I am very glad I did a 2 year preventive medicine residency (in my case, fellowship) after family medicine. I work as a public health physician - medical director at a State Department of Health in health care policy. I also do part-time clinical practice as an urgent care physician (I have been practicing urgent care medicine for many years, even before going into public health).
-My fellow preventive medicine residents, who did an IM or FM residency before PM residency:
--Continued to practice full-time IM or FM, with a focus on clinical preventive medicine
or
--Shifted their clinical practice to the public sector (like working for the county or the state)
or
--Became medical directors in their clinical practices (those who focused their MPH on health administration, after a couple of years in clinical practice )
or
--Became medical directors for insurance companies (after a couple of years in clinical practice)
or
--Went into academic medicine and research
or
--Did additional training in occupational medicine, and practicing occupational medicine full-time.
or
--Went to work for public health federal agencies (for example, CDC...)
-My fellow preventive medicine residents, who only did PM residency:
--Went into academic medicine and research
or
--Became public health physicians for county or state health departments (administrative, non-clinical)
or
--Opened-up their own business in "wellness medicine"
or
--Did additional training in another specialty
or
--Became medical directors for non-profit organizations or advocacy groups (administrative, non-clinical)
or
--Went to work for public health federal agencies (for example, CDC...)
or
--Went to work for consultation companies
PM residency is not like the "typical" medical residency programs (like FM, IM, EM, General Surgery, etc.,) that train residents for a predictable specific clinical career with a specific set of knowledge base and skills, PM residency training gives an individual the very basic tools to prepare for a career in public health and preventive medicine. It is up to the individual to decide how they want to use their preventive medicine training to shape their desired career. This often depends on the individual's prior educational background, medical and non-medical knowledge base, skills, strengths, and personality. I know of a fellow resident, with a very strong business background prior to PM residency, who is now working for a high-end stocks trading firm making close to a million dollars per year as a "medical consultant" (this is not the norm, but shows the wide variety of career paths that one can take after PM residency).