Specialization in Preventive Medicine &
Public Health in the U.S.: A Resolution for
21st Century Reform
Condemning Recent Attacks on Lesbian, Gay,
Bisexual, and Transgender and HIV-Related
Research
Policy
Resolution # 01-04
Title: Specialization in Preventive Medicine
& Public Health in the U.S.: A Resolution
for 21st Century Reform
Author: G.
Ethan Feldman, MD, MBA, MHA, MPH, FACPM
Date:
November 19, 2003
WHEREAS,
Many of key public health leadership roles
at the federal, state, and local levels are
being filled by professionals who have
neither completed residency training or
board certification requirements in
Preventive Medicine & Public Health, nor
become ACPM members; and
WHEREAS,
Residency specialization in Preventive
Medicine & Public Health (PM/PH) in the U.S.
has never been documented to be either well
respected, let alone well known among the
U.S. citizenry or medical community; and
WHEREAS,
Median salaries of Prevention Specialists in
the U.S. remain substantially lower than
virtually all other medical specialties; and
WHEREAS,
Many counties in the U.S. are already
projected to have insufficient numbers of
mental health &/or primary care clinicians
to properly care for patients with acute
complaints despite a prolonged period of
federal financial support for residency
training nationwide; and
WHEREAS,
Current published & anecdotal evidence does
not support a true market need, demand,
added value, or substantive return on
investment for a Preventive Medicine
specialist in either the public or private
sector; and
WHEREAS,
While the Institute of Medicine report and
other evidence-based reports claim that the
U.S. has a relative shortage of
Preventionists, there exist virtually no
published data to support the hypothesis
that PM/PH residency trained &
board-certified Preventive Medicine ACPM
physician members are more effective, save
more lives, earn more money, or receive more
employment inquiries from head hunters, or
more job offers, than those public health
physicians who are not PM/PH board-certified
or eligible; and
WHEREAS,
Recent appointees for prominent public
health positions such as the Surgeon
General, secretary of HHS, director of CDC,
NIH, & NCI, & many other major disease
prevention entities, have not come from the
ranks of physicians who have undergone
formal residency training in Preventive
Medicine & Public Health; and
WHEREAS,
The specialty training in Preventive
Medicine & Public Health was established to
help train doctors for leadership roles in
U.S. public health practice & policy;
WE HEREBY RESOLVE THE FOLLOWING
TO ENHANCE THE PRESTIGE, VALUE,
SPECIALIZATION, & STANDARDS OF TRAINING IN
PREVENTIVE MEDICINE & PUBLIC HEALTH :
1. All physicians applying for residency in
preventive medicine for training starting
July 2005 or later must have completed at
least 3 years of accredited residency
training in a clinical specialty in the U.S.
by the intended start date ;
2. All physicians who apply for board
eligibility in preventive medicine must
already be board certified in a clinical
specialty to sit for the preventive medicine
board exam;
3. Preventive Medicine residency slots will
be reduced by 33% by 2006, & by 50% by 2010;
4. The failure rate of the preventive
medicine board exam will be increased from
its current baseline up to a rate between 55
& 67%;
5. ACPM will advocate for federal
legislation mandating that all physicians
appointed to federal, state, & local public
health leadership positions shall be
board-eligible in Preventive Medicine &
Public Health by 2010.
Policy
Resolution # 02-04
Title:
Condemning Recent Attacks on Lesbian, Gay,
Bisexual, and Transgender and HIV-Related
Research
Author: Christopher R. Armstrong, MD, MPH,
FACPM
Date: December 1, 2003
Whereas, the leadership of the United States
Department of Health and Human Services (DHHS)
and some members of Congress have taken
actions that will limit the free exchange of
scientific information; intimidate
researchers and staff at the DHHS; lessen
support for Lesbian, Gay, Bisexual, and
Transgender (LGBT) and HIV research; and
threaten the health of LGBT people. Recent
actions include:
-
Withholding $75,000 originally offered for
a conference on Lesbian Health issues that
DHHS had supported the year before (1);
-
Withdrawing support of and refusing to
distribute the “Healthy People 2010
Companion Document for Lesbian, Gay,
Bisexual, and Transgender Health”
recommendations concerning LGBT health
issues (2);
- Calling
for investigations and the elimination of
funding of LGBT and HIV research projects
by members of Congress (3);
- Deciding
not to support a 2003 United Nations
sponsored resolution condemning
discrimination based on sexual orientation
(4); and
-
Supporting statements by US Senator Rick
Santorum (R-PA) equating homosexuality
with bestiality (5).
Whereas,
sexual orientation and gender identity are
intrinsic and immutable qualities—not merely
recreational options to conventional
heterosexual sex.
Whereas, the attack on LGBT health research
and programming comes at a time when the
previous Surgeon General, The American
Public Health Association, and other medical
and health organizations are calling for
increased LGBT research and lessening
disparities based on sexual orientation and
gender identity (1).
Whereas, research and programs directed
toward the health needs of LGBT people are
now facing the prospect of being unfairly
scrutinized by federal agencies and losing
their funding because of special bills in
Congress (6).
Whereas, these activities have created an
environment detrimental to LGBT health
research and program development.
Therefore, be it RESOLVED that The American
College of Preventive Medicine:
- Urges
Congressional leaders to investigate
recent attempts to undermine the
scientific peer-review process at the
National Institutes of Health.
- Urges
the President of the United States of
America, Congress, and DHHS to publicly
support the integrity of the National
Institutes of Health’s scientific
peer-review process.
- Urges
the DHHS and Congress to cease all actions
that unfairly jeopardize LGBT and HIV
research and programs.
- Urges
that DHHS recognize that LGBT people
deserve the respect and consideration now
required for racial and ethnic minority
groups, and recommit to end health
disparities based on sexual orientation
and gender identity/expression.
- Urge the
President of the United States of America
and Congress to maintain or increase the
appropriation for LGBT related research.
References
1) Lesbian conference lost help of HHS: Gay
health advocates say administration ignoring
issues. Washington Post. October 3, 2002:
A17.
2) Dean L, Meyer IH, Robinson K, Sell RL,
Sember R, Silenzio VMB, Bowen D J, Bradford
J, Rothblum E, White J, Dunn P, Lawrence A,
Wolfe D, Xavier J. Lesbian, gay, bisexual,
and transgender health: Findings and
concerns. Journal of the Gay and Lesbian
Medical Association. 2000;4(3):102-151.
3) Kaiser J. Politics and biomedicine:
Studies of gay men, prostitutes come under.
Science. 2003;300(5618): 403.
4) Feminist Majority Foundation. US to
abstain from UN human rights/sexual
orientation resolution. Available at:
http://www.feminist.org/news/newsbyte/uswirestory.asp?id=7736.
Accessed on November 12, 2003.
5) Cooperman A. Santorum angers gay rights
groups. Washington Post. April 22, 2003: A4.
6) Epstein E. House narrowly spares S.F.
study of AIDS, drugs. San Francisco
Chronicle. July 11, 2003.
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