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Journal of Veterinary Medical Education, Vol 35, Issue 2, 187-193
DOI: 10.3138/jvme.35.2.187
Copyright © 2008 by Association of American Veterinary Medical Colleges
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Public-Health Training for Veterinarians

Public-Health Education at Kansas State University

Jennifer AkersPatricia PayneCarol Ann HolcombTable 1Bonnie RushDavid RenterManuel H. MoroLisa C. Freeman

Correspondence: Address correspondence to Dr. Lisa Freeman, Kansas State University, College of Veterinary Medicine, 101C Trotter Hall, Manhattan, KS 66506 USA. E-mail: freeman{at}vet.k-state.edu.


    ABSTRACT
 TOP
 ABSTRACT
 INTRODUCTION
 PUBLIC HEALTH IN THE...
 NON-DEGREE OPPORTUNITIES IN...
 THE INTERDISCIPLINARY MASTER OF...
 STRENGTHS, WEAKNESSES,...
 REFERENCES
 
What are veterinary medical and public-health professionals doing to remedy the immediate and impending shortages of veterinarians in population health and public practice? This question was addressed at the joint symposium of the Association of American Veterinary Medical Colleges and the Association of Schools of Public Health, held in April 2007. Thinking locally, faculty and students at Kansas State University (KSU) asked similar questions after attending the symposium: What are we doing within the College of Veterinary Medicine to tackle this problem? What can we do better with new collaborators? Both the professional veterinary curriculum and the Master of Public Health (MPH) at KSU provide exceptional opportunities to address these questions. Students are exposed to public health as a possible career choice early in veterinary school, and this exposure is repeated several times in different venues throughout their professional education. Students also have opportunities to pursue interests in population medicine and public health through certificate programs, summer research programs, study abroad, and collaborations with contributing organizations unique to KSU, such as its Food Science Institute, National Agricultural Biosecurity Center, and Biosecurity Research Institute. Moreover, students may take advantage of the interdisciplinary nature of public-health education at KSU, where collaborations with several different colleges and departments within the university have been established. We are pleased to be able to offer these opportunities to our students and hope that our experience may be instructive for the development of similar programs at other institutions, to the eventual benefit of the profession at large.


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Table 1: KSU MPH graduates as of December 2007

 

Key Words: Master of Public Health • veterinary education


    INTRODUCTION
 TOP
 ABSTRACT
 INTRODUCTION
 PUBLIC HEALTH IN THE...
 NON-DEGREE OPPORTUNITIES IN...
 THE INTERDISCIPLINARY MASTER OF...
 STRENGTHS, WEAKNESSES,...
 REFERENCES
 
It is widely acknowledged that the veterinary profession is failing to meet the national need for veterinarians trained in population health and public practice. Since 2003, numerous articles published in this journal1–4 and three studies conducted by the National Academy of Sciences5–7 have concluded that veterinary medicine needs to change in order to meet society's needs and address new challenges related to public health, national security, and international trade. In the College of Veterinary Medicine and other academic units at Kansas State University (KSU), we are currently examining and revising curricular and co-curricular offerings, as well as degree and certificate programs, to ensure that our graduates are prepared to serve society. In addition, we want to respond to student demands for a professional education that provides them not only with proficiency in clinical veterinary medicine but also with communication skills, leadership development, and real opportunities to explore nontraditional veterinary careers and to collaborate with health professionals from outside veterinary medicine.8

In 2007, as part of a data-gathering effort linked to curricular review and reform, veterinary students at KSU were surveyed about their interest in public health. Veterinary students in all four years of the professional curriculum (n = 410) were queried by e-mail; 202 of these students (49%) opened the e-mail message. There were 54 students who indicated that they expect to pursue public health as a career path, either immediately upon graduation or in the foreseeable future. In addition, 12 students had participated in either senior externships or summer experiences in public health: three with the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS); three with the USDA Food Safety and Inspection Service; one at the Kansas Department of Environmental Health (KDHE); one in the University of Minnesota Public Policy Rotation; one in Brazil, through Louisiana State University; one in the US military; one through the Veterinary Research Scholars Program in public-health-focused research; and one who did not specify the nature of the experience. Eight students are pursuing concurrent DVM and Master of Public Health (MPH) degrees at KSU.

