We hear so often that health systems the world over should be investing more in population and public health.
If we want to prevent illness and suffering, if we want a fairer distribution of health, and if we want a better bang for our buck, then public health can help.
But what is the role of doctors in this brave new world?
Public health has not traditionally been seen as a particularly glamorous area, especially for medical students who so often end up being drawn to the super specialty end of clinical medicine.
So what are medical schools doing to ensure graduates are well-equipped in public health? And what skills do they need?
Associate Professor Mavis Duncanson, head of the Population and Public Health Domain at Notre Dame University’s Sydney medical school, is keen to hear what other medical schools are doing in this area.
What are Australian and NZ medical schools doing in public health?
Mavis Duncanson writes:
We are reviewing how we teach medical students about population and public health (PPH), and would like to hear from other medical schools in Australia and New Zealand about their approaches.
We would like to hear about the general structure of their courses and in particular:
- Perceived PPH priorities for medical students (and doctors) in Australia/ Aotearoa NZ
- Broad topics covered within PPH in the medical degree
- Expected learning outcomes/ competencies before graduation
- Mode of delivery of the PPH learning (lectures/ small groups/ hands on)
- Assessment methods in PPH
- Any practical components or assignments that students are required to complete.
At the NDU School of Medicine, Sydney, the PPH Domain comprises 10% of the curriculum in each of the four years of the MBBS course.
In the first two years, students have a one hour PPH tutorial every two weeks in groups of eight with a clinical tutor; in their third year there are 15 PPH tutorials delivered at Clinical School sites and a weekly structured journal club.
Students are encouraged to apply the “eight questions” previously described by Trevena et al (2005) to their paper-based and real-life cases.
Assessment is by written examination (short answer and MCQ) and in third year a continuous mark is given by the Head of Clinical School to reflect participation in Journal Club.
In the fourth and final year the PPH assessment is derived from a PPH project and participation in the weekly structured journal club.
In reviewing the PPH component of the MBBS curriculum, the Committee identified the following major topic areas, using the Australasian Faculty of Public Health Medicine Advanced Training Curriculum as a guide:
- General public health
- Reviewing the literature and epidemiology
- Equity and social determinants
- Health care and health policy
- Health protection and health promotion
- Chronic disease and injury
- Integrating public health into clinical practice.
We welcome suggestions from other medical schools about specific learning tasks to help students develop the knowledge and skills required to meet learning outcomes in these or other relevant areas of population and public health.
We are also interested to pursue further collaborative work to promote consistency across Australasia and New Zealand.
Further reading on these issues
• Relevant extract from the WHO’s Commission on the Social Determinants of Health
• Teaching public health to medical students in the United Kingdom–are the General Medical Council’s recommendations being implemented?
Other perspectives on what matters in the medical curriculum…
• From the archives (1923), the more things change… The revision of the medical curriculum
Update, 20 July
The Institute of Medicine in the US responded via Twitter. The link given is to the Institute’s latest reports, including ones on oral health, health literacy and pain management.