Journal of Veterinary Medical Education, Vol 35, Issue 2, 177-181
DOI: 10.3138/jvme.35.2.177
Copyright © 2008 by Association of American Veterinary Medical Colleges
Public-Health Training for Veterinarians |
The Dual DVM/MPH Degree at the University of Wisconsin—Madison: A Uniquely Interdisciplinary Collaboration
Christopher W. Olsen•
Patrick L. Remington
 |
ABSTRACT
|
|---|
The University of Wisconsin—Madison (UWM) launched a new Master of Public Health (MPH) degree program in 2005. This 42-credit MPH degree consists of 18 core and 14 elective course credits, two seminar credits, and eight field project/culminating experience credits. Unique strengths of the program include its strongly interdisciplinary philosophy, encompassing both health science (human medicine, veterinary medicine, pharmacy, nursing) and social science units on campus, and its emphasis on service learning through instructional and field project ties to the public-health community of the state and beyond. To date, the program has admitted 87 students, including full-time students as well as part-time students who continue to work in the health care and/or public-health sectors. The program is currently proceeding with the process for accreditation through the Council for Education in Public Health. In 2007, a formal dual DVM/MPH program was approved to allow students to integrate DVM and MPH training and complete both degrees in a total of five years. Nine MPH students over the first three years of admissions have been individuals affiliated with veterinary medicine (five DVM students and four post-graduate veterinarians).
Key Words: MPH • DVM-MPH • dual degree • interdisciplinary
|
INTRODUCTION
|
|---|
The link between veterinary medicine and public health is so fundamental that the veterinary oath, taken by all graduates of schools of veterinary medicine in the United States, includes a statement that veterinarians will use their "scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge."1 Historically, many major public-health concerns have involved issues of food safety and zoonotic infectious diseases (such as brucellosis, animal-origin tuberculosis, rabies, Q-fever, and anthrax) and, thus, have been directly related to veterinary medicine.2 From the late 1960s through the early 1980s, following on the control of many of the classic infectious diseases, a shift in emphasis in public health toward chronic diseases was accompanied by a reduction in the perceived contributions of veterinary medicine to the practice of public health. Recently, however, there has been a renewed recognition of the important roles that veterinarians can play in public health. While endemic and emerging zoonotic infectious diseases (a category that includes virtually all List A and List B bioterrorism diseases3) continue to be an important area of interface between veterinary medicine and public health, veterinarians also work in food safety, environmental health, disaster response and recovery, antibiotic resistance, epidemiology, sustainable development, regulatory affairs—virtually all areas of public health.4,5 Likewise, veterinarians serve in a variety of institutions in the public-health community, including local, national (Centers for Disease Control and Prevention), and international (World Health Organization) public-health organizations; the uniformed services (both the armed forces and the US Public Health service); national (US Department of Agriculture) and international (World Animal Health Organization [OIE]) livestock and agriculture organizations; multinational food-system and pharmaceutical companies; and non-governmental and international aid organizations.6
Recent landmark studies have highlighted the nationwide need for enhanced public-health training of veterinarians. Specifically, in 2002, the Association of American Veterinary Medical Colleges (AAVMC) coordinated a conference in Washington, DC, to address the future of veterinary medicine in public health. The outcome of that conference was a series of papers and recommendations entitled Agenda for Action: Veterinary Medicine's Role in Biodefense and Public Health. Among the conclusions from that conference were that "academic veterinary medicine must develop more graduate and post-doctoral programs to serve the needs of individuals who want to pursue non-practice public service careers" and that there must be "more innovative dual-degree programs,"7 to "build a cadre of skilled professionals who will be successful in biodefense and public health well into the future."9,7–9 A second AAVMC study reached similar conclusions, stating that "satisfying only current needs in population health and public practice will require more than 500 of the approximately 2,500 available new US [DVM] graduates each year" and that "colleges ... should offer specialty training programs for population health practitioners, such as MPH ... and the graduate training of DVM-PhD scientists in epidemiology, pathology, and infectious diseases."4 Dual DVM/MPH degree programs can position schools of veterinary medicine as leaders in creative approaches to public-health education; provide opportunities for students to coordinate veterinary medicine and public-health training optimally and efficiently; enhance the public-health workforce of the nation and beyond; and advance the veterinary medical profession's commitment to a One Health/One Medicine approach to the promotion of animal and human health, the interface of veterinary and human medicine, and cross-disciplinary biomedical research.
