Health Sciences Report Summer 2004

Degrees That Add Dimension:
U’s Highly Ranked Public Health Program Draws Doctors Back to Class
By Phil Sahm

Photos by Steve Leitch

When David J. Bjorkman, M.D., M.S.P.H., enrolled in the U of U master’s of science in public health curriculum, he wanted to expand his knowledge of epidemiology and biostatistics for clinical research. The program helped him do that, but also gave Bjorkman skills for a role he hadn’t anticipated: interim dean of the School of Medicine.

For pediatrician Scott D. Williams, M.D., M.P.H., earning a master’s in public health seemed the logical step as he became more conscious of the link between public health and the myriad childhood illnesses and issues he saw in his practice. His training helped prepare Williams for a public health career and his current position as executive director of the Utah Department of Health.

John C. Nelson, M.D., M.P.H., a Salt Lake City obstetrician/gynecologist and president of the American Medical Association (AMA), pursued his master’s in public health for a slightly different reason. A book he read, Allan Bloom’s The Closing of the American Mind, offered a searing indictment of the U.S. educational system and convinced Nelson he was “poorly educated” and needed to get back in the classroom.

These three are among the growing number of Utah physicians, nurses, pharmacists, dentists, and other health-care professionals returning to school to earn a master’s degree in public health. They have various reasons for seeking the degree, but they all share one thing in common: They didn’t have to look farther than the U of U to find one of best public health programs in the country.

Begun in 1974, the U’s Public Health Program, part of the School of Medicine’s Department of Family and Preventive Medicine, turns 30 this year, but there’s more to celebrate than longevity. The latest U.S. News & World Report ranking lists the U as tied for sixth-best community-based public health program in the country. Even more impressively, the U’s program has ranked in the top 10 nationally since the first rankings appeared. Soon the program’s first 10-12 doctoral candidates will enroll for the 2004-2005 academic year, and eight endowed scholarships will be available for students, also a first for the program.

To date, 730 graduates, working in every aspect of health care, have completed either the master’s of science in public health (M.S.P.H.) or master’s of public health (M.P.H.) degree through the U, according to George L. White, Ph.D., M.S.P.H., program director and professor.

The M.S.P.H. emphasizes biostatistics and epidemiology essential to evaluating and understanding clinical research, such as Bjorkman sought, and requires a publishable paper or thesis. The M.P.H. degree does not require a paper or thesis and is designed with working professionals in mind.

The program prepares graduates for work in every area of public health. Most graduates stay in Utah to serve both the rural and increasingly international urban populations. One of the key principles the program emphasizes, according to White, is that health-care workers need a global perspective. Last year’s SARS (Sudden Acute Respiratory Syndrome) outbreak showed how startlingly fast and surreptitiously disease travels from one part of the world to another. Public health workers need to understand and be able to react to that kind of issue.

“If you don’t have that global perspective, you’re not well equipped to handle disease in America,” White said.

To that end, students are encouraged to travel to Africa, South America, and other places to observe firsthand the public health issues facing poor and developing nations. One group just returned from Mali, West Africa, where they saw how basic public health procedures, such as measles vaccinations, have had a huge impact on villages (see pg. 3). They also saw the devastating effects of malaria, the No. 1 child-killer in tropical Africa, said Steven C. Alder, Ph.D., assistant professor of public health who led the group.

“The biggest benefit for students is seeing what public health really is,” Alder said. “They’re going to be able to better serve our community by seeing what happens in public health at the basic level.”

One-third of students come to the Public Health Program with a degree in medicine, dentistry, nursing, pharmacy, or other health fields, according to White. Many of them enroll to get a better understanding of the distribution of disease and its determinants in a specific population. That’s another key principle White wants students to take away from their training: From the smallest rural county to the busiest city, every health-care worker is a de facto member of a public health department and should understand the connection between his or her daily job and larger public health issues.

That quickly became evident to Scott Williams in his pediatrics practice. Immunizations, screenings for inherited diseases, well-child visits, and numerous other facets of pediatrics are public health issues, Williams said. The lack of health care for children in lower-income families, for example, is an issue that costs taxpayers millions of dollars.

“I saw a lot of children with health-care problems that could have been prevented,” Williams said, “and I realized how much health was tied to public policy.”

Nelson, who in June became president of the American Medical Association, said that earning his M.P.H. “basically changed my practice of medicine and made me a better clinician.” He, too, had seen much in his OB/GYN practice that intertwined with public health: prenatal care, domestic violence, smoking, obesity, and alcohol abuse. But his studies in public health made him more aware of those connections.

“If we could prevent those kinds of problems, imagine the money we’d save,” Nelson said. “The practicing physician has an obligation to do more in public health.”

Bjorkman joined the School of Medicine faculty in 1985. He’d focused on researching the intestine in the highly controlled laboratory environment, but legendary U physician John A. Dixon, M.D., inspired him to go into clinical research.

“The master’s of science in public health gave me the tools to understand clinical research and to apply those findings in clinical practice,” Bjorkman said. As medicine places greater emphasis on quality improvement, those skills will become more important to physicians and others in health care, he said.

His M.S.P.H. helped prepare Bjorkman for a change in career direction. His coursework focused on health services administration, including classes in business principles and financial analysis. That training helped him move into administrative positions—executive medical director of the University of Utah Medical Group, senior associate dean, and now interim dean of the School of Medicine, while Dean A. Lorris Betz, M.D., Ph.D., serves as interim president of the University of Utah. Bjorkman also became president of the American Society of Gastrointestinal Endoscopy in May.

Whether they work in the private sector or academia, or serve in government or other public health organizations, graduates of the U’s Public Health Program are prepared for every facet of the field. White receives no greater satisfaction than seeing them succeed.

“I’m looking for a long legacy of highly motivated graduates,” he said.

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