Formal Public Health Education and Career Outcomes of Medical School Graduates

Few data are available evaluating the associations of formal public health education with long-term career choice and professional outcomes among medical school graduates. The objective of this study was to determine if formal public health education via completion of a masters of public health (MPH) degree among US medical school graduates was associated with early and long-term career choice, professional satisfaction, or research productivity.We conducted a retrospective cohort study in 1108 physicians (17.1% completed a MPH degree) who had 10–20 years of follow-up post medical school graduation. Multivariable logistic regression analyses were conducted.Compared to their counterparts with no MPH, medical school graduates with a MPH were more likely to have completed a generalist primary care residency only [relative risk (RR) 1.79, 95% confidence interval (CI) 1.35–2.29], obtain employment in an academic institution (RR 1.81; 95% CI 1.33–2.37) or government agency (RR 3.26; 95% CI 1.89–5.38), and practice public health (RR 39.84; 95% CI 12.13–107.38) or primary care (RR 1.59; 95% CI 1.18–2.05). Furthermore, medical school graduates with a MPH were more likely to conduct public health research (RR 8.79; 95% CI: 5.20–13.82), receive NIH or other federal funding (RR 3.11, 95% CI 1.74–5.33), have four or more peer-reviewed publications (RR 2.07; 95% CI 1.56–2.60), and have five or more scientific presentations (RR 2.31, 95% CI 1.70–2.98).Formal public health education via a MPH was associated with career choice and professional outcomes among physicians

Unadjusted and Multivariate-Adjusted Analyses of Early Career Activities Associated with MPH Education Completion among Medical School Graduates.

*<p>Including all public health degree completion: MPH, MSPH or MPH&TM; **Including <u>no</u> public health degree completion.</p><p>∧Estimated from odds ratios and adjusted for age, gender, race, undergraduate university region and time since graduation; CI-confidence interval.</p><p>Generalist primary care residency training includes general internal medicine, general pediatrics, and family medicine Specialty care residency training includes all surgical specialties including obstetrics and gynecology, internal medicine and pediatric subspecialties, anesthesiology, radiology, psychiatry, ophthalmology, dermatology, emergency medicine, pathology, neurology, and other.</p

Analyses of Long-term Employment and Medical Practice associated with MPH Education Completion among Medical School Graduates.

*<p>Including all public health degree completion: MPH, MSPH or MPH&TM; **Including <u>no</u> public health degree completion.</p><p>∧Estimated from odds ratios and adjusted for age, race, gender, undergraduate university region, years since medical school graduation, and residency training; ∧ not adjusted for residency training.</p><p>#additionally adjusted for employed by academic institution and faculty or research appointment; CI-confidence interval.</p

Flow diagram of study participation.

<p>Flow diagram of study participation.</p

Baseline Characteristics According to MPH Education Completion among Medical School Graduates.

*<p>Including all public health degree completion: MPH, MSPH or MPH&TM; **Including <u>no</u> public health degree completion.</p>‡<p>Other region includes north, midwest, and west coast regions, and outside the US.</p><p>MCAT-Medical College Admissions Test; grade point average on 1–4 scale.</p

Analyses of Long-term Research Achievements Associated with MPH Education Completion among Medical School Graduates.

*<p>Including all public health degree completion: MPH, MSPH or MPH&TM; **Including <u>no</u> public health degree completion.</p><p>∧Estimated from odds ratios and adjusted for age, race, gender, undergraduate university region, years since medical school graduation, residency training, employment by academic institution, and faculty or research appointment; CI-confidence interval.</p

Analyses of Long-term Practice Region, % Time in Professional Activities, and Professional Satisfaction associated with MPH Education Completion among Medical School Graduates.

*<p>Including all public health degree completion: MPH, MSPH or MPH&TM; **Including <u>no</u> public health degree completion.</p><p>∧Estimated from odds ratios and adjusted for age, race, gender, undergraduate university region, years since medical school graduation, and residency training; CI-confidence interval.</p

The roles of healthcare professionals in implementing clinical prevention and population health

Across the health disciplines, clinical prevention and population health activities increasingly are recognized as integral to the practice of their professions. Most of the major clinical health professions organizations have begun incorporating clinical prevention and population health activities and services into educational curricula, the accreditation process, and training to affect clinical practice. Students in each health profession need to understand the roles played by those in other health professions. This understanding is a prerequisite for better communication and collaboration among the professions and for accomplishing the educational objectives included in Healthy People 2020 and organized using the Education for Health framework. To help accomplish these goals, this article summarizes each health profession\u27s contributions to the field of prevention and population health, explains how the profession contributes to interprofessional education or practice, reviews specific challenges faced in the provision of these types of services, and highlights future opportunities to expand the provision of these services. Several general themes emerge from a review of the different health professions\u27 contributions to this area. First, having well-trained prevention and population health professionals outside of the traditional public health field is important because prevention and population health activities occur in almost all healthcare settings. Second, because health professionals work in interprofessional teams in the clinical setting, training and educating all health professionals within interprofessional models would be prudent. Third, in order to expand services, reimbursement for health promotion counseling, preventive medicine, and disease management assistance needs to be appropriate for each of the professions

Clinical prevention and population health: curriculum framework for health professions

The Clinical Prevention and Population Health Curriculum Framework is the initial product of the Healthy People Curriculum Task Force convened by the Association of Teachers of Preventive Medicine and the Association of Academic Health Centers. The Task Force includes representatives of allopathic and osteopathic medicine, nursing and nurse practitioners, dentistry, pharmacy, and physician assistants. The Task Force aims to accomplish the Healthy People 2010 goal of increasing the prevention content of clinical health professional education. The Curriculum Framework provides a structure for organizing curriculum, monitoring curriculum, and communicating within and among professions. The Framework contains four components: evidence base for practice, clinical preventive services-health promotion, health systems and health policy, and community aspects of practice. The full Framework includes 19 domains. The title Clinical Prevention and Population Health has been carefully chosen to include both individual- and population-oriented prevention efforts. It is recommended that all participating clinical health professions use this title when referring to this area of curriculum. The Task Force recommends that each profession systematically determine whether appropriate items in the Curriculum Framework are included in its standardized examinations for licensure and certification and for program accreditation