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PubMed1976

Is there a discipline of community medicine?

Community Medicine is a distinct and definable discipline. Through Community Medicine Departments of medical schools and hospitals, patient care, teaching and research programs are conducted in an integrated fashion, concerned with a broad definition of health which is beyond the range of other clinical departments. Because Community Medicine is a developing field, and Departments of Community Medicine are not rigidly tied to traditional approaches, there exist unusual opportunities for new design and fresh insight. Community Medicine is in the fore of Medicine's ability to evolve with the society around us. Community Medicine both identifies the need for change, and acts as an agent for the change. There are obstacles. The most difficult challenges we face are obtaining curriculum time for a new discipline which, to those caught in "the vice-like irrational grip of tradition" (18), may not appear worthy; and ridding ourselves of the sterotype that the hospital can be the single unified source of health care for all community people. These problems are being resolved, however, and the inherent value of community medicine as a new body of theory and practice becomes increasingly clear.

Ambulatory Care↗
PubMed1977

Community medicine.

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Community Medicine↗
PubMed1978

A student's perspective on community medicine and the health crisis.

Community medicine is more difficult to teach and to learn than the traditional medical sciences. Teachers of community health have an interest in the rigors and theory of epidemiology and biostatistics, while most students plan a career in patient care. Abstractions and statistical data need not be presented unless it can be shown that these are the "physical findings" of a community and that they have value in the discovery of the etiology of disease, the prediction of risks, and the delivery of health care. Community medicine curricula must include experiential learning, with real patients and problems, in order to prove that health is affected by culture, politics, the environment, and individual behavior. If a student-physician's concern for community health is to be enduring, it must match in sophistication his skill in clinical medicine.

Community Medicine↗
PubMed1979

Community medicine in the training of family physicians.

Family practice residency programs are encouraged to include community medicine training in their curriculum, but there is little agreement as to what community medicine is or what would constitute appropriate training. Community medicine is most commonly defined as a discipline concerned with the identification and solution of health care problems of communities or other defined populations. The inclusion of training experiences in the identification and solution of health care problems of communities has two basic advantages for family practice residency programs: it fosters a contextual approach in the care of individual patients and it builds knowledge and skills for those who will work with communities in future practices. An example of curricular content is included. A survey was conducted in order to determine what residency programs teach in the field of community medicine. The results show that few of the responding programs include the areas which most clearly relate to community medicine. It is hoped that the report of these results, the rationale presented for including community medicine in the training of family physicians, and the suggested outline of curricular content will further encourage and assist family practice residency programs to incorporate such training in their curricula.

Community Medicine↗
PubMed1979

A structured experiential curriculum in community medicine.

In order to provide experimental training in community medicine, a structured curriculum has been developed. Specific methodological skills in community medicine are identified and nine content areas are presented in seminar form during the three-year training program. Each resident is expected to participate in a community health care project and demonstrate one or more of the methodological skills identified. The experiences of two residents are reported. One involved a community health needs assessment and one, the development of a mechanism to ensure continuing consumer/provider communication.

Community Medicine↗
PubMed1976

Community medicine: success or failure?

The development of university-based community-medicine programs represents one of the most fundamental reforms in medical education in recent times. These programs have attempted to train and motivate students to undertake research and innovations in health service and health-care systems, and to provide service to those in need. Since community medicine is based upon the collective needs of population groups, its relevance, value and effectiveness as a teaching, research and service device in the United States must be seriously questioned unless the prevailing system of individualized care is fundamentally changed to one of collective and regionalized organization. Moreover, working with small population groups, university programs do not provide a large enough epidemiologic base to serve as models for this reform. In developing countries community medicine has proved to be ineffective when isolated from broader socioeconomic development, and should, as now constituted, be abandoned as an independent undertaking.

Attitude to Health↗