MEMORANDUM

Extensive changes have been made in the JMI procedures and web site as the result of action taken at the Preventive Medicine 2003 meeting in San Diego, late in February 2003. The major changes are the result of the adoption of a uniform list of “roles” for preventive medicine and public health physicians to serve as the basis for future outreach programming. This update to the policies and procedures went into effect 3/7/03, and supercedes the previous policies and procedures, last updated 11/21/02. The major changes relate to the formatting of the web site pages.

Reference Outline of Entire Job Market Enterprise

1. Job Market Steering Committee and Advisory Panel – for policy and oversight

2. Solicitation and posting of ads.

3. Monthly Surveillance of journals and web sites and Job Market Web Site

4. Hidden administrative activities related to Web Site

a. Site development and maintenance

b. Marketing to secure paid ads (not yet operational)

c. Billing for paid ads (not yet operational)

5. Annual Surveys (not yet operational)

a. Actual and potential employers in both public and private settings

b. Physicians completing PM residency training

c. Other PM physicians known or believed to be seeking new or alternative employment

d. Residency program Directors

e. ??Other

6. Development and Marketing of Postgraduate Fellowships (a seasonal activity conducted during winter months for fellowships to begin the following summer)

7. Outreach/Liaison to sister medical, PH and PM organizations (not yet operational)

8. Outreach/Liaison to national organizations representing actual and/or potential employers of PM physicians (not yet operational)

Introduction and Vision for Both Web Site and Database

This memo is a follow-up to the action taken by the AAPHP Board May 14, 2001 to fund the website development, and the action taken by the Job Market Steering Committee May 19, to reaffirm development of both database and web site, and make a number of policy decisions as to their development.

The purpose of the database is to track the progress (or lack thereof) of the Job Market Initiative.

The purpose of the web site is two-fold:

1. To assist PM physicians who are seeking new employment opportunities

2. To provide the data needed to guide and evaluate progress on the outreach-to-employers component of the JMI. These data will enable us to determine over time, the numbers and percentages, by employer type, that specify a requirement for or preference for a PM physician.

The mission of the Job Market initiative is to increase the quantity and quality of job market offerings that require or prefer PM physicians. The term “PM physician” is taken to mean a physician with residency training and/or board certification in General Preventive Medicine (GPM/PH), Occupational Medicine (OM) or Aerospace Medicine (AM). The Job Market Initiative is primarily oriented toward the GPM/PH-type jobs, but will also engage in limited activities relative to OM and AM jobs.

The problem with such database development is that in GPM/PH, like most if not all other medical specialties, 60% to 85% of jobs are secured through informal networking rather than through advertisements or professional/executive recruitment firms (references available from literature and from AAPHP study). This, in turn, creates a situation in which tracking of published advertisements (both hard copy and internet) can provide only a limited view of the overall job market. Such tracking, while necessary, will have to be supplemented by periodic surveys, and possibly by other data-gathering means if the trends are to be relied upon as the basis for national organization policy and for publication in peer-reviewed journals. This is further complicated in GPM/PH because of the very wide range of PM-specific jobs in both public and private settings, which range from more than 90% clinical to 0% clinical.

All this requires that we develop a web utility that is dramatically different from any other site than we have ever seen. We must list promising jobs from other sites. We must solicit employers to change their specs and qualifications – at least with regard to offering preferential consideration of PM physicians, and we must track our progress.

This web page, when fully developed is expected to list between 200 and 400 PM job opportunities each month. Most will not have been advertised for PM physicians, but would welcome and sometimes prefer such applicants. One of the major goals of the ACPM/AAPHP Job Market Initiative is to educate such employers to the value of PM qualified physicians so that they will require or prefer such qualifications on more of their job postings.

Re-Revised Working List of Roles for PM Physicians as adopted by AAPHP and ACPM Boards, February 2003, at Preventive Medicine 2003 Meeting in San Diego

Preventive Medicine differs from other medical specialties in that PM addresses health/medical issues on a population basis. All other medical specialties address health/medical issues one patient at a time.

1. Academic – primarily focused on teaching and research; mainly, but not entirely, in academic settings. Academic settings could be medical school/medical center, school of public health or other. Possible roles include deanships, department chairmanships and health services research.

