A MEPI Public Health Component targeting Medical Students and New Graduates

Transcription

1 A MEPI Public Health Component targeting Medical Students and New Graduates Petra Wiersma, MD CTS Global Inc. assigned to U.S. Centers for Disease Control and Prevention (CDC) August 2012

2 Background The Centers for Disease Control and Prevention (CDC) FETPs (Field Epidemiology Training Programs) have been a core intervention Public health surveillance and response Detection and control of disease In MEPI CDC is now supporting a public health component for potential broader uptake by MEPI partners

3 What is FETP? Two-year postgraduate program Applied epidemiology Classroom-based instruction Mentored, on-the-job, competency-based training Epidemiologic service

4 Overlap of MEPI and FETPs CDC-supported CDC-supported, in development Independent with CDC-supported Special Projects MEPI Country

5 Objectives of CDC MEPI Activities Sensitize medical students to public health Improve competence among medical graduates public health surveillance and response outbreak management research leadership and management Strengthen in-country capacity to respond to public health emergencies conduct surveillance and research improve communications within country and region Retain trained public health professionals

6 Current CDC MEPI Activities Established Pre-Service Training (Medical Students) Elective in Field Epidemiology and Surveillance Integrated as a field epidemiology course into medical school curriculum In-Service Training (New Graduates) DMO training Competency-based curriculum Mentored on-the job training and field assignments Kenya and Zimbabwe Extension to other countries in progress

7 Current CDC MEPI Activities Being developed Training in Healthcare-Associated Infection (HAI) Surveillance and Prevention

8 Competencies and Outputs Mentorship Formal Instruction Epidemiology Epidemiologic methods Public health surveillance Outbreak investigation Data analysis Basic computer application Introduction to leadership and Management Field Activities Outputs Outbreak reports Surveillance evaluation reports Data analysis reports Abstracts Conference presentations Bulletin articles Manuscripts

9 Critical Outcomes Development of human capacity in applied epidemiology Detection and investigation of public health events Public health decisions driven by scientific data Increased interest in public health careers Increased collaboration between medical schools and MOH / FELTPs

10 Training in Healthcare-Associated Infection (HAI) Prevention Didactic materials Conducive to multiple learning styles Patient care scenarios Hand hygiene and use of PPE demonstrations Outbreak case studies Field application Infection control assessments

11 Evaluation Pre-and post-training test during didactic training Completion & grading of field assignment projects Application of acquired knowledge Data analysis projects Publications Presentations Districts bulletins Follow-up after 1 year Persistent involvement in public health Public health impact of trainee projects

12 Public health surveillance and field epidemiology training--kenya, Dr. Zeinab Gura, MD, MPH Field Laboratory Training Program-Kenya Ministry of Public Health and Sanitation August 2012d

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14 Strategy for Epidemiology Workforce Development FELTP District Health Teams Medical School Students

15 Master Level Training FELTP Master level training Two year program Goal 20-25/year District Health Teams Medical School Students

16 District Medical Officer Training FELTP District Health Teams District officers 6 month program Goal /year Medical School Students

17 Medical Student Training FELTP District Health Teams Medical School Students Elective 10 weeks Goal ~ /yr

18 Strategy for Epidemiology Workforce Development Recruitment FELTP District Health Teams Medical School Students

19 Strategy for Epidemiology Workforce Development FELTP Training District Health Teams Medical School Students

20 MEPI Activities in Kenya 1) Medical student elective in public health surveillance and field epidemiology University of Nairobi 4th year medical school First field elective in ) District medical officer of health training Medical officers deployed as DMOH after graduation Public health skills crucial

21 Implementation Meetings with UoN FELTP MOH Approval process Medical Student Elective Selection of medical students Advertised through school of public health at UoN More applicants than field sites Review of application

22 Curriculum One week didactic instruction One week course Beginning of medical student elective month Topics Basic epidemiology Public health surveillance and respons Outbreak management Data analysis Basic computer

23 Field Assignment for Medical Student Elective Kenya At District Health Office or within the MOH Period of 6-8 weeks Supervised by a qualified field epidemiologist Mentors FELTP graduates 2nd year residents

24 Expected Outputs Medical Student Elective Required field projects Evaluation of a surveillance system Analysis of public health data Participation in outbreak investigation Additional projects Data analysis of interest Involvement in on-going activities at site Examples: Polio Vaccination campaign Quality of care assessment of HIV patients

25 Successes Medical student elective Students scored 90% and above in post-tests All students completed field assignment and projects Students recommended inclusion in undergraduate training Public Health Grand Round Collaboration with University of Nairobi Bi-monthly Grand Rounds Students exposed to public health discussions

26 Graduate training for new DMOs Kenya Introductory course 1 week Completion of a pre-and post-test Course content Basic epidemiology Public Health surveillance Outbreak management Basic data analysis EPI Info training

27 Graduate training (DMOs) Field assignment Training on-the-job Mentorship over 6 months Mandatory projects Data analysis Examples of on-going projects Description of acute flaccid paralysis cases A review of MDR cases in Coast province Prevalence and causes of childhood mortality

28 DMOs Training pictures

29 Successes DMO training Total of 48 trained in 2 provinces All DMOs completing data analysis project Data review meetings started in 4 districts

30 Conclusions Medical student elective can serve as an ideal platform to sensitize future doctors to public health and epidemiology FETP s can play a substantial role in providing epidemiology training to medical students and mid-level practitioners Not just academic training programs Competency-based training through service Build country s public health capacity Tailored to the needs of the country

31 CDC MEPI Activities in Zimbabwe 1) Elective for 4th year medical students Zimbabwe FETP, MOHCW, the Department of Community Medicine at the UZ and CDC Integrated into medical school curriculum Didactic sessions field epidemiology and surveillance One month rural attachment with assessment Trainers from MOHCW and UZ First elective in 2012

32 CDC MEPI Activities in Zimbabwe 2) In-service training for new DMOs Certificate Program in Public Health for DMOs Competency-based curriculum Supports DMOs as chief executives in the health district Six months program Initial 2-week classroom session Five months practical service Final 2-week session and report

33 Questions for MEPI colleagues How to sensitize all future doctors to the public health outlook and approach? How best to illuminate a public health leadership career path for doctors so inclined? How best and most organically to link early CDC MEPI public health activities with the broader MEPI agenda and process?

34 Interested in CDC MEPI activities? Please contact: CDC Regional MEPI Advisor Dr. Petra Wiersma Dar es Salaam, Tanzania Tel:

35 Acknowledgements CDC Atlanta Donna Jones Richard Dicker Steven Becknell Dennis Jarvis Chijioke Okoro Erdenekhuu Nansalmaa Kenneth Johnson Mike St. Louis AFENET CDC Kenya Wences Arvelo MOPHS Kenya Samuel Amwayi Jared Omolo Univ. of Nairobi Dismas Ongore MOHWC-Zimbabwe Gerald Shambira Mufuta Tshimanga