Finally, the success of recent symposia such as A Day at CDC for Veterinary Students (January 2006, January 2008) and the joint AAVMC/Association of School of Public Health symposium titled Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine10 (April 2007) highlights the growing interest in enhancing the roles of veterinarians in public health and veterinary medicine/human medicine/public health cooperative programming.
|
UNIVERSITY OF WISCONSIN—MADISON MPH AND DVM/MPH PROGRAMS
|
|---|
Faculty members on the UWM campus began discussing developing an MPH degree program more than a decade ago. These discussions accelerated in 2000, after Wisconsin's two medical schools (UWM and the Medical College of Wisconsin) were each given approximately $300 million following the conversion of the nonprofit Blue Cross and Blue Shield United of Wisconsin to a for-profit company. The goal of the programs established by the schools with these funds is to improve the health of state residents through research and education in public health. In response to this challenge, the UW Medical School began an ongoing process of "transformation" to integrate public health into its teaching, research, and service missions. In fact, the school changed its name, becoming the UW School of Medicine and Public Health (SMPH)—one of the first medical schools to integrate public health so visibly in its mission.
One of the first steps in this transformation was the establishment of the MPH program in the fall of 2002, building on an existing MS/PhD program in population health.11 From the outset, faculty members from across campus were enthusiastic about the development of this new professional degree program. Most faculty in other health sciences had been considering ways to integrate public health into their existing curriculum and saw the MPH program as an important resource for students wanting more in-depth exposure to the principles and practice of public health. This broad base of support was instrumental in the rapid development of the program, which accepted applications in the fall of 2004 and admitted its first students in the fall semester of 2005.
The UWM MPH degree consists of a minimum of 42 semester course credits (see Table 1). It is a generalist degree program, such that all students are prepared to contribute to multiple areas of public health service. In particular, DVM/MPH students are not limited to what might be considered traditional areas of study in "veterinary public health" or regulatory veterinary medicine. Students complete six three-credit core courses—Public Health Principles and Practice, Introduction to Epidemiology, Introduction to Biostatistical Methods for Public Health, Introduction to Environmental Health, Social and Behavioral Sciences for Public Health, and Health Policy and Management—for a total of 18 credits, as well as two credits of required MPH program seminars. In addition, a minimum of 14 credits of elective courses must also be completed.
For DVM/MPH students, up to eight credits from the DVM curriculum at the UWM School of Veterinary Medicine (SVM) can count toward the 14 MPH elective credits (see Table 1). Four credits come from didactic classroom courses: Veterinary Epidemiology (two credits, year 2 of the DVM curriculum) and Regulatory Veterinary Medicine and Public Health, which encompasses topics of food safety, regulatory affairs, and zoonotic diseases (two credits, year 3). Four additional credits are derived from two fourth-year elective externship rotations: Public and Corporate Practice (two weeks, two credits), a rotation in which students and faculty coordinators visit a wide range of regulatory and corporate public-health practice settings, and a shadowing rotation with the state public-health veterinarian in the Wisconsin Department of Health and Family Services/Division of Public Health/Communicable Diseases and Preparedness (two weeks, two credits).
Finally, all MPH students must complete a field project and a culminating experience. The field project is a minimum 400-hour internship experience designed to integrate public-health theory, knowledge, and skills in a practice setting. Students engage with public-health professionals to explore real-world problems at the community level and apply their coursework knowledge in a practical setting. This externship is typically undertaken after the completion of the majority of the student's didactic training. In the culminating experience, students develop a written paper and an oral presentation summarizing their investigation of a public-health problem during the field experience. The oral presentations take place during a Field Experience Symposium that coincides with the arrival and orientation of the next incoming class of MPH students. Veterinary medical students and professionals in the program to date have undertaken a wide range of field projects, including a study of the prevalence and perceptions of raw-milk consumption among people in Wisconsin; a survey of human infections with Salmonella enterica ser. Newport in Wisconsin from 2003 through 2006; a review of smallpox post-vaccination reactions in Wisconsin; and a community-based, participatory research project to evaluate an ethno-veterinary anthelmintic product among the Karamoja peoples of Uganda.
Administratively, it is possible for students to combine the DVM and MPH degree requirements at the UWM in various ways, but the two degrees are most optimally combined on a two-one-two schedule in which student complete the first two years of the DVM curriculum, then 12 months to complete the majority of their MPH course- and fieldwork before completing the third and fourth years of the DVM degree. In this way, students obtain a grounding in infectious diseases, pathology, and epidemiology from the DVM curriculum as a foundation for their MPH studies while maintaining continuity between the classroom and teaching-hospital phases of clinical training that occur in years 3 and 4 of the DVM curriculum.