2. Aerospace -- health and medical issues on individual and group bases relating to aviation and space travel.

3. Bioterrorism/Homeland Security- Crisis And Disaster Management, surveillance, preparedness, emergency response, etc. (change in title to reflect longer term perspective and more inclusive role.)

4. Clinical Preventive Medicine – Preventive medicine in a clinical setting, with the PM physician doing preventive work on a full time basis, or spending part or most of his or her time in hands-on patient care, with role to advise others in department or agency on clinical and community preventive services.

5. Correctional Health – management of public health and medical issues in prisons and jails, including surveillance, epidemiology and liaison with non-correctional healthcare providers to assure continuity of care after release from prison or jail.

6. Environmental Health

7. Epidemiology, Disease Control, and Community Health Assessment. This includes public health and academic epidemiology, disease management, the technical aspects of community health assessment and pharmacoepidemiology. This differs from the policy/management roles in that it is primarily “technical” in nature.

8. International Health

9. Policy/Management – Healthcare: (primarily or entirely policy/administration) in healthcare, managed care and other health insurance settings. (previously “Leadership/Management”)

10. Policy/Management – Public Health: (primarily or entirely policy/administration) in federal, state and local public health agencies, community health centers, schools, and non-profit settings.(previously “Leadership/Management”)

11. Military Public Health and Medical Leadership

12. Occupational Medicine – a preventive medicine specialty devoted to the health, safety and productivity of workers at their workplaces as well as in their community. It includes prevention and treatment of work-related and environmental injury and disease, wellness, health promotion, disability management, medical surveillance and productivity enhancement.

13. Quality Improvement/Patient Safety/Quality Assurance

14. Product Development in pharmaceutical and other corporate settings

15. Toxicology, Medical on both clinical and population bases, including both acute and chronic effects

16. Wellness and Health Promotion (a new area to be developed that crosses the line between “prevention of illness” and “enhancement of wellness” and deals with fitness, diet, stress

17. Other

Notes:

1. The term “Policy/Management used instead of “Managerial Medicine”

2. Many individual jobs cover multiple roles as described above. Jobs that are not 100% hands-on patient care will be classified by the highest-level non-hands-on-care role as would be perceived by a personnel director.

Process for Data Abstraction, Consolidation and Presentation

There are two major sets of data presented on the JMI web page, located at www.aaphp.org under “Jobs.” The first dataset includes all ads posted as full-page ads on the JMI web site, plus ads abstracted from selected journals and other web sites. This is referred to as the “spreadsheet database.” The second set of data consists of the full-page ads and the summary listing of such ads.

This is referred to as the “full-page-ad data set.” Both data sets are continuously updated through the month.

Spreadsheet Database: Abstracted Advertisements in Print Journals and Web Sites

1) Dr. Nitzkin and several volunteers abstract ads as they can get to them, through the month, with the data directly inputted on-line. More in the way of volunteer assistance would enable us to abstract more journals and web sites.

2) Kim Buttery, MD – the AAPHP Webmaster, maintains the web site. In this role, Dr. Nitzkin oversees Dr. Buttery’s work, in his role as Chair of the ACPM/AAPHP Job Market Initiative. The JMI Steering Committee and the AAPHP Board, in turn, oversee Dr. Nitzkin.

3) Abstraction guidelines – Our basic principle is that any job that would benefit from a physician’s knowledge of human biology, the causes and natural history of diseases, and the efficacy of preventive and therapeutic measures should be filled by a physician. If the job also involves population health issues, dynamics, and/or diagnosis and management on a group or population basis –that job would best be filled by a PM physician.

a) All PM jobs, with following notations

i) For physician positions

(1) “Director” and “Medical Director” positions included, but not “Chief of Clinical Service”

(2) The format of our job listings is adapted from the Epidemiology Monitor format. Other medical subspecialty listings, pathology, radiology and surgical positions only lightly skimmed, as PM opportunities unlikely (but not impossible) in these listings

ii) For PhD positions (any that accept PhD's)

(1) Ads are extracted if MD qualification specifically noted in ad, or job is one that would seem to benefit by medical knowledge

4) Initial abstraction from Journals and other web sites (by volunteer abstractors)

a) Candidate journals and web sites are selected.

b) If not already in hard copy, the full set of ads are printed out

c) Those qualifying for abstraction are identified, then abstracted on-line into the JMI spreadsheet database

d) The primary basic publications reviewed are the APHA journal and newsletter, NEJM and JAMA

e) The primary basic websites reviewed are the JMI web page (full page ads), and, on about a monthly basis, the ACPM and jobsusa website for CDC, FDA and NIH jobs.

