When I matched into preventive medicine, I knew it was a niche specialty. What I did not realize was how fragile the field had become.
The American College of Preventive Medicine’s May 1 2025 update confirmed what many of us had been sensing for months. The eight million dollars in federal funding for Preventive Medicine Residency programs already approved by Congress had been frozen with no timeline for release. This threatens the ability of programs to onboard already matched residents (re:
acpm.org).
For applicants this directly impacts whether you have a residency position. Preventive medicine programs have been declining massively in number for years and most operate on very lean budgets. A single federal funding lapse can wipe out an entire incoming class. Programs usually fund your MPH, but with budget cuts, programs may have trouble doing this and may ask future residents to fund their own, required MPH (told this by my program director). You may be in a situation where you have to either take out additional loans or moonlight during residency to cover this expense.
Even before this freeze the specialty had structural problems. Clinical training will be highly limited, which makes finding a clinical job, should you want to in the future very difficult. I have many friends who simply graduated and now work urgent care, which can be done with the completion of intern year in most states.
Finding a job after graduation is not straightforward. Preventive medicine is not as well recognized as other specialties. Most employers you contact will have no idea what your specialty is or what it does. Public health departments and administrative roles are options but they can be competitive and often pay very little.
What remains is a specialty that still attracts people passionate about prevention and population health but one that requires entering with eyes wide open. Expect to possibly need to fund your own MPH, definitely getting less clinical training and navigating a terrible job market afterward. And, I can’t emphasize enough, as the ACPM made clear on May 2025, you may also find your future residency position threatened by decisions made far above your head in Washington where preventive medicine barely registers as a priority, and, if anything, is an extremely low priority historically given the number of programs that have closed already in the last 2 decades.
It gets worse. After having a ton of difficulty actually finding jobs in my specialty, I have only been able to get contractor, part-time roles at urgent care clinics, which can be done without even completing residency (just need a medical license). For these reasons, I am applying to addiction medicine fellowship. They tell you preventive medicine is pathway to this fellowship. That is intellectually dishonest. I've networked with a lot of program directors who have never hired a preventive medicine boarded physician, some had never even heard of the specialty. I will be fighting as hard as I can to get placed into a fellowship and I’m just hoping for the best at this point.
Don't make the mistake that I did.
