ICU. Her clinical rotations were destroying her and she ultimately decided not to pursue residency.

When she told me that she wasn’t going to apply for residency, I was shocked and I didn’t know what she was going to do. In fact, she also didn’t know. Her school counselors tried to convince her to pursue clinical medicine. They made it sound like she would be wasting all her education if she didn’t practice medicine. Since she had some significant student loans, she really didn’t know what to do.

Sandy started doing some research and getting reconnected with her college colleagues. It didn’t take long, and during her fourth year of medical school, she was interviewing at various companies and exploring the possibilities that were out there in the world of non-clinical medicine. She loved to write, so she finally ended up working in a medical education company and worked her way up to be a Vice President of Medical Affairs.

There are many people like Sandy who find themselves in a position where they realize that they don’t want to practice medicine. Sandy didn’t enter medical school with the intent of pursuing a non-clinical career. She also didn’t have an MBA, so she wasn’t the business-minded physician executive.

Most medical schools don’t teach students about non-clinical career options. In fact, most medical schools don’t even teach students about some of the uncommon specialties like Preventive Medicine (and all the subspecialties within it such as Medical Toxicology and Undersea & Hyperbaric Medicine). Medical schools also don’t properly equip students about the business side of healthcare. I’m not just talking about practice management. Physicians should be educated about what happens within the medical industry. They should know what happens within pharmaceutical, biotechnology, and medical device companies. They should also learn about market research practices and have a clear understanding of the differences between industry-supported marketing versus industry-supported certified medical education (CME). In the past, those two may have been considered synonymous, but that’s changed dramatically since the early 2000’s when the ACCME (Accreditation Council for Continuing Medical Education) updated its guidelines on certified continuing medical education. These are just a few examples of thing medical students don’t learn in medical school or residency training. As a result, physicians who decide to leave clinical practice end up feeling very lost about their options. I hope you’ll find this book to be helpful as I lay out my personal journey and share with you some of my insights as I’ve researched and written about various types of non-clinical opportunities for physicians.

American Board of Preventive Medicine (ABPM) Certifications

The American Board of Preventive Medicine (ABPM) was incorporated in 1948 and has gone through quite a few changes over the years. Instead of offering certification in a single medical specialty, it offers board certifications in several, including:

• Occupational medicine (1955)
• Aerospace medicine (1953, formerly called Aviation medicine, name changed in 1963)
• General preventive medicine (1963) - which is now called public health and general preventive medicine (1983)
• Undersea and hyperbaric medicine (1989)
• Medical toxicology (1992)

So, if you're considering a non-clinical career, you may wish to explore some options in the world of preventive medicine. The latest certification was added in 1992 and I won't be surprised if a few more get added over the next few decades.

The Board consists of members from the following organizations:

• Aerospace Medical Association
• American College of Occupational and Environmental Medicine
• American College of Preventive Medicine
• American Medical Association
• Association of Schools of Public Health
• Association of Teachers of Preventive Medicine
• Trustees of the American Board of Preventive Medicine

Have you ever considered being a NASA astronaut physician?