Developing primary care curricula in preventive medicine: some practical considerations.

I describe a practical approach to developing primary care curricular in preventive medicine, starting with the articulation of a rationale that relates training to current medical education, mortality, medical manpower, and health care system characteristics. I discuss recommended features of the ambulatory care setting for instruction and include automated record systems, practice teams, multidisciplinary staff, faculty role models, conferences and rounds, and needs of low-income populations. Further, I advocate a careful review of the three-year residency curriculum including conferences, rounds, and rotations to identify elements of the desired curriculum on which to build preventive medicine training so as to alter scheduling minimally. I consider longitudinal as well as block rotation experiences. I highlight published resources for defining preventive medicine content areas and recommend local resources for preventive medicine training and for involving residents in personal health promotion. Finally, I offer an example of a family medicine resident experience in breast and cervical cancer screening to illustrate an approach to accomplishing specific objectives for preventive medicine training.