DSH - Patton: Preventive Medicine Resident Program

Loma Linda University Preventive Medicine Resident Program at Department of State Hospitals (DSH) - Patton

Loma Linda University offers a Preventive Medicine Residency Program to medical school graduates and residents interested in health promotion.  This three-year program trains physicians in disease prevention by developing skills in research, health promotion, administration, and policy development.   Preventive medicine graduates work in a wide variety of fields:

  • Public Health
  • Administration
  • Outpatient Primary Care
  • Occupational Medicine

The first year (PGY-1) is an internship, attained either through the preventive medicine program or programs in other specialties/universities.  In the second year, residents spend much of their time in academic training, working to complete a Masters in Public Health (MPH).  Residents also work in primary care clinics and learn the basics of research.  The final year of training is mostly clinical and research -- applying skills learned from the classroom.   As part of this training, residents work at DSH - Patton under the guidance of the public health office.

Loma Linda preventive medicine residents have been working at DSH - Patton since 1986.  During that time, residents have contributed in many important ways to the hospital.  Each of the learning projects has benefited DSH - Patton by helping to solve a problem, develop a policy, investigate or study the epidemiology of a disease, or develop a system of value to the institution.

Residents learn to design and/or conduct outbreak or cluster investigations, as well as to organize epidemiological studies and surveillance.  Results have also been used to guide public health policy at DSH - Patton.  Other skills that residents learn include:  program quality assessments based on measurable criteria, computer applications (database management, statistical analysis, word processing) relevant to preventive medicine, and diagnosis and management of preventable diseases/injuries/conditions.  Residents can also work on implementing screening programs, implementing individual/community risk factor modifications, and communicating with health care professionals and target groups about potential health hazards and therapies.

In general, a preventive medicine resident spends three months at DSH - Patton.  Some residents return for a second or third rotation.  DSH - Patton pays for the services of one "full-time equivalent" resident.  This time is usually divided among two or more different residents working on various projects a few half days a week.  The residents are under the direct supervision of Dr. Ronald Hattis, MD, MPH, Chief Physician, who is an associate clinical professor on the Loma Linda faculty in preventive medicine and health administration.  In addition to working with Dr. Hattis, the residents work closely with other members of the public health staff on research, writing, and presentation of projects and policies.

In the past, residents have worked on a variety of projects.  For example, the residents have been active in many aspects of HIV/AIDS education.  This includes literature reviews on federal AIDS control strategies.  Residents have helped formulate policies on AIDS education for patients.  Protocols for HIV antibody testing, managing HIV infected patients, and post-exposure prophylaxis have been designed, and residents have also helped in HIV counselor training and lecturing on AIDS to counselors.  Residents have gained administrative experience with quality improvement techniques by analyzing performance of HIV counselors and evaluating compliance with HIV/AIDS education requirements.

Other examples of resident contributions include creating policy for the management of Hepatitis B and C.   Research on Hepatitis B carrier status and associated risks and the use of Interferon for the treatment of Hepatitis C have been recent projects improving resident education and public health at DSH - Patton.  Residents have also participated in policies for monitoring patients, testing and interpreting results, and counseling carriers.

Some residents have elected to spend their time developing clinical skills through the employee health clinic and the patient health clinic.  Others use and develop computer skills such as word processing (Word Perfect, MS Word), data management and analysis (MS Access, Epi-Info, SPSS), and presentations (PowerPoint); some of this experience is used to make recommendations on health risk appraisal software for DSH - Patton and instructing staff on various computer programs (e.g. Epi-Info).  Administrative projects in the past have included participation in infection control meetings, developing statistical reports needed for Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation surveys, and developing a proposal for patient movement tracking to monitor infectious disease exposures.

Some other examples of residents’ activities in policy development at DSH - Patton include:   addressing air pollution concerns by developing patient management algorithms for periods of high temperatures/poor air quality and developing a protocol for treadmill testing and a method for analyzing ECG abnormalities in the presence of psychotropic medications.  Residents have also worked on immunization policies, including pneumococcal vaccine use, updating patient fact sheets, and development of a Varicella immunization protocol.  Residents contribute to infection control policies, such as infection control in the ECG/EEG lab, employee infection control policy, revision of the Infection Control manual for JCAHO review, and creating an infection control manual for employees.  Other areas of policy development include infectious waste management, injury prevention, smoking cessation, sexually transmitted disease testing and therapy, and tuberculosis guidelines.

The Loma Linda Preventive Medicine Residency Program provides physicians with the tools needed to excel in public health and disease prevention.  These skills will become more valuable as concern increases over the high costs associated with the traditional medical model.  DSH - Patton offers an outstanding opportunity to develop the key skills required by the preventive medicine physician.

For further information, contact: Ronald Hattis, M.D. at (909) 425-7876.