Master of Public Health in Family and Community Medicine

Clinical Public Health represents the interface between public health and primary care clinical practice, which is receiving increased attention as an underdeveloped area of collaboration (1,2,3).  It has long been established that the health of a population is directly related to the availability of primary care services (4). Family physicians and other primary care clinicians are already at the “frontline” of public health in terms of identifying emerging public health problems, promoting healthy lifestyles, screening appropriate patients for disease, advocating for individual patients and discharging public health initiatives to their patients (5). These individual-level services skillfully provided by primary care clinicians can be improved and enhanced by equipping those same clinicians with the population-level knowledge and skills offered by an MPH degree program (6).

In addition to these more traditional individual-level services, there is enormous potential and indeed increased expectations of primary care teams that they deliver services using a population-focus which would include, among other things, skills such as defining one’s population, tracking health indices of that population and planning and evaluating programs to improve health outcomes and equity within that population. This is an emerging area of primary care clinical practice that is well-suited to a unique, tailored graduate degree program targeted to primary care clinicians. The solid grounding in public health that is provided with this MPH gives family physicians and other primary care practitioners knowledge and skills that they will employ in their professional work in community-oriented primary care. The degree also provides the skills learners need to become more effective educators, scholars, and leaders in their respective clinical areas.

  1. Harvey B. The issue of public health. Canadian Family Physician 2009;55:1057.
  2. Brown A, Upshur R and Sullivan T. Public Health and Primary Care: Competition or Collaboration? Healthcare Papers 2013;13(3):4-8.
  3. Levesque J-F, Breton M, Senn N et al. The Integration of Public Health and Primary Care; Functional Roles and Organizational Models that Bridge Individual and Population Perspectives. Public Health Reviews 2013;35(1):1-27.
  4. Starfield B. Is primary care essential. Lancet 1994;344:1129-1133.
  5. Sikora C and Johnson D. The family physician and the public health perspective. Canadian Family Physician 2009;55:1061-3.
  6. Zweifler J and Evans R. Development of a residency/MPH program. Family Medicine 2001;33(6):453-8.

Target audience

The Family and Community Medicine field of the MPH is intended for licensed and regulated primary care clinicians currently working in their field. This program is not intended to assist applicants in becoming licensed health practitioners in Canada.

Program Length

2 years full time or up to 6 years part time

Goals

  1. Train family physicians and other primary care practitioners to optimize their impact on the health of their communities by applying public health-related knowledge and skills to the individuals, families, and communities that they serve
  2. Provide opportunities for learners to develop skills in primary care leadership and scholarship
  3. Provide opportunities for learners to pursue an area of special interest (ie Health Education, Research, Global Health)

 

For more information, please contact us

Detailed Objectives

(A) The Family Physician as a community-based resource to a defined practice population (Community-oriented primary care-COPC and primary health care)

1. Assess the health status/social determinants of health/health needs of their practice population (including vulnerable populations) as well as the broader community and address/strategize interventions targeting these needs and issues of inequity

Health Assessment

2. Utilizes appropriate methods for assessing their practice 

  • Demographic assessment (Health profile)
  • Quality assessment (QA) and evaluation

3. Prepares for disease outbreaks and other emergency/disaster situations

4. Recognizes and reports significant diseases/disease patterns to public health

Addressing Health Needs

5. Implements quality improvement (QI) strategies within their clinical practice

6. Implement infection control practices to minimize risk to staff/physicians/other patients

7. Meaningful communication/collaboration/engagement with public health professionals and other community partners

 

(B) The family physician as a skilled clinician harnessing the power of the doctor-patient relationship

Primary Prevention

8. Identify and mitigate risk factors at the individual and community level, including environmental and occupational risks

9. Promote healthy development through the family life cycle including identifying and managing maternal-child challenges

10. Accesses and articulates the evidence base behind recommended clinician-driven primary prevention strategies (such as…immunization, smoking cessation, physical activity)

11. Advocate for policy changes relevant to primary care in order to reduce inequities and promote health/prevent disease and injury in the population

Secondary Prevention (eg. screening)

12. Accesses and articulates the evidence-base behind recommended screening strategies

13. Understand the required characteristics of effective screening strategies

Tertiary Prevention

14. Improve evidence-based chronic disease management to minimize complications from chronic disease

15.  Considers the spectrum of individual to population-based interventions and for the wide range of models of care- (solo v. team-based, clinic v. home-based)

 

(C) Scholarship

Based on Boyer’s taxonomy of scholarship, MPH equips students to better engage in the scholarships of discovery, application, integration, education and social responsibility

16. Engages in regular reflective self-directed learning and Continuing Professional Development

17. Understands research methods and employs the knowledge to critically appraise research

18. Teaching of the above competencies to family medicine residents/others

 

