Overview of public health education and training systems in Portugal



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Overview of public health education and training systems in Portugal Bernardo Gomes, MD, Medical Resident in Public Health bernardomgomes@gmail.com

Public Health Education and Training Systems in Portugal Public Health Services Basic Overview Example pregraduate training (Medical Degree); Postgraduate training; Medical Residency in Public Health.

Regional Health Administration Directorate-General of Health Primary healthcare cluster Regional Health Department Public Health Unit

Ministry of Health Directorate-General of Health Regional Health Administration National Health Institute

Public Health Unit Develop information and plans in the fields of Public Health and monitoring the health status of the population through: Systematic collection and analysis of health data; Diagnosis of population health; Elaboration of the local health plan; Communication of information; Propose interventions to the primary healthcare cluster Director, targeting the identified health problems

Public Health Unit Proceed to the epidemiological surveillance of communicable diseases and environmental health issues, including: Mandatory notification diseases; Vaccine-preventable diseases; Foodborne illness outbreaks; Monitoring of water quality; Food safety in school cafeterias and canteens; Other epidemiological surveillance systems

Public Health Unit Participate and manage, as a whole or in part, in the development of programs (for example) National Immunization Program; Program for Surveillance and Control of Meningitis in the Community; Contingency Plan for Heat Waves; Program Evaluation of Safety Conditions and Health in Schools; Occupational Health Program; Health Education Programs. Health Authority.

Public Health Units Community Health Nurses; Environmental Health Technicians; Public Health Doctors; Other important professionals (Nutritionists, Dental Hygienists, Psychologists) nowadays more frequently included in other units inside the primary healthcare cluster.

Community Nursing Specialist Postgraduate course in Community Nursing: 17 different training sites available. 90 ECTS Master in Community Nursing 5 different training sites available 90 ECTS Both give the possibility of being a specialist

Environmental Health Technicians 240 ECTS course (4 years); Multidisciplinary training with a strong environmental health component;

Regional Health Units Very similar profile to public health units; Mathematicians; Engineers; Geographers; Nutritionists; Psychologists;

Directorate-General of Health and INSA Nutritionists Microbiologists Pharmacists Dentists Statisticians Biologists Geneticists

Medical Degree Pregraduate training

Pregraduate training overview UBI 1st year General Epidemiology and Community Health 3rd year Preventive Medicine FCML 4th year - Public Health (OP) 6th year Research Practice: Public Health Knowledge Integration

Pregraduate training overview FMUC 2nd year - Community Health Introduction 4th year - Epidemiology and Preventive Medicine I 4th year - Epidemiology and Preventive Medicine II FMUL 3rd year - Public Health / Epidemiology 4th year Clinical Epidemiology (I and II) (OP) 3rd year Environmental Health (OP) 5th year Clinical Epidemiology (OP) 5th year Health Policy and Management

Pregraduate training overview FMUM 2nd year Family, Society and Health I 3rd year - Family, Society and Health II FMUP 1st year Population Health 3rd year - Epidemiology I 3rd year - Epidemiology II 6th year - Public Health

Pregraduate training overview ICBAS 2nd year Epidemiology 5th year - Public Health UAlg No Public Health rotation formally defined

Public Health Specialization Course, MSc and PhD City Specializatio n course in Public Health Master of Public Health PhD Program in Public Health UP (FMUP/ICBAS/IS PUP) Porto x x UC(FMUC) Coimbra x UNL(ENSP) Lisboa x x x

PhD in International Health PhD in Tropical Medicine MSc in Tropical Health MSc in Health and Development PhD in Epidemiology MSc in Health Education MSc in Epidemiology City UP(FMUP) Porto x x UL(FMUL) Lisboa x x UNL(IHMT) Lisboa x x x x x UM Braga x

The Public Health Doctor. Perez on Medicine: The Whimsical Art of Jose Perez, Specialty by Specialty. WRS

Training Program PUBLIC HEALTH RESIDENCY (48 MONTHS) 12 MONTHS 1st year Community Health Training Site Public Health Unit (PHU) Objectives Participating in PHU activities, elaborating a community health diagnosis.

Training Program PUBLIC HEALTH RESIDENCY (48 MONTHS) 12 MONTHS 2 nd Year Specialization Course in Public Health (73 ECTS) Training Site Lisboa (vs opting out) Objectives - Acquisition of competences in Biostatistics, Epidemiology, Health Promotion, Health Administration, etc.

Training Program PUBLIC HEALTH RESIDENCY (48 MONTHS) Epidemiological Research rotation 5 MONTHS Training Site Local (PHU), regional (PHD), other national or international site Objectives Applying a research protocol developed during the specialization course

Training Program PUBLIC HEALTH RESIDENCY (48 MONTHS) Public Health Intervention rotation Training Site Local (PHU) Objectives Identify a health problem in the community ; elaborate an intervention plan; execute it and evaluate it. 12 MONTHS

Training Program PUBLIC HEALTH RESIDENCY (48 MONTHS) Auditing rotation Training Site local (PHU), regional (RHD) or national (DGH) Objectives Select, study and evaluate a problem/procedure/institution and elaborate a report/ quality manual at the end 3 M

Training Program PUBLIC HEALTH RESIDENCY (48 MONTHS) Optional internship Training Site Local (PHU), Regional (RHD), National or International Objectives Variable. 3 M

Areas defined by the Public Health Doctors Board as essential to the exercise of Public Health Specialist 1. Epidemiology. 2. Demography. 3. Biostatistics. 4. Health planning. 5. Methodologies of health research (specially epidemiological research). 6. Microbiology and infectious diseases of public health importance. 7. Non-infectious diseases with public health significance. 8. Principles and techniques of computer science applied to public health. 9. Environmental sciences. 10. Social and behavioral sciences. 11. Economic sciences. 12. Communication sciences.

Public Health Doctors Workforce In 2011, 86% was, at least, 50 years old

PORTUGAL AND EURONET MRPH France, Italy, Portugal, Spain and UK - Placements in universities or hospitals; - Hospital rotations; - Master of Public Health included or strongly recommended in the residency; - University link throughout the residency; - Stronger connection between academic public health and practice; - Bigger focus on research; - Jack of all trades

Wishlist Stronger connection between public health research and practice; Hospital Public Health Professionals (or improved models of cooperation); Harmonization of public health residencies / shared training programs; Global Health perspective. Funding? A vision for Public Health Services

Twitter Account - @BLMG bernardomgomes@gmail.com Overview of public health education and training systems in Portugal Bernardo Gomes, MD, Medical Resident in Public Health