5) Consolidation and quality assurance by Dr. Nitzkin

a) The abstracts are sorted by state, city and employer to eliminate duplicates

b) Once every two to four weeks, the listings are reviewed to eliminate abstracts more than 60 days old, and to assure that the JMI listed abstracts are still open for recruitment – this involves contact from Dr. Nitzkin to the respective employers on about a monthly basis.

c) The spelling and formatting of the category and subcategory designations are checked and corrected as needed.

6) The list of web sites and journals abstracted is updated through the month, as new material is added to the site. At these times, the listings that have aged-out are deleted.

7) A statistical summary report to the JMI Steering Committee and Advisory Panel is generated on or about the 15^th of each month.

8) Also see “Definitions and Data Parameters” for more detail re data abstraction

Full Page Ad Data Set

These ads are submitted to Joel L. Nitzkin. He, in turn, posts them to both the web site and to the spreadsheet, usually within the same working day they are received. Dr. Nitzkin then checks with each of the employers on about a monthly basis to assure job still available. Some ads are received from sources other than the employer. These are posted at Dr. Nitzkin’s discretion for 60 days, then deleted. At this time, Dr. Nitzkin is the sole authority and sole decision maker as to which ads are accepted for posting.

Outline of Job Market Web Page/Site

The JMI web page can be reached by a hotlink from the ACPM web site, or from the “Jobs” button on the AAPHP home page.
The opening JMI page consists of an outline of the contents, with hotlinks to each of the subsidiary pages.

3. The opening JMI page includes both AAPHP and ACPM logos, and a counter for visits to this page.

Proposed Detailed Structure of Job Market Web Page/Site

Advertising posted on Web Site (only accept jobs of interest to PM Physicians)

1. Jobs and training opportunities

2. Executive Recruitment Firms (not yet operational)

Listing of Journals and Web Sites Surveyed This Month

(Line listing of data sources, with each line containing the following:)

a. Name of journal or web site

1. Date of journal or date of data extraction from web site

Spreadsheet Format for Abstracting Lists of Jobs of interest to PM Physicians Ads by Journal and Website (One line per job, with following info)

Informational Note for database subcategory to be inserted between Master List and Categories

Clicking on a category will bring you to a line listing of jobs or training opportunities by subcategory and state. The “Other Jobs” category includes Aerospace, Correctional Health, Environmental Health, and other jobs of interest to preventive medicine and public health physicians. Epidemiology jobs are listed within each of the other categories.

The “other jobs” and “training” categories are proceeded with “x: “ as a means to assure that they consistently appear in the same location at the bottom of the listings.

Subcategories (not to be tabulated, but to appear within the listing of each category)

(This list of subcategories is for information only – this list, as a list, is not to appear on the website. This is the list as of 3/7/03; with provision for additional subcategories to be added at will as needed.)

(multiple)
(unspecified)
Academic
Aerospace
Cancer Prevention
Clinical
Clinical Preventive Services
Corporate
Correctional
Disease Management
Environmental
Epi:Crisis/Disaster/Terrorism
Epidemiology
Medical Informatics
Nonprofit
Other
Pharmaco-epidemiology
Policy/Management
Product Development
Public Health
Quality
Quality Improvement
Toxicology
Wellness

Fields in Spreadsheet

1. ID number

2. Category

3. Subcategory

4. State

5. City

6. Employer

7. Job Title

8. Qualifications

Newly Established Classification – 8/02	Corresponding Old Database Classification	Coding in use 7/17/02 to 8/15/02
PM – PM Physician required or preferred	1. PM Physician required 1a also requires or prefers clinical certification 2. PM Physician preferred 2a also requires or prefers clinical certification	1.0 1.1 2.0 2.1
MD – Physician required, with or without other credentials	2. Physician +MPH 3a also requires or prefers clinical certification 3. Physician 4a also requires or prefers clinical certification	3.0 3.1 4.0 4.1
PhD or MD – PhD or other doctoral degree accepted as minimal qualification	5. PhD	5
(cell left blank) – other or unspecified	6. RN 6b also requires MPH 7. Admin 7b also requires MPH 8. MPH only specified educational qualification 9. Other 10. no specific qualifications specified in ad (code “0”)	6.0 6.1 7.0 7.1 8 9 0