The documented level of interest in public health among KSU veterinary students stimulated us to ask the following questions:

The enthusiasm for and commitment to expanding public-health opportunities available to veterinary students at KSU was evident from our participation in the Association of American Veterinary Medical Colleges/Association of Schools of Public Health (AAVMC/ASPH) joint symposium Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, held in Atlanta, Georgia, on April 22–24, 2007. A dozen representatives from KSU attended the meeting, including two administrators, four faculty members, one post-doctoral trainee engaged in public-health-related research, one graduate of the interdisciplinary MPH program, three students currently enrolled in the interdisciplinary MPH program, and one senior veterinary student interested in pursuing advanced training in public health. The goal of this group was to network with students and faculty from other institutions in order to share and compare public-health offerings and programs, to identify best practices for infusing public health into the veterinary curriculum, and to become better acquainted with potential collaborators. The following article summarizes the deliberations that took place before, during, and after the symposium. Specifically, we describe the public-health offerings currently available at KSU, then reflect on strengths, weaknesses, and opportunities.


    PUBLIC HEALTH IN THE PROFESSIONAL VETERINARY CURRICULUM AT KSU
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Veterinary students at KSU are made aware of public-health careers and concepts at various times during the four years of the DVM program; their exposures are typical for students in a US school or college of veterinary medicine with a traditional, untracked curriculum:


    NON-DEGREE OPPORTUNITIES IN PUBLIC HEALTH FOR KSU DVM STUDENTS
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In addition to the coursework and elective clinical rotations embedded within the professional curriculum, veterinary students at KSU can learn about VPH through a number of veterinary student programs not associated with academic credit. Some of these, like the Smith-Kilborne Program for Foreign Animal Disease Training at Plum Island, are national programs available to students at all US schools and colleges of veterinary medicine. Four opportunities specific to KSU are described below.


    THE INTERDISCIPLINARY MASTER OF PUBLIC HEALTH (MPH) AT KSU
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Students at KSU have the opportunity to earn a Master of Public Health (MPH) degree. The MPH requirements can be completed concurrently with a veterinary degree, after completion of a veterinary degree, or by non-veterinarians. The MPH degree at KSU is a 42-credit-hour program that is campus-wide and interdisciplinary.

The MPH program at KSU has five central student learning outcomes: (1) knowledge, (2) skills, (3) integration, (4) diversity, and (5) professional development. The knowledge outcome outlines an ability to describe and discuss the five core areas of knowledge that are basic to public health and biosafety: biostatistics, epidemiology, environmental health, public-health administration, and the social/behavioral aspects of public health. In the evaluation of skills, students are expected to demonstrate the acquisition of skills and experiences in applying knowledge from an area of emphasis to the solution of regional, national, and international public-health problems. The integration outcome stresses the ability to integrate knowledge and skills to solve problems and to produce scholarly work in a culminating experience in the form of a thesis, report, or community-based field project. The diversity outcome affirms the worth and personal dignity of everyone, regardless of individual differences; students are expected to contribute to a climate of civility, community, trust, and reasoned discussion on campus and in public-health delivery settings. Students are also encouraged to nurture their professional development and to recognize the value of intellectual curiosity and the need for lifelong learning in order to keep abreast of changes in the fields of public health, biosafety, and security.

Currently, 42 semester credit hours are required, distributed over three areas: (1) core coursework in general public health (16 credit hours), (2) additional coursework focused on one of four defined areas of emphasis (20 credit hours), and (3) a culminating experience (6 credit hours). At present, the distribution of coursework required in the five core areas of knowledge is as follows: biostatistics (3 credit hours), epidemiology (5 credit hours), environmental health (2 credit hours), public-health administration (3 credit hours), and social and behavioral aspects of public health (3 credit hours).

The KSU MPH program is unique in allowing concentration in one of four areas of emphasis: (1) public health nutrition, (2) public health physical activity, (3) food safety and bio-security, and (4) infectious disease and zoonoses. The food-safety curriculum is designed to prepare students for professional practice and research relative to the safety of food products from animals. Specialized training in the recognition, evaluation, and control of food-borne infectious agents and toxins is emphasized. The focus in infectious disease and zoonoses aims to prepare leaders for national and regional initiatives in protection against zoonoses and in bioterrorism preparedness and response. These two MPH emphasis areas are aligned with KSU's strength in agricultural bio-security and are attractive to veterinary students and practicing veterinarians.

