Plans for reform of the U.S. health system emphasize the importance of promoting good health and preventing disease as crucial elements for better use of scarce resources. As competition for health resources increases, the central importance of prevention must be emphasized. Preventive services are the most cost effective measures to improve the health of populations, especially those at high risk of disease because of poverty or ignorance, lack of education or skills to alter unhealthy behaviors, or shortage of appropriately trained health professionals.

The Association of Teachers of Preventive Medicine, recognizing increased emphasis on disease prevention and health promotion in the training of physicians, assembled a group of members to articulate the basic prevention content of a comprehensive medical education curriculum. The need for an inventory to assist academic units having responsibility for teaching prevention and health promotion within medical schools became apparent with the documentation of marked diversity in their curricular offerings.^{1, 2} Even the names and departmental locations of the academic units within medical schools with responsibilities for teaching in these areas have lacked recognizable consistency. Names include preventive medicine, community medicine, social medicine, and many others.³ Organizational locations include departments at the preclinical and clinical levels and divisions or sections within other departments, e.g. internal medicine and family medicine. The range of responsibilities is likewise remarkably varied, undoubtedly reflecting complex individual institutional histories. The heterogeneity of organization and content has been so widespread that the field of prevention has suffered diffusion of definition and identity to the point where responsibility for many of its component elements has risked begin lost altogether.

The inventory is the cumulative product of a steering committee within the Association of Teachers of Preventive Medicine, which began work in 1985 with funding under a cooperative agreement with the Centers for Disease Control. The committee elicited input and comment from fifty-one practitioners and teachers involved in clinical prevention. The resulting first edition of the inventory was distributed widely to teachers of preventive medicine and others.⁴ It was also the subject of full public discussion at the 1988 annual national preventive medicine meeting, PREVENTION 88, and revisited at PREVENTION 89, in light of its special relevance to implementation of the 1988 Institute of Medicine report, The Future of Public Health⁵, which called for a recommitment to physician leadership in public health. Further comment was obtained from representatives of the various primary care specialties, and drafts of a revised edition were reviewed by a panel of twenty-one practitioners and others in the field of prevention. The inventory was again reviewed and revised in 1994.

The inventory is intended as a guide for curriculum planners to ensure that medical students are introduced to the range of topics and basic skills in prevention and health promotion appropriate for medicine in the coming decades. It attempts to define the breadth of these areas appropriate for the general education of all physicians. It is not intended to be exhaustive. Being an inventory only, it does not specify depths of understanding or levels of proficiency. Nor does it specify the amounts of curricular time needed or the educational/learning approaches to be used.

Although the inventory was drafted with academic units of preventive and community medicine in mind, it is fully recognized that the responsibility for teaching will be shared across many disciplines. Indeed, success in learning the precepts and in using the skills will require both understanding of the underlying basic disciplines and application across a variety of clinical disciplines and situations, with extensive opportunity for their reinforcement. The teaching, of necessity, will involve academic departments beyond those specifically focused on prevention and community medicine. As the pace of restructuring the American health care system and the emphasis on primary care delivery increase, so will the mandate for producing a modern and relevant prevention curriculum. One of the challenges to teachers within the disciplines of prevention and community and social medicine is to ensure such integration.