Opening up public health education to those without an MBBS: expert


Public health education must go beyond medical schools, be available outside of MBBS programs, says PHFI president.

Public health must go beyond medical schools, says Dr Srinath Reddy

NEW DELHI: The COVID-19 pandemic has confirmed the need for more public health professionals in India. Dr Srinath Reddy, President of the Public Health Foundation of India, spoke to Careers360 about the need for the country to open up public health education to applicants from all backgrounds, both within and outside faculties of Medicine. Excerpts edited below.

Q. How does one become a public health professional in India?

A. We at the Public Health Foundation of India (PHFI) accept students with any bachelor’s degree as long as they have aptitudes for public health and then direct them to a mix of disciplines. In India, community medicine is reserved for doctors only. Other institutions abroad are also doing the same but are not necessarily limited to medicine. They also take people from the social sciences. Here, we really have to talk about systems and talk about determinants of health that are not only biological, but social, economic, environmental and commercial. Many people actually view public health in a much broader sense – this is how most international institutions leave the door open to multiple disciplines.

Most countries do not have community medicine. They have what is called family medicine, where people are trained for general practice. At the same time, Public Health is either an MPH or an MSc. In the UK it is mainly MSc. In the United States, this is mainly MPH. In most countries in Europe this is MPH. Thus, in most international programs, it is not restricted to physicians.

At PHFI, we follow the global standard. We admit anyone with a bachelor’s degree in any field. It can be liberal arts or humanities, or any other.

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Q. What is the essential requirement to become a public health professional?

A. A public health professional and a public health official are different. For example, the workers of Asha [accredited social health activists] are public health officials, mid-level health workers are also public health officials.

But public health professionals should be trained in community medicine, preferably a master’s degree in public health, and nothing prevents them from working in primary care centers. They will be available in district hospitals, in health services and even in other services. Public health workers are needed for the sale of food, for example. Thus, there are many areas in which a person with a good public health education and a little specialization and skills can work in more than one department.

Q. Is there interest in the public health course?

A. Yes, students are interested and we receive quite a few applications. We admit them, but the important thing is that unless the country defines career paths for public health executives, which the national health policy has recommended, students will not necessarily see career opportunities. That said, we are still seeing placement rates of around 93-97% for all those trained in our schools.

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Q. Are we doing this by limiting community medicine to physicians only?

A. It is up to those of the NMC to answer. They are in charge of teaching medical schools. As far as we are concerned, we have the open-to-all program under the Public Health Foundation of India in Indian Institutes of Public Health (IIPH).

Q. How did public health professionals work during the pandemic?

A. Many people trained in community medicine did well in public health during the pandemic. We have to give them credit. However, there are public health professionals who are not doctors but trained in public health; they have also contributed well, both to research and action in the field of public health. For example, behavior specialists are trying to understand why people don’t wear masks or why some people don’t want to be vaccinated. There are so many other things to do that are necessary for an effective response to the pandemic. People who work in public health management training and supply chains, people who are statisticians… epidemiologists necessarily have medical training. So we need a lot of skills.

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Q. What employment opportunities are available for public health professionals?

A. Some of them would come from government and go back to government because they are sponsored candidates. Even for unsponsored applicants, we found a very high level of placement in field-based NGOs, in public health service delivery, in research organizations. They also join government programs on contractual appointments or international organizations such as UNICEF [United Nations Children’s Fund].

Q. Does India have sufficient expertise in public health?

A. Well, I think we should have used a lot more public health expertise at all levels, from policy design to program design, program implementation, program evaluation and even the frontline implementation. Public health skills are required at several levels. If we haven’t invested adequately in training this kind of multi-level, multi-skill public health workforce, now we need to make sure we do. We need to invest much more in public health education inside medical schools or outside medical schools.

Frontline health workers are also part of the public health workforce. So if we have auxiliary nurses, midwives and other skilled workforce, for example middle level health workers with public health skills, then the rural population does not need to. go see the doctors. They can go to village sub-centers and primary health centers. But we need numbers and we need skills. We don’t need someone from community medicine or a doctorate in public health.

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Q. What do we need to acquire this expertise?

A. We have institutions that train them, but we need more. We need a lot more government funding to make sure that happens. Again, we need to make sure that public health education is delivered outside of medical schools and within medical schools. Public health focuses on prevention. He seeks the identification and early orientation of sick people; locate the organization and health facilities to see if there are doctors and nurses. He is interested in the system aspect. He is looking at the political aspect. It looks at the aspect of the program.

First of all, the institutions, which exist, must be strengthened. Also, we need to create new institutions.

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