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对公共卫生专业医生的需求。

The need for professional doctors of public health.

作者信息

Roemer M I

出版信息

Public Health Rep. 1986 Jan-Feb;101(1):21-9.

Abstract

Planning, organizing, and operating today's complex health care systems or heading Federal, State, and city public health agencies in the United States and other countries require professionals broadly prepared in the meaning, philosophy, and strategies of public health. It is and has been recognized that the best trained clinical physician could not be expected to know the policies and practices of official public health programs. The chief health official of a State or other jurisdiction, for example, deals with the epidemiology of many diseases; with all aspects of the environment; with hospitals, drugs, health manpower, and nutrition; with issues of health economics, finance, and politics; and with administration. For these tasks, most of medical education is irrelevant. To produce the needed specialists, candidates with a BA degree would be educated as doctors of public health. The proposed 5-year postgraduate curriculum is as demanding as the training for the MD degree, but completely different. The 38 subjects or courses in the curriculum are grouped into four categories: basic tools of social analysis, health and disease in populations, protection of health and prevention of disease, and health care systems and management. At present, MPH degree holders take only a handful of core and elective courses and emerge with little systematic knowledge about the majority of problems they face. The DrPH candidates at schools of public health spend most of their time on research and dissertation writing--adequate preparation for university teachers, but academia is not the goal of most candidates, nor the greatest need of society. Recruits for the proposed new doctorate in public health may be found among the thousands of young people who want to do "community health work" but see no way to play a significant role without getting an MD degree first.

摘要

规划、组织和运营当今复杂的医疗保健系统,或者在美国及其他国家领导联邦、州和城市的公共卫生机构,需要在公共卫生的意义、理念和策略方面有广泛准备的专业人员。人们已经认识到,不能期望训练有素的临床医生了解官方公共卫生项目的政策和实践。例如,一个州或其他辖区的首席卫生官员要应对多种疾病的流行病学;处理环境的各个方面;涉及医院、药品、卫生人力和营养;处理卫生经济学、财政和政治问题;以及行政管理。对于这些任务,大部分医学教育并不相关。为了培养所需的专业人员,拥有文学学士学位的候选人将被培养成为公共卫生博士。提议的5年制研究生课程与医学博士学位的培训要求一样高,但完全不同。课程中的38门学科或课程分为四类:社会分析的基本工具、人群中的健康与疾病、健康保护与疾病预防、以及医疗保健系统与管理。目前,公共卫生硕士学位获得者只修少量的核心课程和选修课程,对他们所面临的大多数问题几乎没有系统的了解。公共卫生学院的公共卫生博士候选人大部分时间都花在研究和论文写作上——这对大学教师来说是充分的准备,但学术界并不是大多数候选人的目标,也不是社会的最大需求。在成千上万想要从事“社区卫生工作”但又觉得如果不先获得医学博士学位就无法发挥重要作用的年轻人中,可能会找到提议的新公共卫生博士学位的招募对象。

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