10/7/2010. Darwin Brown, MPH, PA-C James F. Cawley, MPH, PA-C Colleen Wight, MA, PA-C

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1 Darwin Brown, MPH, PA-C James F. Cawley, MPH, PA-C Colleen Wight, MA, PA-C Intro Presenters MPH core requirements and focus areas Potential pros/cons (common ones from all 3 programs) Presentation of each program Description of program History Motivation for including an MPH Evolution Pros/Cons at the Program Growing pains/stumbling blocks What we do Curriculum Pearls Wrap-Up: Summarization Q&A School of Public Health vs Public Health Program Five core areas of public health knowledge Biostatistics Epidemiology Environmental health sciences Health services administration Social and behavioral sciences Focus Areas 1

2 PA faculty member Officer in the US Public Health Service State epidemiologist Health care association executive/staff t Occupational medicine clinician/specialist Clinical research staff/investigator Practice/hospital administrator Health care planner/policy analyst Longer training program, 2.5 to 3.5 years More expensive education Packed curriculum (no down time) Impact on academically disadvantaged students Compression of PH and PA curriculum Will it be cost effective Recruitment of potential students Marketplace issues - Debt load and specialty jobs Late use of MPH degree in career 2

3 Expands career opportunities The downstream effect Public Health credential Strengthens curriculum in the current ARC-PA Standards B1.06: medical care to diverse populations B2.10: Instruction on medical literature interpretation B2.12: Instruction in concepts of public health Are the professions complimentary? Will it ultimately make a difference? Will graduates provide better care? How will this be measured? 3

4 Darwin Brown, MPH, PA-C Well established PA Program Poor Public Health infrastructure in state MPH Program developed d in 2000 College of Public Health established in 2008 Dual Degree proposed in 2009 PA Program interest initially in 2001 New Dean of CPH, previous experience Providing a primary care focus on PH Provides graduates with dual perspective Rural state in need of both services Institutional support present Community support 4

5 Institutional and Community support Experienced leadership in place Primary care with PH perspective graduates Recruitment option Improved patient care in rural areas Interprofessional collaboration with FNP 3.5 year program Year 1: PA Didactic education Year 2: MPH core and Concentration courses Year 3+: PA Clinical rotations, MPH Service Learning experience and Capstone SL & Capstone Rural community for 4 months Develop institutional and community support intially Plan, Plan, Plan and provide details early on Identify a couple of champions Start small with room to grow Select the right students 5

6 Colleen Wight, MA, PA-C Private, Jewish institution Established in the Jewish tradition of service Institutional Evolution 1997: COM 2003: Joint MSPAS/MPH Program 2004: COE 2006: COP 2007: Independent MPH developed 2002: MPH initially online course (45 units) : Joint program (30 PH units+12 PA ) Generalist track + PH field study 2007-present: Independent/Dual degree Global or community health track For CEPH accreditation have required student:faculty ratios Global 8:1 for global Community 12:1 6

7 Community Health Track (Joint students) Core courses (5): Epidemiology Biostatistics Health Services Administration (management & policy) Social & Behavioral Health Environmental Health Community track courses (4) Year 1: (16 months semesters I-IV) Didactic (MSPAS & PH) Year 2: (12 months semesters V-VII) PH courses (6 weeks) PA Clinical rotations (7 x 6 wks) Year 3: (4 months semester VIII) 6 week PH field rotation PH Capstone Elective rotation (6 weeks) MSPAS Summative course Integration of public health - consistent with mission Attracts students who are committed to mission Provides graduates with a dual perspective If student fails out of PA program, potentially still can complete a degree 7

8 Full integration of PA and MPH programs different faculty different policies (philosophical differences) different accreditation requirements Academically rigorous Growing pains Revamping curriculum If running curricula simultaneously, scheduling can be a problem Faculty, students and the institution need to be committed to the concept Faculty need to work together PA Program attrition rate may increase James F. Cawley, MPH, PA-C 8

9 Founded in 1987, the GWU PA/MPH Program was the first PA/MPH program established Jointly sponsored Awards the MSHS for the PA program, and the MPH from the SPHHS Over 90 graduates, the majority of whom are in active practice as PAs Benzie, K, Miller, K, Cawley, JF, Heinrich, JJ. Interest in Physician Assistant/Public Health Dual-Degree Programs. Perspective on Physician Assistant Education, 2003; 14: Founded as part of the establishment of the MPH program at GWU; School established in 1997 Three year integrated curriculum The default MPH track is the COPC track The Program s primary philosophy GWU PA-MSHS/MPH Program 181 applications 45 interviews 74% female 26% male Age = 25 years SGPA = 3.34 OGPA = 3.53 Science Credits = 62 Verbal GRE =534 Quant GRE = matriculants 9

10 The PA/MPH degree broadens the educational perspective Not a burden Provides in-depth coursework in PH topics Integrating the curricula Cross-credited courses, more are better Areas of cross-crediting? i Benzie, K, Miller, K, Cawley, JF, Heinrich, JJ. Interest in Physician Assistant/Public Health Dual-Degree Programs. Perspective on Physician Assistant Education, 2003; 14: A three year program Students may select from among 6 departments/tracks within the SPHHS - Community-Oriented Primary Care (COPC) - Maternal and Child Health, HP/DP - Health policy, global health - Epidemiology Year 1 comprises primarily MPH courses Gofin, J., Cawley, JF. Community Oriented Primary Care and Physician Assistants. Perspective on Physician Assistant Education 2004;15:

11 Keys to successful PA/MPH programs: -Logistics - Number of cross-credited courses - Reasonable tuition costs The addition of an MPH degree will always enhance one s PA career in health care either as a clinician or as something else The trend to better merge the disciplines of public health and medicine Changes at institutional levels Public health concerns such as chronic diseases are closely linked to the problems most commonly seen in clinical practice Clinicians need to appreciate the larger picture of population-based health Shortell, S.M., Swartzberg, J.The Physician as Public Health Professional in the 21 st Century. JAMA 2009;300: Programs that aim to integrate public health into the training of clinicians are on the forefront of health professions education Obstacles such as logistics, cost, and length of education can be overcome in the design and implementation of such dual degree Programs Value added degree combination 11

12 Standards, 4 th Edition. Accreditation Review Commission for Physician Assistants, Shortell, S.M., Swartzberg, J.The Physician as Public Health Professional in the 21st Century. JAMA 2009;300: Accreditation Criteria for Schools of Public Health Accreditation criteria for Public Health Programs 12