9. Contact

10. Opening and Closing Dates, Contact Info and Comment

11. Hotlink to website

12. Hotlink to e-mail

13. Journal or Website reference(including date of posting if not otherwise specified)

Format for Line Listing of Abstracted Ads on Web Site

Title: ACPM/AAPHP Job Market Initiative, Abstracted Ads Job Line Listing; (date of posting line listing on web page)

Instructional Note: To see details of any line item, click on the hyperlink in the leftmost column, Then highlight the material to be printed, and print.

Column Headings:

ID (for hyperlink)

Format for each job-specific box on Detail Page for Abstracted Ads

ID
Category
Subcategory
State
City
Employer
Job Title
Qualifications
Contact
Comments
Job URL
e-mail
Journal or Website Reference
Date Posted
Date Updated
Date Closed

The detail should reflect the numbered items, per spreadsheet format for Abstracting

When printed, each page should show header of “ACPM/AAPHP Job Market Initiative (date of posting data on web site). There should be ample space to accommodate up to 250 characters of comment.

Reference Annotated list of promising web sites and Journals, with hotlinks to web sites

Note: This will provide narrative description of the types of jobs offered and approximate percentages that might be of interest to GPM, OM and AM physicians.

a. To Contact AAPHP re JMI

Joel L. Nitzkin, MD, MPH, in his role of Chair of the ACPM/AAPHP Job Market Initiative, is sole contact for all JMI purposes – inquiries, post ads, etc. E-mail: jln@jln-md.com; Phone: 504 899 7893; Fax: 504 899 7557.

Format for Posting of Submitted Ads

A top line will be added by JMI staff as follows: State, City – Employer, Job Title, Date Posted

This will be followed by job description and details. Where available, employers are encouraged to post salaries.

Then – who to contact, and how to contact for further information and to apply. This section will also specify closing date, if any

Finally – Date posted

Ads are to be in Word, RTF or HTM format, and no larger than one sheet, 8.5x11

Policy for submitted Ads

Such ads will be free to members of ACPM and AAPHP, and possibly governmental agencies. On an interim basis all individually posted ads will be free until a policy is established to implement and define the fee schedule.

Definitions and Data Parameters

Preventive Medicine Job (PM Job)

1. Any position that calls for medically informed preventive or population-based skills is considered to be a position best filled with a physician with PM training. This includes policy, management, public health, epidemiological and quality improvement jobs in public, private and academic settings, and includes quality assurance/quality improvement jobs that are not primarily “preventive” in nature. Any position that includes policy leadership, program management, or supervision of other staff relative to these skills shall be considered to be a “PM Job” even if these roles are a small part of a larger job description.

2. The term “PM Job” shall include General Preventive Medicine (GPM), Occupational Medicine (OM) and Aerospace Medicine (AM).

3. Purely clinical jobs that specifically reference preventive medicine roles and skills shall also be considered “PM Jobs.”

4. For consistency in coding and classification, any job that carries the title “Director,” “Medical Director” (including “assistant directors” shall be classified as a PM job on the basis that the title implies some need for both population and management skills. The text of advertisements generally makes it impossible to discern whether or not PM skills are or are not pertinent to any specified job with this title.

5. It is noted that many of the partly or purely clinical PM jobs will also require board eligibility or board certification in a second medical specialty.

Physician – MD or DO, without regard to licensure to practice medicine, or foreign medical graduate with another degree licensed to practice medicine in the United States, or otherwise eligible to sit for licensure exams.

PM Physician – a physician Board Certified in GPM, AM or OM, or with residency training in PM, and/or eligibility to sit for PM boards (GPM, AM or OM). An MPH degree, without further training, and without eligibility to sit for PM board examinations does not qualify a physician as a PM physician.