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Public-Health Training for Veterinarians |
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ABSTRACT |
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Key Words: dual degree • public health • One Medicine • two campuses • Capstone research projects
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BACKGROUND OF THE DVM/MPH PROGRAM AT THE UNIVERSITY OF ILLINOIS |
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In 2003, based in part on their experiences with monkey pox and West Nile encephalitis, faculty at the University of Illinois at Urbana-Champaign College of Veterinary Medicine (UIUC-CVM) and the University of Illinois-Chicago School of Public Health (UIC-SPH) began the development of a collaborative dual-degree program designed to award both Doctor of Veterinary Medicine (DVM) and Master of Public Health (MPH) degrees upon successful completion. Both faculties recognized that veterinarians have made a substantial contribution to public health, in Illinois and nationally, over the past 120 years. It has been estimated that 25 years of the 30-year gain in human life expectancy at birth achieved over the course of the twentieth century were due to improvements in sanitation, hygiene, and infectious disease control, three areas in which veterinarians continue to play an active and productive role.5
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THE DUAL-DEGREE DVM/MPH PROGRAM AT THE UNIVERSITY OF ILLINOIS |
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 TOPABSTRACTBACKGROUND OF THE DVM/MPH... THE DUAL-DEGREE DVM/MPH PROGRAM... STRENGTHS AND UNIQUE FEATURES...ADMISSION REQUIREMENTSAPPLICATION PROCESSCOSTCHALLENGESSUMMARY AND FUTURE DIRECTIONSREFERENCES |
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The MPH is the basic professional degree offered by the UIC-SPH. The program ensures that the graduate has a general understanding of the field of public health and specific competence in areas such as epidemiology, biostatistics, and health policy. The graduate is prepared for careers in public-health practice at local, state, and federal levels; in research in the private or public sectors; or in a hybrid of private veterinary medical practice and consultative work at a local health department.
The joint DVM/MPH degree program is a five-year program of study combining online and on-site courses and concluding with a research-based capstone project. Students in the program must satisfy the required four years of the professional veterinary medical curriculum as well as the required 42 semester hours of the MPH Professional Enhancement Program (PEP) (see Table 1). Veterinary medical students complete the four years of their veterinary medical training at UIUC while taking UIC public-health core courses online or on site in Chicago. Students accepted into the MPH program can receive core credit in the MPH program for courses within the graduate programs of the Pathology and Veterinary Biosciences Departments at the CVM that are deemed equivalent to required MPH courses. Courses within the DVM curriculum in food safety, public health, toxicology, and virology are also accepted for elective credit in the MPH program.
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Dual-degree students spend a minimum of two semesters in residence at UIC-SPH following the third or fourth years of the DVM curriculum. It is anticipated that most, if not all, students will opt to finish their DVM studies prior to finishing the MPH degree in Chicago. Students are encouraged to spend a summer in Chicago in a public-health-related setting while completing their field experience and capstone project. Alternatively, with the agreement of the student's co-advisors, capstone research may be initiated and completed while in residence in Urbana. It is not uncommon for students to complete all online courses, the field experience, and the bulk of the capstone project during the DVM curriculum prior to the academic year in Chicago, leaving only 21 semester hours of coursework to complete the MPH. Graduate DVM students finishing the MPH degree have the opportunity to take elective courses in Chicago, in addition to their required courses, and to work in private veterinary medical practices and other health agencies while completing the MPH program.
Each student has two advisors, initially the co-directors of the program (Herrmann in Urbana and Hershow in Chicago), who counsel him or her on coursework and research projects. The capstone project requires the student to synthesize knowledge acquired through coursework and other learning experiences and to apply theory and principles in some aspect of professional public-health practice. The field practicum experience frequently provides the foundation for the student's capstone project. The capstone and field experiences are opportunities for MPH students to participate in professional public-health activities while developing their own meaningful projects.
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STRENGTHS AND UNIQUE FEATURES OF THE ILLINOIS DVM/MPH PROGRAM |
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TOPABSTRACTBACKGROUND OF THE DVM/MPH...THE DUAL-DEGREE DVM/MPH PROGRAM...STRENGTHS AND UNIQUE FEATURES...ADMISSION REQUIREMENTSAPPLICATION PROCESSCOSTCHALLENGESSUMMARY AND FUTURE DIRECTIONSREFERENCES |
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Since one campus is rural, set within a major agricultural area in east-central Illinois, and the other campus is located one of the great cosmopolitan cities of the world, our students gain valuable experiences by interacting with two faculties in two environments. Students have the opportunity to develop their interests in many areas of public health, from rural health care access and the effect of livestock manure management on groundwater to urban pets as sentinels for human diseases and bio-security plans for urban zoos.
The Urbana Experience
The professional program leading to the DVM degree at UIUC is a traditional program, in that it trains students broadly in epidemiology, infectious and zoonotic diseases, food safety, environmental and occupational health, and population dynamics. This broad, systems-based approach, especially focused on agricultural production systems, makes veterinarians unique among medical professionals.
