Studies & Degrees in Community Medicine
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A new branch of medicine provides comprehensive health services for the prevention of illness, promotion of health, curative and rehabilitative services to the community is called Community Medicine. Community Medicine, like preventive and social medicine, public health and community health, shares a mutual understanding and that is, to take care of the local community. The concern does not focus on the optimum health of the individual anymore; instead it has expanded into those that concern the community as well. The key factor in making the “Health for All” goal is through Community Medicine.
New problems concerning slums, accumulation of refuse and human excreta, overcrowding as well as other social problems developed during the industrial revolution of the 18th century. Frequent disease outbreaks such as cholera gained the attention of the people and the government to better the health conditions of the public. A great sanitary awakening was brought about by the Public Health Act of 1848 in England as a sign of acceptance to the fact that the state is responsible for the people’s health. A more comprehensive act was made in 1875 known as the Public Health Act of 1875. The American Public Health Association was created in 1872 as an organized professional body.
To become a specialist in Community Medicine, a medical student is required 5 years of approved residency training after medical school which includes:
- Basic Clinical Training for one to two years
- Three years in a RCPSC-approved, university-sponsored program which includes course work in the community medicine sciences and responsibilities.
- Further training for another year in a RCPSC-approved, university-sponsored programs that can include residency in any relevant clinical specialty usually internal medicine, pediatrics, obstetrics or psychiatry
- Clinical Training for two years through the Family Medicine Residency Program which leads to the eligibility to gain certification for family medicine (CCFP).
- Students are also required one year of academic courses in Community Medicine plus an additional one year of minimum field placement.
There are various settings where a community medicine specialist can work in. The highest percentage work in an administrative office, followed by a university or faculty medicine, academic centers for health sciences or research unit, and lastly in private offices or clinics. The following are the career options for the Community Medicine Specialist:
- Public Health Officer in State or Central Health Services
- Project Health Manager
- Family Physician
- Clinical Instructor or Teacher in a University or Public Health Schools
45% of community medicine specialists state that their main patient-care setting is an inter-professional practice. Those who are into group practice are on-call and all the expenses including office staff, equipment and office space are equally shared and divided among the physicians. A small percent of 17% engage in a solo practice.
40% or two-fifths of the community medicine specialist’s income comes from a salary and only one-fifth and below receive 90+% of their income from sessions or hourly rates. 27% get their income from a mixed source such as free-for-service, capitation, per session contract, benefits or pensions, or on-call remuneration.
Job positions for Community Medicine:
People of the community who may or may not have access to appropriate health care services can turn to a Health Advocate who focuses on such population segments for support. A Health Advocate can opt to primarily focus on a single parent household to make sure that the primary caregiver and the children visit a physician on a regular basis regardless if the family has no health insurance policy with very little financial funds to support medication and the physician check-ups. Some advocates choose to deal basically with older patients or persons living together with individuals sick with AIDS or HIV or people with chronic and permanent disabilities.
The Health Advocate can function in diverse ways which make working in the field more exciting. An advocate is often involved in shelling out important information to various clients in the private and public aspects. An advocate can teach a diabetic client for example the differences between simple and complex carbohydrates, know how to maintain a balanced nutrition and food portions, and the role of daily exercise as a part of the ongoing health regimen.
Advocates can wish to work in any setting or area of the health care system such as hospitals or functioning as a liaison between the hospital and the community. He or she can opt to be a part of a community health agency such as free clinic. Health Advocates are also being employed by insurance companies to help in evaluating the claims filed by the clients. Since the specific duties are dependent on the type of position handled, there is no doubt that a Health Advocate can be as versatile as can be.
The role of a Health Advocate is to assist members of a particular community with their problems and to find solutions for those that are related to health care as well as their health insurance needs; they can also locate and research on all the latest treatments for a medical conditions, give second opinions to help enrich peace of mind, do initial check-up on clients or refer them to specialists; and obtain information on health in an unbiased way.
To become a Health Advocate you have to have a college degree. Community medicine specialists who choose to practice as health advocates have a far greater edge in this field compared to others who do not have medical science-related courses. There are certain colleges who do offer programs on health advocacy, but mostly, degrees in specializations are more accepted. Among the companies that specialize in health advocacy is the National Patient Advocate Foundation which employs Health Advocates to assure that every client is given the chance to make informed decisions regarding healthcare for them. Hospitals and clinics do employ health advocates as a part of the staff to work as liaisons. Even with advanced knowledge regarding patients and their basic unit, every Health Advocate must enhance his or her knowledge and skills by attending relevant training programs.
The United States has just recently launched a wake up call for the nation’s public health workforce. Federal funding was increased in 2002 for everything that concerned public health. Public Health Advocates are now in high demand with various advancement opportunities. Annual salary ranges from $37,050 to $ 161,400.