On this schedule, students will typically apply to the MPH program during the fall semester of their second year in the DVM program. Factors in the MPH admissions decision-making process include academic preparation (undergraduate and health-professions program grades, grade trends and academic rigor, GRE scores); a personal statement outlining the candidate's goals related to a career in public health; prior public experiences, such as working in social-service agencies, public-health departments, or public-health volunteer activities (clinical care alone does not constitute public-health experience for the purposes of admission to the MPH program); unique aspects of a candidate's work and life experiences and his or her cultural background; and letters of recommendation.
|
WHY A DUAL-DEGREE APPROACH?
|
|---|
It is certainly possible for students to complete the DVM curriculum and subsequently pursue the MPH degree, either immediately after graduation from veterinary medical school or later in their careers. However, a dual DVM/MPH degree program has several strategic advantages over the sequential approach. In particular, the dual-degree approach allows for optimal integration of students’ education in veterinary medicine and public health. Examples of such integration might include a broader understanding of and appreciation for the public-health implications of issues addressed in the DVM curriculum; an enhanced ability to incorporate animal-health examples into the epidemiology, biostatistics, and environmental-health training in the MPH curriculum; and development of contacts in the public-health community early enough in the DVM curriculum to facilitate planning of DVM fourth-year public-health externships or preceptorships. In addition, completing both degrees within a five-year period allows for the most efficient use of the time and tuition dollars students must commit to their education, both of which are practical issues of great importance in recruiting veterinary students to public-health careers. Finally, the simultaneous completion of both DVM and MPH degrees facilitates application to the prestigious Epidemic Intelligence Service (EIS) training program at the CDC, which requires that veterinarians have MPH training or relevant public-health experiences at the time of application.
Conversely, MPH programs can also benefit from the creation of dual DVM/MPH degree programs and the inclusion of veterinary medical students, since human health and disease are affected by animal health and disease in many ways (including, but not limited to, issues of food safety, zoonotic infectious diseases, agro-chemical environmental contamination, antibiotic resistance, farm safety, and mental health/the human–animal bond). Institutions, such as the UWM, that have schools of both human health sciences and veterinary medical sciences on a single campus have a unique opportunity to incorporate both a technical understanding of and a philosophical appreciation for the interrelationships between human and animal health into their MPH programs. Furthermore, the involvement of veterinary medical students in such MPH programs can facilitate expanded public–health-related teaching and research collaborations among faculty members of human and veterinary medical schools.
|
FOCUS ON SERVICE LEARNING AND INTERDISCIPLINARITY IN THE UWM MPH
|
|---|
The MPH program at the UWM is unique in two principal ways. First is its emphasis on service learning. At its core, this emphasis reflects the so-called Wisconsin Idea, first articulated by UW president Charles Van Hise in 1904 when he stated that "he would never be content until the beneficent influence of the University reaches every family in the state."12 This philosophy permeates much of the university's work and is reflected in the MPH program faculty's strong focus on applied public-health research and teaching. The MPH program in particular benefits from strong connections with communities through the Wisconsin Division of Public Health, the City of Milwaukee Health Department, and other health care and not-for-profit agencies.
The field experiences that MPH students complete are a major focus of their learning, and staff in the MPH program, the state Division of Public Health, and the Milwaukee Health Department have specific responsibilities to facilitate and coordinate these field experiences. Students can choose to complete their field experiences in these agencies or at other preapproved sites, or they can seek approval for field projects in other public-health venues of their choosing in Wisconsin, elsewhere in the United States, or globally.
The second unique aspect of the UWM MPH program is its focus on interdisciplinary learning. The initial impetus for the UWM MPH came from the School of Medicine, and the MPH is administratively housed in the Department of Population Health Sciences in the SMPH. Since the earliest planning stages, however, the program has consistently had a strongly interdisciplinary emphasis, encompassing each of the health science schools on the campus; social science, business, and law programs on campus; and human and animal health authorities from the state public-health community.
This interdisciplinary focus is derived in part from the fact that the UWM is one of the few universities in the nation to have multiple health sciences schools geographically co-located on the same campus—in our case the SMPH, the SVM, the School of Nursing, and the School of Pharmacy—as well as programs in physical therapy, occupational therapy, biostatistics and medical informatics, environmental sciences, and many other topics. However, it also reflects the cross-disciplinary sense of collaboration that has historically characterized the UWM's research enterprise. For instance, UWM SVM faculty members hold joint or affiliate appointments for the purpose of research and graduate training in approximately 40 departments and multidisciplinary cross-campus graduate programs, including joint appointments within the SMPH. Furthermore, the UWM campus is fortunate to also have very strong programs in the social sciences; the LaFollette School of Public Policy, the School of Business, and the School of Law have also been integral players in development of the MPH.