Critical to the success of any program are the human resources available to mentor and instruct students. At UIUC-CVM, there are six veterinarians with PhDs in epidemiology and two with master's degrees in public health. All have extensive experience in either public-health practice or translational research. Two veterinary medical students also have MPH degrees and act as teaching assistants in public-health courses. Current MPH capstone projects are investigating the role of birds in Salmonella outbreaks at commercial dairies; spatial and temporal associations of human and canine blastomycosis; wildlife reservoirs for human candidiasis; pet-therapy programs at nursing homes; and the roles of specific bird species in West Nile virus activity.
A unique aspect of the Urbana experience is the clinical rotation in public health for fourth-year veterinary medical students. Although this limited-enrollment rotation is open to all fourth-year students, preference is given to those enrolled in the DVM/MPH program. The four-week clinical rotation combines didactic and experiential learning in a fluid, dynamic format. Basic principles of epidemiological biostatistics are reviewed in a case-study format, using a combination of PowerPoint lectures, discussion, work groups, and critical review of published examples of four basic study designs.
Field trips and projects are designed to exemplify public-health principles of epidemiology, case definition, surveillance, bio-security, occupational safety and health, community health, determinants, and disparities. During the rotation, students are able to collect samples for their capstone research projects, spend time with public-health leaders at state and federal agencies, and visit local health departments.
The Chicago Experience
At the Chicago campus, academic and research programs housed within the Epidemiology-Biostatistics Division at the SPH have several particularly strong areas in applied public health research. Faculty are currently serving the Chicago community through ongoing research projects studying asthma in schoolchildren and providing needle exchange and STD counseling to heroin addicts in the Community Outreach and Intervention Program (COIP). UIC research on prisoner health, occupational health, and aging has had a significant impact on shaping national public-health policies.
The Student Epidemiology Corps (SEC) provides additional research opportunities for students, many of them relevant to the interface of human and animal health. Founded after the terrorist attacks of September 11, 2001, the SEC is a group of student and faculty volunteers from the SPH that provides surge capacity to local and state health departments during crises and natural outbreaks of disease. The SEC is an excellent opportunity for students to participate in outbreak investigation, and in recent years students have assisted in several investigations, including a nosocomial outbreak of multi-drug-resistant Acinetobacter baumanii at a local hospital, a cyclosporiasis outbreak in one of Chicago's collar counties, a community outbreak of Escherichia coli O157:H7, and a Chicago outbreak of salmonellosis linked to consumption of unpasteurized dairy products. In 2007, the SEC won the Illinois Public Health Association's Public Health Student Group of the Year Award.
Opportunities to develop collaborative research with the Illinois Department of Public Health and other local health departments extend beyond membership in the SEC. Through recent internships at local health departments, students have developed MPH capstone projects focused on rabies, West Nile virus, arboviral encephalitides, HIV infection, sexually transmitted diseases, and other infectious diseases.
Students can also work with the Chicago-area zoos, Lincoln Park and Brookfield, on projects that study the interface of wildlife, ecosystem, and human health. Over the past year, the UIC-SPH, the UIUC-CVM, and the Lincoln Park Zoo have been working together to foster the development of ecosystem research. In collaboration with investigators at the Lincoln Park Zoo, another group associated with the DVM/MPH program is developing a plan to investigate zoonotic diseases in game-park workers in the Gombe Stream National Park and villages surrounding the Serengeti National Park in Tanzania. The joint DVM/MPH degree program will be an important source of students for envisioned student exchange programs and training-grant opportunities that will emerge as research involvement in Tanzania expands.
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ADMISSION REQUIREMENTS |
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Because applications for the joint program are considered early in the spring semester, students are encouraged to consult with the Office of Academic and Student Affairs and the director of the DVM/MPH program during the fall semester. Interested students are also encouraged to take the introductory public-health course, Public Health Concepts and Practice (CHSC 400), which is a core course of the MPH program, to confirm and further develop their interest in public health. The course counts for elective credit within the DVM program and, if the student is admitted to the MPH program, for core credit in that program. Students are allowed to take one additional online MPH core course while their applications are being considered.
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APPLICATION PROCESS |
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Applications must be submitted through the Schools of Public Health Application Service (SOPHAS) by the February 1 deadline for admission to the MPH program for the following summer semester. Applicants with international credentials must submit their applications by January 1.
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COST |
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It is anticipated that virtually all DVM/MPH students will be licensed veterinarians and able to work in private veterinary medical practices and other health agencies by the time they transfer their studies to the Chicago campus.
