Authors

  1. Madanat, Hala PhD
  2. Maddock, Jay E. PhD

Article Content

The field of public health has been an interdisciplinary one since its inception.1 More than 100 years ago, the disciplines of psychology, sociology, anthropology, medicine, biology, sanitation, and many others worked together to form the field of public health.2 Through our MPH core curriculum, students were exposed to the 5 "core" disciplines of public health. As integrative core curriculums have developed, students are being exposed to a variety of interdisciplinary experiences in their core curriculum.3 Concurrently, as emphasis has increased on the social-ecological model, additional interprofessional and interdisciplinary foci have been created with a variety of fields including architecture, engineering, urban planning, political science, and public policy.

 

Simultaneously, there has been an awakening that clinical health professionals have not always worked well together. This has led to the development of groups such as the Interprofessional Education Collaborative whose vision is: "Interprofessional collaborative practice drives safe, high-quality, accessible, person-centered care and improved population health outcomes."4 While improved coordinated care is essential in improving health outcomes, most public health professionals will never work in a clinical setting. This greatly differs our profession from the other health sciences (ie, pharmacy, dentistry, nursing, medicine, etc) where clinical practice is the modal expectation.

 

The new accreditation guidelines from the Council on Education for Public Health require that every MPH student has a foundational competency working on interprofessional teams.5 While the guidelines do acknowledge that this can be with nonclinical health professionals, it is required to be outside of the field of public health. Therefore, an epidemiologist working with someone in health promotion is no longer considered doing interprofessional work, at least by the Council on Education for Public Health. We have also been advised that the field practicum while typically an interprofessional experience does not count for this criterion and rather the expectation is on didactic classroom experiences. We believe that while this criterion is well intentioned, it is ripe for a variety of unintended consequences.

 

The basic premise that public health professionals should be able to work with professionals trained in other disciplines is solid foundation. However, depending on the student and career track, this can be quite different. A student interested in One Health may be best suited to work with the Veterinary School, whereas another student's interest in health law and policy would fit better with the law school or the public policy department. A third student might be interested in public health and the built environment and find working with urban planning to be the best choice. Under the previous accreditation standards, which did not mandate interprofessional education, students had the opportunity to choose which discipline fit them best. With the requirement that all students must have a documented competence they can work in an interprofessional team, we fear that this will narrow, rather than broaden, the choices and force students into partnering with specific disciplines that they never plan to work with again. Every required course also reduces the number of electives students have and their ability to explore the disciplines where their passions lie.

 

With many schools of public health located in health science centers, and organizations such as the Association for Prevention Teaching and Research developing clinically based interprofessional curriculum, the default option will be interprofessional education across the clinical sciences.6 While important, this serves only a small fraction of our students well and reduces the ability to collaborate across disciplines that can actually have more impact on the public's health.

 

In closing, we fully support the interdisciplinary training of public health professionals. However, the approach to achieving this needs to be flexible and accommodating to support the rich tradition of interdisciplinary work that has long been the hallmark of our field. We agree with our colleagues that public health education needs to be relevant, authentic, and practical.3 Additional flexibility in addressing interdisciplinary requirements is needed to realize this aspiration.

 

References

 

1. Rosen G. A History of Public Health, expanded ed. Baltimore, MD: Johns Hopkins University Press; 1993. [Context Link]

 

2. Fee E. The Welch-Rose report: blueprint for public health education in America. http://www.deltaomega.org/documents/WelchRose.pdf. Published 1992. Accessed December 8, 2017. [Context Link]

 

3. Sullivan L, Galea S. A vision for graduate public health education. J Public Health Pract Manag. 2017;23:553-555. [Context Link]

 

4. Interprofessional Education Collaborative. Vision and mission. https://www.ipecollaborative.org/vision-mission.html. Accessed December 8, 2017. [Context Link]

 

5. Council on Education for Public Health. Accreditation Procedures. Silver Springs, MD: Council on Education for Public Health; 2017. [Context Link]

 

6. Association for Prevention Teaching and Research. Interprofessional prevention education. http://www.aptrweb.org/page/IPE_Resources. Accessed January 26, 2018. [Context Link]