Back to Front PageVOLUME 6, NUMBER 4

The CDC and AAMC: Public Health and Academic Medicine at the Crossroads

By Barbara A. Gabriel

Whether it's funding a multimillion-dollar study on health disparities or encouraging a single medical student's interest in public health, a new cooperative agreement between the AAMC and the Centers for Disease Control and Prevention (CDC) promises to bring together the increasingly complementary and interdependent disciplines of medicine and public health.

The agreement provides a mechanism for funding projects of interest to both the CDC and the academic medicine community, including ones that aim to enhance medical school training in public health, increase the number of underrepresented minority medical students, and reduce health disparities.

"By allowing AAMC member institutions to participate more fully in the CDC's extramural research activities, this agreement will help medical schools and teaching hospitals fulfill their mission of improving the health of the public," says AAMC President Jordan J. Cohen, M.D. "It also will support our commitment to integrate population health studies into the medical school curriculum." Population health is a key component in the AAMC Medical School Objectives Project's (MSOP) recommended learning objectives for medical school graduates.

Through the cooperative agreement mechanism, the CDC's partnering institutions broker programmatic activities between their members and the CDC's various centers, institutes, and offices. The AAMC may be asked to solicit applications from its member institutions that address specific areas of interest to the CDC. Alternatively, the AAMC may propose topics to the CDC. In each case, initial communications take place between the CDC and the AAMC. Once an award is made, the AAMC member institution works directly with the CDC.

The AAMC joins two other nonprofit academic associations - the Association of Schools of Public Health and the Association of Teachers of Preventive Medicine - that have cooperative agreements with the CDC. Over the past eight years, these two associations have collectively received $153 million in funding from the CDC. The funding level for the last fiscal year for the two totaled approximately $30 million. Although awards range from the tens of thousands into the millions, the typical CDC grant is between $100,000 and $150,000.

Rika Maeshiro, M.D., M.P.H., senior preventive medicine advisor with the CDC's Public Health Practice Program Office, is currently working at the AAMC to assist with the successful implementation of the new agreement. "In the past, medicine and public health tended to operate independently rather than collaboratively," she says. "The AAMC is clearly positioned to promote a better understanding among clinicians of their role in the public health arena."

Deborah Danoff, M.D., AAMC assistant vice president for medical education, is also assisting with the implementation process. "Traditionally in medicine, we talk about the one-on-one doctor-patient relationship," she says. "Now the medical education community is evolving to think about the individual patient as part of a family, a community, and a specific population. We need to teach medical students how to approach the broader issues this thinking engenders, particularly as they relate to prevention."

Specifically, the agreement between the CDC and the AAMC is based on four defined objectives: promoting the teaching of prevention and public health in academic medical centers; advancing the training of public health and prevention researchers; increasing the number of underrepresented minority students in medical schools; and stimulating activities aimed at eliminating health disparities.

Dr. Maeshiro adds that the agreement provides opportunities for funding the activities of individual medical students and residents as they relate to public health. "Other associations with cooperative agreements help broker opportunities for public health students to work in the CDC headquarters, in one of its satellite research facilities, or in local or state health departments, allowing them to develop a better understanding of public health practice," she explains. The new partnership with the AAMC will make these opportunities available to medical students. "

Many medical students don't know what the CDC does or the enormous scope it has," Dr. Danoff says. "If they are given the chance to work with people whose primary focus is population health, many may return to medical school wanting to specialize in this area, putting pressure on schools to expand their curricula to embrace public health studies."

But, she stresses, the agreement's benefits extend beyond medical school training. "We believe this partnership will have a significant influence on the delivery of health care and the health status of many populations."

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18 April 2001