PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE

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1 PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE Public health and Preventive medicine (PhPm) is the branch of medicine concerned with the health of populations. These specialists use population health knowledge and skills to play leading and collaborative roles in the maintenance and improvement of the health and wellbeing of the community. The public health and preventive medicine specialist measures the health needs of populations and develops strategies for improving health and well-being, through health promotion, disease prevention and health protection. A public health and preventive medicine specialist demonstrates skills in leadership; development of public policy; design, implementation and evaluation of health programs and applies them to a broad range of community health issues. It is a broad specialty that includes the fields of general preventive medicine, public health and occupational medicine. It requires knowledge and expertise in: management skills; epidemiology; health education/promotion/policy; nutrition; biostatistics and health services administration. These specialists work in a number of settings, such as public health departments, hospitals, universities, family practice settings, public agencies, industry and non-governmental organizations. Most public health and preventive medicine specialists have little contact with individual patients. Instead, their patient is the community and their focus is on measuring health needs, addressing primary causes of disease (including behaviour and lifestyle factors) rather

2 PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE than on treating symptoms and developing methods for improving the community s health level. These practitioners are heavily involved in influencing public policy and public health issues. After completing medical school to become a public health and preventive medicine specialist it requires 5 years of approved residency training. This includes: years of basic clinical training; - 3 years in a Royal College-approved, university-sponsored program that includes course work in the sciences of community medicine and experience and responsibility in community medicine; - 1 further year of training, in a Royal College-approved, university-sponsored program which may include residency in a clinical specialty relevant to the practice of public health and preventive medicine (normally internal medicine, pediatrics, obstetrics or psychiatry); or with selective clinical experiences related to disease prevention and health promotion for specific populations or groups. Many complete 2 years of clinical training through the Family Medicine Residency Program, leading to eligibility for certification in family medicine (CCFP). Also required are a minimum of 1 academic year of courses in community medicine and a minimum of 1 year of community medicine field placement.

3 PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE For more detailed information on the training requirements go to: The Canadian Public Health Association (CPHA)

4 Number of physicians and physicians/100,000 population in Public Health and Preventive Medicine in Canada, 2015 Province/Territory Physicians Phys/100k pop'n Newfoundland/Labrador Prince Edward Island Nova Scotia New Brunswick Quebec Ontario Manitoba Saskatchewan Alberta British Columbia Territories CANADA Source: 2015 CMA Masterfile

5 Physicians/100,000 population in Public Health and Preventive Medicine in Canada, 1995 to Source: CMA Masterfile

6 600 Public Health and Preventive Medicine specialists by gender and year in Canada, 1995 to Total Males Females Source: CMA Masterfile

7 Public Health and Preventive Medicine specialists by age and gender in Canada, 2015 Gender Age Group 34 and under 5% Male 52% Female 48% 65 and over 18% % % % Source: 2015 CMA Masterfile

8 Public Health and Preventive Medicine specialists by age and gender in Canada, and over and Under 14 9 Female Male Source: 2015 CMA Masterfile

9 Main work setting of Public Health and Preventive Medicine specialists in Canada, 2014 Free-standing Lab/Diag Clinic 56% Academic Health Sciences Centre 10% Admin/Corp office 8% Community Clinic/Health-centre 8% Nursing home/ long term care facility/ seniors residence 6% University 5% Private Office/Clinic 4% Source: 2014 National Physician Survey. CFPC, CMA, Royal College

10 Practice organization for Public Health and Preventive Medicine specialists in Canada, 2013* 14% 63% 23% Solo Practice Group Practice Interprofessional Practice * 2014 data for this specialty is not available. Contrary to the 2014 survey, the 2013 survey did not include hospital-based practice as an option to choose from. Source: 2013 National Physician Survey. CFPC, CMA, Royal College

11 Hours worked per week (excluding on-call) by Public Health and Preventive Medicine specialists in Canada, 2014 Activity Hours worked per week Direct patient care without teaching component 4.2 Direct patient care with teaching component 1.7 Teaching without patient care 3.9 Indirect patient care 2.9 Health facility committees 3.1 Administration 12.0 Research 5.0 Managing practice 2.0 Continued professional development 2.9 Other 3.6 TOTAL HOURS PER WEEK 41.3 Source: 2014 National Physician Survey. CFPC, CMA, Royal College

12 Remuneration for Public Health and Preventive Medicine specialists in Canada Primary payment method 1 in % 3% 31% 44% Average gross clinical earnings for all medical specialists in 2013/14 (those earning at least $60,000) = $339, % Average percent overhead reported by all medical specialists in 2010 = 20% 3 90% + fee-for-service 90% + salary 90% + other* Blended NR * Other includes capitation, sessional, contract and other methods 1 National Physician Survey, 2013, CFPC, CMA, Royal College 2 National Physician Database, 2013/14, CIHI 3 National Physician Survey, 2010, CFPC, CMA, Royal College

13 Satisfaction among Public Health and Preventive Medicine specialists in Canada, % Balance of personal & professional commitments 7% 17% 22% 38% 14% 2% Current professional life 7% 11% 7% 37% 36% NR Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied Source: 2013 National Physician Survey. CFPC, CMA, Royal College

14 Public Health and Preventive Medicine specialists who are Royal College, CFPC or CMQ certified in Canada, % 33% 22% 5% Royal College CFPC CMQ Outside Canada Note: Physicians could indicate more than one certification body. Source: 2014 National Physician Survey. CFPC, CMA, Royal College

15 Number of Public Health and Preventive Medicine specialists who retired during the THREE year period of 2012 to 2014 Males Females < Total Age Group Source: CMA Masterfile year over year comparisons Note: Retired is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their licence but may return to practice at a later date.

16 Total and Ministry funded postgraduate MD trainees in 2014/15 Public Health & Preventive Medicine Faculty of Medicine Ministry funded Total Faculty of Medicine Ministry funded Memorial U N&L 0 0 McMaster U 8 8 Dalhousie U 0 0 UWO 0 0 U Laval 7 7 NOSM 7 7 U Sherbrooke U Manitoba 5 6 U Montréal 9 9 U Sask 5 5 McGill U 6 6 U Alberta 8 8 U Ottawa U Calgary Queens U 9 9 UBC Total U Toronto Canada Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

17 First year and exiting postgraduate MD trainees in 2014/15 Public Health and Preventive Medicine Female Male IMG GCMS 0 First year Exits from postgrad 0 First year Postgrad exits IMG International Medical Graduates GCMS Graduates of Canadian Medical Schools Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

18 Postgraduate-MD trainees in 2014/15 Public Health and Preventive Medicine Total of 20 first year Public Health and Preventive Medicine trainees representing 15% of all Public Health and Preventive Medicine trainees. Total of 136 Public Health and Preventive Medicine trainees representing 1% of all Ministry funded trainees. Total of 2 visa trainees in Public Health and Preventive Medicine. Total of 19 Public Health and Preventive Medicine trainees completed postgraduate training in Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

19 Location of 2013 Postgraduate-MD exits in 2015 Public Health and Preventive Medicine Of the 15 exits in 2013, 14 (93%) were known to be practising in Canada Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

20 Stress associated with finding employment at end of residency FM resident 7% 43% 42% 8% Other spec res 6% 20% 50% 25% NR/NA Not stressful Somewhat stressful Very stressful Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College

21 Links of the organizations supplying information for this document National Physician Survey Canadian Medical Association Association of Faculties of Medicine of Canada Royal College of Physicians and Surgeons of Canada College of Family Physicians of Canada Canadian Institute for Health Information

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