The culminating experience may be a research-based thesis, a report, or a community-based field project. KSU students pursuing the MPH focus on infectious disease and zoonoses have chosen diverse activities to complete this requirement. Some have elected to work regionally, at state health departments in Kansas and Nebraska, studying public-health issues of local importance such as the public-health threat posed by blue-green algae in Nebraska. Others have done fieldwork at national agencies such as the CDC. As the program evolves, we expect to see more students seeking international field experience. For example, a DVM/MPH student with a well-developed interest in global veterinary medicine recently chose to study public-health issues in Kenya's Masai community through a six-credit-hour summer field-study experience in environmental and community health sponsored by the School for Field Studies at Boston University.

For the infectious disease and zoonoses area of emphasis, programs of study have been designed to meet the specific needs of three types of students: non-veterinarians; post-graduate veterinarians; and veterinary students concurrently pursuing the DVM and the MPH. Non-veterinarians are required to complete all 16 hours of required core courses plus 20 hours of classes in the area of emphasis. By contrast, graduate veterinarians and DVM students can apply up to 10 hours of credit from an AVMA-accredited veterinary curriculum to the 20 hours related to the disciplinary focus. These students can also receive two hours of credit toward the epidemiology requirement of the core courses, as this course is part of the DVM curriculum at KSU as well as at most other veterinary schools and colleges.

Annual enrollment has steadily increased from the MPH program's inception in 2003 to the current academic year: six students were admitted to the program in 2003/2004 and 14 in 2007/2008. Of the 28 students currently enrolled in the MPH program, 21 are in the emphasis area of infectious disease and zoonoses. KSU had graduated 15 MPH students as of December 2007; Table 1 lists the area of study emphasis, job description, and location of employment for each of these graduates.


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Faculty members and trainees recognized as thought leaders in VPH have highlighted areas of importance to promote, sustain, and perpetuate VPH education.1,3,4 Veterinary students’ concerns are focused on the need for more information and encouragement to seek positions outside clinical practice, as well as on the importance of tuition subsidies and loan-repayment programs to reduce educational debt.8 These perspectives are shared by veterinarians from government, corporate practice, organized veterinary medicine, and academia.1 KSU has been proactive in addressing some of these concerns. Our curriculum informs students about the full scope of veterinary career pathways by exposing them to veterinarians with careers outside clinical practice and by offering interactive learning opportunities through externships and non-degree programs. The Veterinary Training Program for Rural Kansas provides a significant financial incentive for students interested in food systems and public health to pursue training in these areas.

The senior leadership of KSU is dedicated to supporting multidisciplinary research in food safety and security. As a result, veterinary students interested in public health have the opportunity to enhance their educational experience through exceptional collaboration supported not only by the Colleges of Agriculture and Veterinary Medicine but also by the resources associated with the Food Science Institute,c the National Agricultural Biosecurity Center,d and the Biosecurity Research Institute.16 These centers integrate multidisciplinary expertise in food safety, bio-security, infectious disease, and related areas of public health across KSU. As a result of their success, KSU veterinary students in the MPH program have the option of being advised by faculty members with unusual expertise. The Department of Diagnostic Medicine/Pathobiology is the academic home not only of a cadre of excellent epidemiologists, bacteriologists, parasitologists, toxicologists, and virologists but also of historian Justin Kastner, who studies historical and contemporary trade-policy questions related to food safety and security, and journalist Douglas Powell, who directs the International Food Safety Network,e an online repository of information related to food safety.

This institutional investment in the food, agricultural, biomedical, and social sciences relevant to public health forms a strong foundation for public-health education at KSU. A strength and weakness of the interdisciplinary MPH is that the degree program is newly established; the program is unproven because it lacks a significant track record. On the other hand, the program will probably never again be more open to innovation or less beholden to tradition. This is a time of tremendous opportunity for KSU students and faculty interested in advancing an MPH distinguished by its interdisciplinary structure and its direct relevance to food and agricultural sciences and rural communities. The KSU MPH program is still developing strategies to facilitate accreditation by the Council on Education for Public Health and to ensure long-term vitality and sustainability. At present, the MPH program leadership is actively seeking creative and collaborative ways to reinforce the infrastructure that supports public-health education at KSU and to address the issues that challenge the long-term success of the interdisciplinary degree program.

The major issues facing the interdisciplinary MPH program at KSU are related to recruiting, retaining, and advising DVM and non-DVM students interested in public health; providing MPH students with a balance of public-health research and professional practice experience; and creating and sustaining new courses that can be offered through mediated distance education as well as on campus. These issues are not unique to our program or to our campus. Thus, the solutions sought should be of interest to other veterinary colleges and land-grant institutions that are trying to increase their efforts in public-health education and workforce development.