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CHALLENGES |
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In general, the program has not had problems in attracting students or in fostering collaboration between faculty members. Instead, its problems have centered on encouraging administration and records units on both campuses to think of creative solutions to support the needs of a new model of cross-campus educational cooperation. There have been valuable lessons learned that may help other universities contemplating initiating a similar program. In retrospect, it seems clear that we should have included admissions and records staff earlier in the development of the dual-degree program, crafted memoranda of understanding between cooperating administrative units, and had them help us identify potential glitches in existing records systems.
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SUMMARY AND FUTURE DIRECTIONS |
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The program has grown from these initial three students to 16 as of 2007. There are currently seven third-year and six second-year veterinary medical students enrolled in the program. All 16 applicants to the program have been accepted; they come from both urban/suburban (9) and rural (7) backgrounds. Interests include zoonoses, public policy, epidemiology, community assessment, and health promotion. Fourteen students are female and two are male. Ten students applied for admission in 2008; nine are women, and two of the 10 applicants come from rural backgrounds. A number of other students have expressed interest in public health but, for familial or financial reasons, have decided to postpone formal training in public health until later in their careers.
Students in the DVM/MPH program have served in externships at the Centers for Disease Control and Prevention (1), the Food and Drug Administration (1), the US Department of Agriculture's Animal and Plant Health Inspection Service (3) and Food Safety Inspection Service (2), the Illinois Department of Public Health (1), the Illinois Department of Agriculture (2), the Center for Zoonotic Research (4), and a number of private organizations dedicated to animal and wildlife health. Capstone projects already completed were presented at the Conference of Research Workers in Animal Disease in December 2007.6,7
As the program evolves, students may be enrolled in divisions other than epidemiology and biostatistics, such as health policy or environmental and occupational health. Faculty members continue to guest lecture, either in person or via videoconference, in public-health courses taught at each campus. There is interest among faculty in increasing the number of MPH courses offered online and anticipation that DVM students will be able to take at least half of their coursework through Web-based instruction over the next few years.
In addition, the University of Illinois is committed to developing the Illinois Center for One Medicine, One Health (ICOMOH), an intra-university collaborative that will provide even more opportunities for dual-degree students to explore the interface of human, animal, and ecosystem health, with a particular focus on agricultural systems. The formation of the ICOMOH is a direct result of the collaborations and shared interests recognized during the development and conduct of the dual-degree program. Unlike many federally funded training sites, the ICOMOH is a collaboration between many academic programs, including veterinary medicine, human medicine, public health, law, engineering, environmental sciences, and informatics.
A graduate-level course covering the concepts of One Health and One Medicine will be offered to students in medical and veterinary medical curricula, as well as those in an eclectic mix of graduate programs, during the fall 2008 semester. A funded graduate position to train an MD or DVM student in the concepts of One Medicine is expected to follow.
If we are to meet the demands of our society for safe food and a productive economy while ensuring the conditions in which all communities can be healthy, we must develop public-health leadership that is cross-trained in the complexities of human/animal/ecosystem interactions. The dual-degree DVM/MPH at the University of Illinois is poised to meet that need.
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Footnotes |
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John A. Herrmann, DVM, MPH, Dipl. ACT, is Director of the DVM/MPH dual-degree program and Section Head of Community Health and Preventive Medicine, and a clinical theriogenologist at the University of Illinois, LAC 231, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA. E-mail: jah1110{at}uiuc.edu. Dr. Herrmann received his DVM degree from the University of Illinois at Urbana-Champaign in 1978 and his MPH from the University of Illinois—Chicago School of Public Health in 2003. From 2003–2004, Dr. Herrmann served as an American Association for the Advancement of Science Congressional Science Fellow in the Washington, DC offices of Senator Richard Durbin and wrote numerous pieces of federal public health legislation including the Public Health Preparedness Workforce Development Act of 2004. His public-health research interests include zoonoses; the effect of agricultural production systems on animal, human, and ecosystem health; and pets as sentinels for human disease.
Ronald Hershow, MD, FACP, is Associate Professor of Epidemiology in the School of Public Health, University of Illinois—Chicago, 1603 W. Taylor St., Room 987, Chicago, IL 60612 USA. E-mail: rchersho{at}uic.edu. Dr. Hershow obtained his MD degree from SUNY at Stony Brook Medical School in 1978, completed an internal-medicine residency and infectious-disease training at Washington Hospital Center in Washington, DC, and later served as an Epidemic Intelligence Service (EIS) officer at the Centers for Disease Control. In 1987, Dr. Hershow’ came to University of Illinois at Chicago and has engaged in epidemiologic research that mainly deals with human immunodeficiency virus in women, hepatitis C virus infection, and nosocomial infections. Specific areas of focus include investigation of viral co-infections and other co-factors that may influence HIV disease progression, the early natural history of hepatitis C virus infection, prevention of infectious-disease morbidity in substance users, and the epidemiology of antibiotic-resistant microorganisms in hospitals. Since 1989 Dr. Hershow has maintained continuous NIH and CDC funding.
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REFERENCES |
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