key: cord-0009133-4q6idwn8 authors: Contractor, Dhruti; Bellamy, Patsy; Hamilton, Doug; Koo, Denise; Kellerman, Scott title: Applied epidemiology elective at the Centers for Disease Control and Prevention, 1997–2002 date: 2004-03-10 journal: Am J Prev Med DOI: 10.1016/j.amepre.2003.10.020 sha: 9750c5534e4a0a9a3048303d731b85e210cf368c doc_id: 9133 cord_uid: 4q6idwn8 nan T he Division of Applied Public Health Training (DAPHT) at the Centers for Disease Control and Prevention (CDC) is responsible for training health professionals in preventive medicine, epidemiology, and other applied public health sciences. To increase awareness of and interest in public health and epidemiology, DAPHT has offered an elective rotation to fourth-year medical and veterinary students since 1975. The elective program is administered from July through June of the following year, and a student's rotation ranges from 6 to 8 weeks. In 1999, American Journal of Preventive Medicine (AJPM) published a description of the elective's progress-from its inception in 1975 through June 1997-including demographics of participants, the types of assignments, and the number who returned to CDC for the 2-year Epidemic Intelligence Service (EIS) postdoctoral program in applied epidemiology. 1 We have since compiled data from July 1997 through June 2002 to update AJPM's readers on the progress of the epidemiology elective. From 1975 through June 1997, enrollment in the elective peaked at 58 students during the school year July 1996 -June 1997. Since July 1997, the peak enrollment was 70 students during the July 2001-June 2002 academic year. Table 1 presents the types of assignments, background, and other information about the participating students. The trend toward greater interest in infectious disease assignments may continue because of the intense media attention surrounding the public health response to recent outbreaks of West Nile Virus, anthrax, Severe Acute Respiratory Syndrome (SARS) and monkeypox. Currently evaluation of the epidemiology elective is informal, so determining its effect on the students is difficult. Beginning this academic year, we plan to institute a formal evaluation to assess the effect of the epidemiology elective. As one measure of influence, of the 728 students participating in the elective through June 1998, almost 15% (104) had enrolled in the EIS program by March 2003. (Note that medical students must complete at least an internship before they apply to EIS and most complete a residency in a clinical specialty.) While the 6-to 8-week epidemiology electives will continue to be a valuable introduction to applied public health, DAPHT has worked to identify ways to allow students a more in-depth and integrated CDC experience. With a grant from The Pfizer Foundation and Pfizer Inc. through the CDC Foundation, DAPHT is developing a 10 -12 month fellowship in applied epidemiology for eight competitively selected medical students, beginning in Fall 2004 (i.e., The CDC Experience at www.thecdcfoundation.org/thecdcexperience). The program offers students a combination of didactic training and interactive seminars, participation in applied epidemiology projects (including Epi-Aids and other field investigations), and opportunities to present their work. The students will benefit from direct mentoring by their specific assignment supervisors and the many opportunities to network with public health professionals working in a variety of areas. Although the fellowship assignments will be based primarily in noninfectious disease programs at CDC, the students will be assured a wide range of experiences and opportunities in all fields. In addition, the fellowship's emphasis on noncommunicable disease and the role of public health in clinical medicine will provide students with a firm grounding in applied public health regardless of their future career paths. Several organizations have underscored the importance of integrating public health concepts into undergraduate medical education. [2] [3] [4] Most recently, the Institute of Medicine (IOM), in their report "Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century," stated that all medical students should receive "basic public health training in the population-based prevention approaches to health." 5 To the Editor: In their article that assessed the association between alcohol consumption patterns and farm work-related injuries, Drs. Stallones and Xiang 1 used quantity and frequency measures to assess average daily alcohol consumption. Although widely used, this methodology does not identify binge-drinking episodes, the most risky pattern of drinking. One of the reasons for this limitation is that quantity/frequency measures typically underestimate binge alcohol use, generally defined as the consumption of five or more alcoholic drinks on one occasion. 2 Information on binge drinking is important because this pattern of use is an important indicator of alcohol misuse among all drinkers 3 and is strongly associated with injury-related outcomes. 4, 5 Studies have also shown that most binge drinkers are moderate drinkers on the basis of their average daily consumption and that there are as many binge-drinking episodes among moderate drinkers as among heavy drinkers. 6 This surprisingly high rate of binge drinking among moderate drinkers might actually help explain the authors' finding that the incidence rate of farm injuries was higher among Colorado farm residents who reported consuming an average of one to two drinks/day than among Colorado farm residents who reported consuming three or more drinks/day. As a result, alcohol researchers often index average daily consumption to capture binge-drinking episodes. 7 Therefore, although we applaud the authors for their study showing that alcohol consumption was significantly associated with farm workϪrelated injuries, we believe that their characterization of this relationship would have been more complete had they specifically assessed the effect of binge drinking. An elective rotation in applied epidemiology with the Centers for Disease Control and Prevention (CDC), 1975-1997 The Informatics Panel and the Population Health Perspective Panel. Contemporary issues in medicine: medical informatics and population health Inventory of knowledge and skills relating to disease prevention and health promotion Prevention for the 21st century: setting the context through undergraduate medical education Who will keep the public healthy? Educating public health professionals for the 21st century Alcohol consumption patterns and work-related injuries among Colorado farm residents Binge drinking and the American college student: what's five drinks? Validation of a single screening question for problem drinking Infectious disease: 438 (69) Medical: 548 (87) 1975-1979: 16/year 278 (44) through Veterinary: 84 (13) 1980-1989: 29/year Chronic disease: 59 (9) Other*: 40 (7) 1990-1997: 42/year (Total range: 11 in 1976 to Chronic disease: 26 (8) Other a : 28 (6) Medical: 246 (75) Veterinary: 81 (25) 1997-2002: 56/year (Total range: 43 in Note: Dhruti Contractor was a Public Health Prevention Specialist in this division at the time this article was written.