IMPROVING PUBLIC HEALTH TEACHING FOR MEDICAL

STUDENTS AT UQ

Professor Charles Gilks

Head of School of Public Health

CAPHIA forum, Perth; September 2014

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Core premises

Public Health concepts are poorly valued and badly taught in current medical curricula

Students understand social justice but want to practice curative medicine

All doctors need to understand the concept of Health as well as Disease and ill-health

Doctors today need to be well equipped to practice Evidence-Based Medicine

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Specific context at UQ

1. Undergraduate health taught at three campuses; with two distinct u/grad programmes for entry to MB BS

2. No defined “pre-clinical” stream for undergraduates

3. Very large medical student intake: 550 students per year with 33% o/seas; but not covering costs …

4. Strong School of Public Health next to SoM with staff keen to teach, but little interaction or shared vision

5. Limited advocacy for Public Health teaching in the School of Medicine: $$$ and expertise

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Changes at UQ

• New heads of School: SoM and SPH

• Major Faculty reorganisation: SBMS joins

• UQ is moving from MB BS to MD in 2015

• Campus closure: one site for first-year u/g

Major opportunities to reintegrate Public Health teaching across the clinical

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Undergraduate teaching

1. Adopted B Health Sci approach for year one St Lucia Social Determinants of Health underpin approach More focus on epidemiology and biostatistics Expand Environmental Health teaching Link better with health students / allied professions

2. Majors in Public Health, PH nutrition, Health Promotion and Environmental Health Herston campus

3. Students better prepared for a broader clinical course with stronger Public Health content

4. More awareness of / interest in MD MPH

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MD teaching• Appointed MD coordinator• Review cases used in PBL/CBL

– Relevant Public Health content– Epidemiology and patterns of disease

• Social determinants of Health – Inequality within Australian Society– Mainstream Indigenous Health – Inequality across Societies – global health

• Evidence-based medicine– Biostatistics: Case-control; Cohort; and RCTs– Health economics: CEA, DALYs; QALYs

• Elite MD MPH streamCRICOS Provider No 00025B

Research & Higher Degree Pathways in MD

Junior DoctorPGY1-2

D Eley 26 June 2014 Graduate School

BSc = Y1 Y2 Y3

Preferred degrees Biomed ScienceHealth Scienceoptional Hons year

Encourage research

experience in undergrad BSc

across UQ & SOM e.g. summer research & volunteer

placements & optional Hons year

Graduate MD-RHDMD-MPH

Year 1 MD3 units research

skills training

Year 2 MD2 units research

skills trainingCapstone Research

Approved students may enrol MPhil or PhD or MPH

Year 3&4 MD Y3 Elective for research

Concurrent MPhil or MPH students work part time on degree alongside full time MD. May apply skills training to their own project in Y2. Finish ~2-3 years

Eligible students for RHD or MPH

may begin application prep & seek approval

GPA > or = 5.5EOIApproved project Approved advisor

Foundation Research Skills Training

Upgrade to PhD here

†Intercalated RHD or MPH

interrupt here

*All MD students eligible to apply

for a RHD

*Approved students enrol in MPhil, MPH or PhD at end Y2. Concurrent or Intercalated are possible. Intercalated interrupt MD in Y3. Concurrent continue MD full time & RHD or MPH part time.

† Intercalated MPhil or MPH interrupts MD for 1 year, intercalated PhD for 2 years

Intercalated finish RHD/MPH close to MD graduation = 5year MD-MPhil /MPH or6 year MD-PhD

PH teaching outcomes

• All clinicians have an understanding of EBM and core Public Health concepts and how this impacts their speciality or practice;

• PH Physician pathways (MD MPH)

–Public Health Physician cadre in QLD–Health Workforce assessment

–Global Public Health practitioners

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Conclusions

UQ recognises the need to improve Public Health teaching for medical students

Started to reintegrate teaching and revise curriculum and content, taking advantage of a series of opportunities and changes

Hope to report progress back periodically

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Thank you