Weaving prevention into the heart of medical education: Reflections from Public Health Educators in Medical Schools (PHEMS) workshop

As NHS England looks ahead in its 10 Year Health Plan, the message is clear: prevention and population health must sit at the heart of a sustainable, equitable healthcare system. But what does this mean for medical education? How can medical schools prepare future doctors not just to treat illness, but to champion health and wellbeing?

These questions were at the centre of a recent Faculty of Public Health workshop for Public Health Educators in Medical Schools (PHEMS), where participants shared experiences, challenges and opportunities for embedding prevention and public health within clinical curricula.

Although the NHS Long Term Plan is an English policy, its focus on prevention, and tackling inequalities reflects priorities shared across all four UK nations. Scotland, Wales and Northern Ireland each have their own long-established frameworks for prevention and community-based care, and it’s within these complementary contexts that PHEMS aims to support collaborative learning and innovation.

In a nutshell: Key takeaways

1. Prevention: everywhere or somewhere?

Should we teach prevention and public health everywhere or should it sit in specific timetabled and public health-badged sessions in the timetable?

The “everywhere” approach is ambitious and aligns with real-world medicine, where population health thinking should be part of every clinical decision. But there were concerns about quality and consistency - if it’s everywhere, who’s making sure it’s delivered well?

The consensus? We need to reframe the challenge. Instead of overloading an already packed curriculum, we should reformulate it. We need to make prevention visible across disciplines, and ensure that assessments reflect its importance.

Some practical ideas included:
•    Pairing clinical topics with relevant public health principles - normalising prevention as a core aspect of medical thinking and medical care – rather than treating it as an add-on.
•    Forming alliances across disciplines and postgraduate bodies to track and integrate public health teaching.
•    Embedding prevention into reflective practice and case-based learning, where students can explore the social determinants of health.
•    Using assessment as a driver of change - because we know students are strategic and assessment drives learning.

2. Changing mindsets: Prevention as core clinical practice

Cultural change is always the hardest part. Some participants challenged the idea that prevention and cure should have equal billing: after all, medical schools are training clinicians to diagnose and treat disease. But others argued passionately that the best clinicians are also advocates for health.

We talked about the importance of senior decision-makers - curriculum leads, deans, and department heads who can champion prevention at the strategic level. Everyone agrees with the principle of reducing inequalities, but making the case for how and where to teach it still takes persistence and clarity.

There was also discussion about unconscious bias in how some clinical educators perceive prevention: supportive in theory, but still “secondary” in practice. Finding shared language, aligning with sustainability and planetary health agendas, and building multi-disciplinary teams were seen as powerful ways to shift this mindset.

And we can’t underestimate the power of role models. Students need to see prevention in action not just in lectures, but in clinics, communities, and conversations. Role models are those who lead teaching, but potentially more important are the people who practise the principles.

3. Learning from communities, not just classrooms

Public health placements are valuable but hard to scale. It’s more difficult than ever now given how much of our public health expertise sits outside the NHS. Still, there are opportunities hiding in plain sight.

General practice is one: it’s often where population health (usually secondary prevention) and clinical management naturally meet. But educators warned against reducing “prevention” to posters and pamphlets - the goal is to help students recognise how every patient encounter connects to the wider determinants of health.

The most memorable learning happens when students observe prevention in real communities - seeing the lived reality of inequalities, and understanding how their future role can make a difference.

4. Measuring impact and shaping identity

Can we measure whether prevention-focused teaching actually changes how doctors practise? This question divided opinion.

Some felt that chasing quantifiable outcomes risks missing the point. The goal isn’t just to produce data - it’s to cultivate doctors who think differently about health and are aware of how the social determinants shape behaviour and outcomes.

Others argued that visibility of public health specialists matters most: we should be able to show that graduates understand population health thinking, see public health as a legitimate clinical discipline, and recognise it as a potential career path.

We also touched on professional identity. For some, moving into public health can feel like stepping beyond medicine - but maybe it’s time to challenge that. Perhaps rather than considering public health as a departure from clinical medicine, it should be viewed as an extension of it.

Looking Ahead

Our collective wisdom from the seminar suggests that population health in medical education is about shifting the mindset of tomorrow’s doctors to see that every clinical decision has a population driver and a population impact.

The 10 Year Health Plan challenges us to build an NHS that prioritises prevention and equity. That transformation starts in medical schools, with the educators who can make prevention part of every future doctor’s story.

Case studies

• “Bridging the Gap”: Response to health equity and prevention mandates in England’s 10-year Health Plan - Dr Kelly Mackenzie, Dr Samantha Caton, Prof Liddy Goyder
• Embedding Public Health, Inclusion Health and Planetary Health into the ARU MBChB Curriculum: A Curriculum Audit and Innovation Plan - Haniya Syed
• BRIDGING THE GAP BETWEEN MEDICAL EDUCATION AND PUBLIC HEALTH PRACTICE - Kehinde Akin-Akinyosoye, Kath Roberts, Alexandra Macnamara, Paul Whybrow, Tim Green, Martin McAreavey