University of Pittsburgh School of Medicine
Public Health Area of Concentration: The Physician as Public Health Professional
Introduction
The IOM reported in 2007 that, “Public health physicians are physicians whose training, practice
and world view are based in large part on a population focus rather than individual practice, that
is, on assuring the availability of essential public health services to a population using skills such
as leadership, management, and education as well as clinical interventions” (Gebbie and
Hwang, 1998). While public health physicians are distinct practitioners who often acquire
additional training in public and population health, it is now widely recognized that all physicians,
regardless of specialty, are integral members of the public health workforce.
To that end, the AAMC strongly recommends that every medical student receive training in
“epidemiology; biostatistics; disease prevention/health promotion; health care organization,
management, and financing; environmental and public health; social and behavioral sciences;
informatics; genomics; communication; cultural competence; community-based participatory
research; global health; policy and law; and ethics” (Maeshiro, 2008). Additionally, to maximize
the benefit of didactic education in these areas, applied training (such as working with a public
health department) is essential. The American Medical Association notes that “…ultimately, we
both hope and believe that integration of public health and primary care will be a key component
of the health system reform that will inevitably result from the current widespread discontent with
America's health care system” (Sloane et al, 2007).
Many UPSOM students and faculty agree with the IOM and AAMC recommendations and have
expressed interested in increased public health training (in the broadest sense) at the UPSOM.
Here we propose a new Area of Concentration in Public Health that allows students to
proactively enrich their education in accordance with suggestions from the IOM and AAMC to
become versatile physicians in the public health workforce.
Goal of the Public Health AOC
The goal of the PH AOC is to provide students a rich, integrated, longitudinal training program in
the theory and practice of medicine and PH. This synergistic training program will help future
physicians optimize their practice, allowing them to become consummate physicians and care
for individuals and populations.
Leadership and Resources of the Public Health AOC
Faculty Director:
Samuel Stebbins, MD, MPH
Dr. Stebbins is an assistant professor in the Department of Epidemiology at the
Graduate School of Public Health. He is a board-certified Family Medicine Physician and is
board-eligible in Preventive Medicine/Public Health. He has secondary appointments with Pitt’s
Clinical and Translational Science Institute (CTSI) and GSPH’s Department of Behavioral and
Community Health Sciences. He is principal investigator and Director of the Center for Public
Health Preparedness, Associate Director for Public Health and Medicine at the Center for Public
Health Practice, Director of GSPH’s Graduate Certificate Program in Public Health
Preparedness and Disaster Response, and co-teaches medical students in a number of venues,
including a senior public health practicum, annual mini-courses and disaster drills, and the
Introduction to Being a Physician course.
Dr. Stebbins also brings administrative support and additional faculty and staff
assistance to the project. One key player is Chuck Vukotich, senior project manager at the
Center and previously at the Allegheny County Health Department for over 30 years.
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Faculty Leadership: 4 core faculty members will share responsibilities and tasks for the AOC.
They have been selected to bring a diverse background and commitment to working with
medical students who have a wide variety of public health interests. Members are: Sam
Stebbins; Bruce Pitt, Professor and Chair of GSPH’s Department of Environmental and
Occupational Health; Ron Voorhees, Chief Medical Epidemiologist at the Allegheny County
Health Department and Visiting Professor in Epidemiology; and Jeannette South-Paul, Chair of
the Department of Family Medicine at the University of Pittsburgh School of Medicine.
Student Leadership: Student leadership is a focal point of the AOC, and the project has
already created a core group of current UPSOM students who work with classmates and faculty
mentors to keep the AOC topical and responsive to student needs and desires. Their work will
be overseen by the AOC Director.
Overarching themes of the Public Health AOC
1) Build students’ knowledge of medical and PH theory - including where medicine and PH
converge and diverge - through their engagement of literature, self-directed projects,
internships, faculty mentors, and each other.
2) Develop students’ ability to provide a continuum of care for individuals and populations
by evaluating a PH problem; creating, implementing, and assessing a solution to the
problem; and integrating both PH and medically-based solutions.