(D) Leadership, Management and Administration

Graduates are expected to play a leadership role in their professional practice environments

19. Understands how Canada’s health system is organized and how it compares to other countries

20. Appreciates the issue of resource allocation

21. Skilled in interprofessional collaboration

22. Demonstrates that above skills are portable (ie global health work

23. Leaders in best practices in primary care, including technology, and resources to primary care colleagues and public health officials

Program Requirements

The MPH (FCM) program requires the completion of 10 full course credit equivalents (FCE), offered on a full or part time basis. It provides a study of the principles and practice of medical education, research in family medicine, and community health. A seminar series integrates a broad range of primary health issues. Courses in individual and family development and leadership and management are offered. Practicum work in medical education, primary care research and community health delivery is facilitated. No thesis is required and there is no comprehensive evaluation (examination).

Public Health Courses (2 half credits)

  • CHL5004H: Introduction to Public Health Sciences
  • CHL5300H: Public Health Policy

Family Medicine Courses (9 half credits)

  • CHL5601H: Appraising and Applying Evidence to Assist Clinical Decision-Making
  • CHL5603Y: Social, Political and Scientific Issues in Family Medicine (1.0 credit)
  • CHL5607H: Teaching & Learning by the Health Professions: Principles and Theories
  • CHL5608H: Teaching and Learning by the Health Professions: Practical Issues and Approaches
  • CHL5613H: Leading Improvement in the Quality of Health Care for Community Populations
  • CHL5620Y: Required Medical Education Practicum in Family Medicine (1.0 credit)
  • (0.5 credit) Research oriented course (CHL5605H or other equivalent research courses, subject to approval)

Selective Courses and Practica (9 half credits)

Students are encouraged to investigate the wide range of courses offered by the DFCM, the DLSPH graduate department and elsewhere in the School of Graduate Studies at the University of Toronto. 

They will be encouraged to develop research and/or educational expertise and to take appropriate courses in behavioral science, clinical and population epidemiology, health administration and health promotion as well as consider courses offered by the Ontario Institute for Studies in Education/Faculty of Education or range more widely, for example, in Philosophy, Sociology and Anthropology. 

The School of Graduate Studies procedures also permit a small portion of the student's program to be taken at other Universities if relevant courses cannot be found at the University of Toronto. Appropriate documentation, approval forms, etc. must be completed in advance.
 

Collaborative Specializations

The DLSPH sponsors and participates in several collaborative specializations which provide students with additional experience in a multidisciplinary area. For more information on these specializations, please click here
 

FAQs

I'm a health care practitioner who just arrived in Canada? Is this the right MPH program for me?

If you are a regulated health professional currently working in your field and you consider yourself to be a primary care provider, then you are eligible to apply for the MPH (FCM). If you are interested in gaining knowledge and skills that will enable you to think more broadly about your patient population and to try to impact the health of your community in ways other than direct patient care.

What makes this program different from the MPH Epidemiology program?

While the FCM field acknowledges the importance of introductory epidemiology skills in any MPH degree, our field does not aim to graduate epidemiologists.

Brief information about the required practicum (CHL5620Y)

The MPH (FCM) required practicum provides an opportunity for learners to apply and reflect on the theory and knowledge gained in coursework by engaging in new academic projects in their professional settings.

Learners are required to spend a minimum of 320 hours involved in an appropriate practicum to earn the 1.0 FCE credit. Students must also identify and meet regularly with a practicum field supervisor and all practicum projects require the approval of the Program Director.

Because the practicum involves the hands-on application of knowledge obtained via coursework, the practicum activities must be new endeavours that are related to either an area of academic core competency¹ or one of the Faculty of Medicine’s faculty promotion planks² to which the learner has been exposed during previous or concurrent MPH coursework. See references below for specific examples.

Throughout the practicum, it is essential for learners to reflect on and record their experiences and to engage in regular discussions with their practicum field supervisor about their practicum progress. The practicum evaluation is based on the student’s record of experiences; a 2-3 page scholarly, analytical and reflective report based on the overall experience; and ideally a presentation to their classmates.

It is important that you remember to register for CHL5620Y on ACORN. Though the practicum is listed as a “continuous” course, we recommend that you aim to have the practicum completed and work submitted to the Program Director within 12 months of starting the practicum. The CHL5620Y Practicum is graded CR/NCR.

References

  1. Harris D. et al. Academic competencies for medical faculty. Family Medicine 2007;39(5):343-350.
  2. Faculty of Medicine, University of Toronto, Academic Promotions Manual 2008-2009.

Career options

Rather than preparing you for a career change, the FCM field aims more for career enhancement. This degree will prepare primary care practitioners to increase their teaching, scholarly and leadership opportunities and effectiveness. Of course, such knowledge and skills might result in adjusting and taking on new roles within the health arena.

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