Researchers call for more globalized public health training in UK
MedWire News: Global public health issues are not adequately addressed during training of UK public heath registrars, study findings indicate.
"In order to retain its position as a leader in the field of public health, the UK needs to adapt its training program to better reflect today's challenges," write Andrew Lee (University of Sheffield, UK) and colleagues in the Journal of Public Health.
"Global health issues encompass everything from pandemics of infectious diseases to climate change or obesity," the researchers explain.
"Therefore, irrespective of location, many of the 'public health' challenges health professionals face are in fact 'global health' challenges and require an understanding of the determinants of health on a global level," they add.
To investigate whether the current UK public health training program adequately prepares its graduates to operate in a globalized world, Lee and team conducted an online cross-sectional survey of UK public health trainees on the international content of the Faculty of Public Health's (FPH's) written examination. They also carried out a qualitative review of the FPH's 2007 training curriculum, and sent a survey to all 10 specialist public health training schools in the UK.
Of the 350 registrars registered with the FPH at the beginning of 2010, 80 (23%) responded to the examination survey.
Overall, 57% said the public health examination was "substantially" UK centric and 58% thought the examination content covered generic knowledge - generic skills and knowledge, which could be applied to international contexts to some extent - "a lot."
Just 5% thought the topics covered had no international relevance, whereas 6 % thought the examination had significant international relevance. These findings may be due to the high perception that the examination focused on generic skills and knowledge, says the team.
A high proportion (60%) said that they wanted the examination to have "somewhat" or "a lot" of international relevance, whereas only half felt that this was currently the case, indicating a desire for more international relevance.
In addition, the responses from the specialist training showed a spectrum of attitudes to international placements, with many unreceptive to such placements.
"We believe that public health training in its current form does not prepare registrars to work in the globalized world of public health whether they work exclusively in the UK or more globally," Lee and co-authors remark.
"If we are to appropriately address key global health challenges, the prevailing anachronistic practice of public health needs to change and the training program with it," they conclude.
In an accompanying commentary Sian Griffiths (The Chinese University of Hong Kong) noted that, as with many workforce-based surveys, the response rate was low and the methodology had its weaknesses.
However, this does not detract from the finding that the present training and accreditation processes are not viewed as having enough of a global perspective, she said.
"This needs to change," she remarked. "If we are to practice effectively we need to encourage those in training to think outside their local situation and understand the bigger picture."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Laura Dean