Competent with patients and populations: integrating public health into a medical program

Abstract

Background As the global burden of chronic disease grows, and infectious disease threats loom large, the need for medical graduates with expertise in public health medicine (PHM) is growing. A recurrent challenge is integrating this broad knowledge into crowded medical curricula and making PHM relevant. This study describes the process of integrating public health content into an Australian graduate entry medical course. Methods A redesign of the PHM curriculum at Deakin University School of Medicine was conducted in 2014 to make the curriculum practice-based and solution-oriented. Central to the redesign was the development of a curriculum map. Results Public health is now taught from a practice-based framework adapted from the World Health Organization emphasizing skills aligned with the Australasian Faculty of Public Health Medicine domains that prepare students for specialisation. Learning outcomes are structured to build depth and application in student knowledge. Mapping the curriculum provided the ability to measure alignment of learning outcomes with course, university and accrediting body outcomes. Regular feedback from students indicates engagement has improved along with perceived relevance to future careers. Conclusions Doctors with public health skills are increasingly sought after in Australia, particularly in rural areas. Deakin graduates are well placed to meet this demand.

Merging academy and healthcare in the Public Health training of medical students

“…The contact with the community leads students to physically experience part of what they have learnt during the medical education regarding the determinants of health, observe people's context, read the motives behind their unhealthy behaviours, and perceive why these are transmitted from generation to generation, from neighbour to neighbour. The comprehension of the determinants of health and health inequities may create a more humanistic approach to health and diseases, which is fundamental for the clinical practice and for their role as advocates for health and social policies [13]. Gaining knowledge on health planning and health promotion may be useful for critical thinking regarding planning and organisation of health programmes and services, decision-making, and participation as advocates for health policies and health reforms [13,14].…”

“…The comprehension of the determinants of health and health inequities may create a more humanistic approach to health and diseases, which is fundamental for the clinical practice and for their role as advocates for health and social policies [13]. Gaining knowledge on health planning and health promotion may be useful for critical thinking regarding planning and organisation of health programmes and services, decision-making, and participation as advocates for health policies and health reforms [13,14]. Finally, the contact with the specialty opens their perspectives in health careers, looking beyond the hospitals' walls into community health or healthcare management positions, and from the healthcare sector to non-governmental organisations or research organisations, amongst others.…”

“…These issues have been revised in the end of the first year and the number of students complaining decreased, but are still high. Considering that there is a moderate variation of the kind of activities students are exposed to, and as practice favours the knowledge acquisition [13], the next year module programme will probably include simulations and problem-solving exercises combined with online contents, as suggested by Godfrey et al (2019) [16]. Second, students have a limited contact with Public Health consultants, despite our efforts.…”

“…Populations' health exposes first-year medical students to the theoretical concepts of morbidity and mortality, transmission and control of infectious diseases, as well as of chronic noncommunicable diseases, and of health inequities, and Epidemiology and Clinical Epidemiology are included in the following year's curricula. As knowledge must be materialised in practice [13], a module of Public Health was included in the sixth and last year of medical education. It is a module that aims at linking the theoretical teaching to a community and practice-based training.…”

Carga horária de saúde coletiva antes do internato em escolas médicas brasileiras

“…The transformation of the view on public health and of its representation in undergraduate medical curriculum also occurred in all continents where public health education was covered during medical school. Countries such as Canada 6,7 , China 8 , Spain 9 , Australia 10 , United Kingdom 11,12 and Ghana 13 are some examples.…”