In this series of public health articles, you will be able to learn about the fundamentals of public health which will serve you well for your medical school interviews. These principles will help you to understand how medicine and public health are intertwined especially as a result of the Coronavirus pandemic.
The significance of Medicine and Public Health is well established in society but are often considered separate from each other, particularly in education.
The main difference between the two is that medicine deals with health from the perspective of the individual, whereas public health looks at health at the population level.
It is important to understand that while they are separate fields, without one the other would not be effective. The goal of improving health at an individual, local, national, and global level can only be achieved when these two disciplines are effectively integrated, and this should start from the level of education.
In 2003, the GMC published an updated version of ‘Tomorrow’s Doctors’ which stated that Public Health education must be integrated into the curriculum for medical students to allow for better understanding of the effect of diseases on communities and individuals. This has now been replaced with the ‘Outcomes for Graduates’ document, the latest 2018 version of which highlights key Public Health knowledge and skills that Medical graduates should encompass. The basic Public Health goals of “health services”, “health protection” and “health improvement” are key to understand for every aspiring medic/doctor, without which the efforts to treat individual diseases will not be effective.'
Learning public health principles and disciplines aids in clinical practice and, therefore, makes for a better doctor. For example, epidemiology can be used in Clinical practice to better treat patients based on treatment benefits & risks, cost effectiveness analysis, social determinants of health, using diagnostic tests effectively, medical statistics etc. All these principles shape health systems, health policies & guidelines, intervention effectiveness, access to healthcare & essential medicines and many more aspects.
The way in which public health education is delivered to medical students vary. Some provide separate programmes/modules, options for intercalating into public health courses or integrating it into tutorials and seminars. However, it can be argued that many medical schools fail to feature adequate public health education & disciplines into the core curriculum.
💉Empowering future doctors
To understand this better in current times, I conducted a small poll over 24 hours asking medical students/recently graduated doctors if they felt their medical school/curriculum integrated adequate education on Public Health principles and disciplines. 86% (total sample of 50) answered no. I further asked them to provide some comments on how their schools deliver public health education and in what ways they are examined. A common answer was that they were “given only a couple of lectures” at the start or it is integrated within clinical teaching and problem based learning in which the learning is mostly self-directed. They are usually examined with MCQs (Multiple Choice Questions). However, most students would often sacrifice these marks as the larger proportion of the exam would be on medical knowledge. These responses are worrying because it could be argued that medical schools are creating doctors who do not feel equipped with essential public health knowledge, and this will inevitably affect the way doctors’ practice and the healthcare patients receive.
However, it is not all bad news, as many medical schools are starting to integrate more components of public health into their curriculum and in a range of different and innovative ways. A study in 2016 published in the Journal of Public Health describes how this teaching has changed overtime and in what ways this can improve.
Aspiring medics should actively seek out the best ways in which they can acquire public health knowledge and skills.
This Public Health blog series aims to highlight key public health principles and disciplines such as health inequalities, epidemiology, medical statistics, research methods, social determinants of health, health services and health systems and many more essential topics so that doctors can become competent with patients and populations.
Here are some key things you can do to start learning and getting involved in Public Health:
Learn about the basic principles and concepts of Public Health
Follow case studies of diseases or affairs and how a public health approach is taken