The future of the interdisciplinary MPH program at KSU depends on the ability to recruit and retain students in the undergraduate and professional degree programs that feed the four areas of emphasis. The coordinating committee that oversees the graduate program has recognized the importance of increasing undergraduate students’ awareness of public-health careers and accepted this responsibility. To this end, we have developed an integrated recruitment and retention strategy that targets community college students who are interested in learning more about public-health professions, as well as undergraduate students enrolled in degree programs relevant to public health (e.g., biology, food science, human nutrition, and kinesiology). The proposed program, Pathways to Public Health, has four components:

  1. An introductory survey course focused on public-health topics that will be made available at community colleges through distance education
  2. An eight-week summer immersion experience that will expose students to the four public-health emphasis areas: food safety, infectious diseases and zoonoses, human nutrition, and physical activity
  3. A five-year concurrent BS/MPH option
  4. A Director of Undergraduate Public Health Programs dedicated to mentoring students

Together, these components should stimulate and increase the number and preparation of students seeking a baccalaureate or higher degree in disciplines relevant to public-health practice. Funding is currently being sought from a number of sources to support implementation of Pathways to Public Health at KSU.

KSU students currently enrolled in the MPH program would benefit from access to a greater number of mentors, a broader selection of courses, and the availability of more courses offered through mediated distance education. Increased enrollment would exacerbate these needs. Steps are already being taken to address these issues associated with program growth. We have focused on building capacity through collaboration and have been relatively successful in these efforts. For example, a number of public-health professionals from outside agencies have accepted our invitations to join the graduate faculty associated with the CVM as either adjunct members or part-time employees, including Dr. Gail Hansen, the Kansas state veterinarian; Dr. David Ashford, a federal veterinarian working with USDA APHIS in Brazil; and Dr. Cathleen Hanlon, a rabies expert working actively with the Global Alliance for Rabies Control. They are creating course materials that can be offered via distance education and advising students interested in public-health practice.

There is also new potential for synergy between KSU and the University of Kansas (KU) to enhance graduate education in public health statewide. Academic leaders at both institutions have identified advantages to creating new educational alliances. Faculty members at these two flagship universities are discussing how to leverage existing resources for maximal impact on MPH and PhD students in disciplines relevant to public-health practice. The MPH programs at KSU and at the KU School of Medicine have complementary strengths and structures. In contrast to the MPH at KSU, which requires students to focus in an emphasis area and allows them to either perform research or gain practical experience during the capstone project, the MPH at KU is a 42-credit-hour generalist degree that requires a culminating practicum experience.f There are also public-health-focused PhD programs in existence and under development at KU that would be of interest to KSU students and to which KSU faculty could contribute, including health policy and management, biostatistics, and preventive medicine. Clearly, there is tremendous potential for collaborative efforts between KSU and KU to enhance the experience of students in their MPH programs by sharing educational resources. The precise nature of the partnership remains to be determined.

There are differing opinions about the importance of research experience to students seeking the MPH among students, faculty, and thought leaders in the fields of higher education and public-health practice. At KSU, MPH students may perform a traditional master's thesis research project, gain practical field experience, or pursue a combination of these activities as part of the required capstone project. Campus-based faculty members in all four emphasis areas often encourage options that include research, because they perceive this as the most appropriate use of their skills as advisors. However, many research-focused students prefer to pursue Master of Science degrees in public-health-related disciplines, rather than the MPH, because they believe that research associated with the latter degree is undervalued by the academic community. To encourage broader awareness of public health among KSU graduate students, the MPH program faculty and the KSU Graduate Council have proposed a certificate program in Core Public Health Concepts. This graduate certificate will be awarded on completion of the core coursework in general public health (16 credit hours) and can be pursued in conjunction with a DVM, MS, or PhD degree. The certificate will allow students to strengthen their educational programs by providing a mechanism for them to gain proficiency in core public-health concepts without detracting from their existing graduate degree programs. The certificate option will be implemented in fall 2008 and is expected to be popular with both DVM and non-DVM students.

Our long-term goal is to provide veterinary students and graduate students interested in public health with the tools they need to work effectively at the interface of human medicine and veterinary medicine to promote "One Health." We will be able to achieve this if we are committed to change and open to collaboration. Attending the presentations at the AVMC/ASPH joint symposium opened our eyes to a spectrum of possibilities for enhancing the interdisciplinary MPH and public-health education at KSU. Networking with public-health professionals at that meeting also reinforced our commitment to creating and sustaining innovative, high-quality educational programs and inspired us to work hard for the future.