Input from across these university units occurs at multiple levels of the MPH program: the administrative steering committee, the community advisory committee, the admissions committee, MPH program faculty members, field project mentors, and, most importantly, the student body itself. An MPH degree program drawing from multiple backgrounds in the health and social sciences will uniquely position students to become tomorrow's leaders in addressing the full range of public-health challenges, from the classical issues of health promotion and disease prevention to problems of health-care economics and health disparities, emergency preparedness, and health policy and administration.
|
VETERINARY MEDICINE-AFFILIATED UWM MPH STUDENTS
|
|---|
Of the 87 students who have enrolled in the UWM MPH program to date, nine have been affiliated with veterinary medicine: five dual DVM/MPH students as well as four post-graduate veterinarians (three as full-time students and one as a part-time student). These students come from a variety of backgrounds and interests, though they appear to have a stronger interest in infectious diseases than the total population of MPH students.
Two DVM students from the graduating class of 2007 and two post-graduate veterinarians have completed their MPH degrees to date; one continues in food-animal practice, one is working with the Wisconsin Department of Health and Family Services/Division of Public Health, one is a member of the US Army Veterinary Corps, and one is a member of the EIS of the CDC. A third post-graduate veterinarian works for the USDA's Animal Plant Health Inspection Service/Veterinary Services and continues to complete MPH requirements as a part-time student.
|
Footnotes
|
|---|
AUTHOR INFORMATION
Christopher W. Olsen, DVM, PhD, is Professor of Public Health in the Department of Pathobiological Sciences and Associate Dean for Academic Affairs in the School of Veterinary Medicine, University of Wisconsin—Madison, 2015 Linden Drive, Madison, WI 53706 USA. E-mail: olsenc{at}svm.vetmed.wisc.edu. Dr. Olsen's area of research interest is zoonotic diseases, particularly the interface of animals and humans in the ecology and evolution of influenza viruses.
Patrick L. Remington, MD, MPH, is Professor of Population Health Sciences and Director of the MPH program, School of Medicine and Public Health, University of Wisconsin—Madison, 610 N Walnut Street, Madison, WI 53726 USA. Dr. Remington's current research interests are in methods used to measure the health of communities and in public health approaches to tobacco and cancer control.
|
REFERENCES
|
|---|
- American Veterinary Medical Association [AVMA]. Veterinarian's Oath <http://www.avma.org/careforanimals/animatedjourneys/aboutvets/aboutvets.asp#2>. AVMA, Schaumburg, IL, 1999.
- Turnock BJ. What is public health? In Turnock BJ, ed. Public Health: What It Is and How It Works. Sudbury, MA: Jones & Bartlett, 2004 1–37.
- Centers for Disease Control and Prevention [CDC]. Bioterrorism Agents/Diseases <http://www.bt.cdc.gov/agent/agentlist-category.asp>, Atlanta, GA, CDC, n.d.
- Hoblet KH, Maccabe AT, Heider LE. Veterinarians in population health and public practice: meeting critical national needs. J Vet Med Educ 30: 287–294, 2003 p287.[Free Full Text]
- Pappaioanou M, Garbe PL, Glynn MK, Thacker SB. Veterinarians and public health: the epidemic intelligence service of the Centers of Disease Control and Prevention, 1951–2002. J Vet Med Educ 30: 383–391, 2003.[Abstract/Free Full Text]
- Pappaioanou M. Veterinarians in global public health. J Vet Med Educ 30: 105–109, 2003.[Free Full Text]
- Walsh DA, Murphy FA, Osburn FI, King L, Kelly AM. Executive summary: agenda for action. J Vet Med Educ 30: 92–95, 2003 p95.[Free Full Text]
- Baker J, Blackwell M, Buss D, Eyre P, Held JR, Ogilvie T, Pappaioanou M, Sawyer L. Strategies for educational action to meet veterinary medicine's role in biodefense and public health. J Vet Med Educ 30: 164–171, 2003.[Abstract/Free Full Text]
- King L. Veterinary medicine's role in biodefense and public health. J Vet Med Educ 30: 161–163, 2003 p162.[Free Full Text]
- Association of Schools of Public Health [ASPH]. Summary of 2007 AAVMC/ASPH Joint Symposium, Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, April 22–24 <http://www.asph.org/document.cfm?page=1005>, Atlanta, GA, 2007.
- University of Wisconsin. Master of Public Health program <www.pophealth.wisc.edu/MPH/>. University of Wisconsin—Madison, 2005.
- A century-old legacy: influence of Van Hise lives on through Wisconsin idea, University of Wisconsin—Madison News <http://www.news.wisc.edu/8502>. 2003.
| AAVMC APPRECIATES THE SUPPORT OF OUR TWO PATRONS, HILL'S PET NUTRITION AND BAYER ANIMAL HEALTH, WHO IN COMBINATION ARE FULLY SUPPORTING THIS SITE. |
 |
 |
 |
|
|
|
TOP
ABSTRACT
INTRODUCTION