    Footnotes
 
AUTHOR INFORMATION

Jennifer Akers, DVM, is a clinical instructor in the Department of Clinical Sciences, Q208 Mosier Hall, Kansas State University, Manhattan, KS 66506 USA. Dr. Akers is a current post-graduate MPH student at KSU, and attended the AAVMC/ASPH joint symposium Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, held in Atlanta, GA, on April 22–24, 2007.

Patricia Payne, DVM, PhD, is Assistant Professor of Parasitology in the Department of Diagnostic Medicine/Pathobiology, K-222 Mosier Hall, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506 USA. She contributes to the parasitology course offered in the second year of the professional veterinary curriculum and coordinates the third-year course Zoonoses and Preventative Medicine. Dr. Payne's research program is focused on insecticide resistance in fleas and ticks.

Carol Ann Holcomb, PhD, CHES, is Professor of Nutritional Epidemiology in the Department of Human Nutrition, 102 Justin Hall, College of Human Ecology, Kansas State University, Manhattan, KS 66506 USA. She is also Director of the MPH program at KSU. Dr. Holcomb compiled the data shown in ; she attended the AAVMC/ASPH joint symposium Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, held in Atlanta, GA, on April 22–24, 2007.

Bonnie Rush, DVM, MS, Dipl. ACVIM, is Professor of Equine Internal Medicine in the Department of Clinical Sciences, Q208 Mosier Hall, Kansas State University, Manhattan, KS 66506 USA. Dr. Rush is currently Interim Head of the Department of Veterinary Clinical Sciences and has previously served as Associate Dean for Career Development. In this position she provided leadership to the task force responsible for recommending changes to the professional curriculum at KSU.

David Renter, DVM, PhD, is Assistant Professor of Veterinary Epidemiology in the Department of Diagnostic Medicine/Pathobiology, K-222 Mosier Hall, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506 USA. His primary teaching role is to further develop graduate student training in epidemiology. Dr. Renter also contributes to the epidemiology courses in the DVM and MPH programs. His research program is focused on the application of epidemiologic principles and methods to the study of disease agents associated with livestock and related food products. Dr. Renter attended the AAVMC/ASPH joint symposium Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, held in Atlanta, GA, on April 22–24, 2007.

Manuel H. Moro, DVM, MPH, PhD, is Assistant Professor of Public Health in the Department of Diagnostic Medicine/Pathobiology, K-222 Mosier Hall, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506 USA. Dr. Moro coordinates the Infectious Diseases/Zoonosis emphasis area in the interdisciplinary MPH program; his primary research interest is in understanding the immuno-inflammatory effects of vector-borne pathogens on mammalian hosts. Dr. Moro attended the AAVMC/ASPH joint symposium, Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, held in Atlanta, GA, on April 22–24, 2007.

Lisa C. Freeman, DVM, PhD, is Professor of Pharmacology in the Department of Anatomy and Physiology and Associate Dean for Research and Graduate Programs at the College of Veterinary Medicine, 101C Trotter Hall, Kansas State University, Manhattan, KS 66506 USA. E-mail: freeman{at}vet.k-state.edu. Dr. Freeman serves on the Coordinating Committee for the interdisciplinary MPH program at KSU. She attended the AAVMC/ASPH joint symposium Partnerships for Preparedness: Future Directions for Schools of Public Health and Colleges of Veterinary Medicine, held in Atlanta, GA, on April 22–24, 2007.

NOTES

a An hour of semester credit indicates 15 hours of contact time per semester. Back

b EEAD was developed specifically for veterinary students by faculty from Iowa State University, the University of California, Davis, and the University of Georgia in collaboration with USDA APHIS. It is available to students at no charge through the Veterinary Information Network (VIN). KSU students are allotted time during scheduled class periods to complete the assigned portions of this Internet-based course. Back

c For information on the Food Science Institute see <http://foodsci.k-state.edu/DesktopDefault.aspx>. Back

d For information on the National Agricultural Biosecurity Center see <http://nabc.ksu.edu/>. Back

e For information on the International Food Safety Network see <http://www.foodsafety.ksu.edu/en/about.php>. Back

f For information on the KU MPH program see <http://mph.kumc.edu/about.html>. Back


    REFERENCES
 TOP
 ABSTRACT
 INTRODUCTION
 PUBLIC HEALTH IN THE...
 NON-DEGREE OPPORTUNITIES IN...
 THE INTERDISCIPLINARY MASTER OF...
 STRENGTHS, WEAKNESSES,...
 REFERENCES
 

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