3) Improve students’ ability to translate research into practice on the community and
population level.
4) Augment students’ abilities to serve as effective agents of change through training in
leadership, team building, multidisciplinary problem solving, meeting planning,
interagency collaboration, project management, and negotiation.
5) Foster overall professional growth in analytical thinking, written and oral communication,
and rational decision-making.
AOC requirements
 PH journal club (>75% attendance during MS1 and MS2; 1 presentation)1
 PH interest group sessions (>75% attendance during MS1 and MS2)2
 Summer internship3
 Completion of Scholarly Project with PH focus4
 Leadership training seminar (attend one 1-day session)5
 Rotations, electives, and mini-courses6
 Self-evaluation7
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PH journal club
Goals: 1) build students’ knowledge base in a wide range of PH fields through interactive
sessions; 2) expose students to cutting-edge scientific hypotheses and research techniques in
PH being conducted at the University; 3) develop students’ skills in scientific presentation,
critical thinking, and literature review; 4) foster close-knit relationships between and among PH
AOC students and faculty in order to develop new research projects.
Format: The PH journal club will meet once per month throughout the academic year and will be
open to PH AOC students and faculty. Students will present a faculty-chosen peer-reviewed
paper related to PH research and practice. The presenting student will meet with the mentor at
least 1 week before journal club to discuss the paper and faculty’s research. At journal club, the
student will conduct a 15-30 minute presentation, and, in conjunction with faculty, lead a
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discussion about the paper.
Tentative Schedule:
September:
October:
November:
health (Pitt)
December:
Jan – April:
Introduction to being a public health physician (Stebbins)
Local public health and the role of physicians (Voorhees)
Things you should know about environmental and occupational
Community-based public health research (Stebbins)
TBD
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PH interest group sessions
Goals: 1) create a PH interest group to involve students who are interested in PH but are unable
to commit to a rigorous AOC experience; 2) expose the student body to applied PH, PH
research, and the intersection of medicine and PH.
Format: The PH interest group, a larger group that encompasses PH AOC students and nonAOC students interested in PH, will hold lunch talks or workshops 1-2 times per semester.
Lunch talks will be interactive and include presentations by expert faculty in PH-related fields.
During a workshop, students will work through a real-life PH problem solved through PH
practice, such as case studies published by the Epidemic Intelligence Service of the Centers for
Disease Control and Prevention. Workshops will be led by a faculty member or senior student.
Interest group members will also be welcome to conduct research and practice projects with PH
AOC faculty; attend the leadership training seminar; and access the database of PH
opportunities maintained by the AOC.
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Summer internship
Goal: 1) provide AOC students real-world experience in PH practice and/or research.
Format: AOC students will complete a real-world PH experience during the summer after MS1.
The experience may consist of a rotation with local, state, or national public health offices or
involvement with PH community interventions conducted by AOC faculty mentors. Alternatively,
students may pursue PH research with an AOC faculty mentor or another faculty mentor outside
of the AOC (with approval from the AOC Director). The research or practice experience must be
approved by April 1 preceding the summer. A poster presentation, abstract, or manuscript
summarizing the summer experience is required following the rotation.
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Scholarly Project
Goals: 1) foster analytical thinking skills and the development of tools for rational decisionmaking in future physicians; 2) provide role models, mentorship, and guidance for students
interested in PH careers that integrate research, teaching, and clinical service; 3) present
research and scholarly PH pursuits to students as endeavors that involve collegial interaction; 4)
enhance the medical school culture of self-directed and peer group-fostered learning; 5)
improve the oral and written communication skills of graduating medical students.
Format: Scholarly Projects conducted in PH will be approved by the PH AOC Director and will
follow the Scholarly Project format already in place in the SOM.
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Leadership training seminar
Goals: 1) develop students’ leadership, networking, team-building, problem-solving, and other
vital skills for effective practice in medicine and PH.
Format: Students will participate in a leadership seminar developed by the Pennsylvania
Preparedness Leadership Institute and Center for Public Health Preparedness. Activities include
skill building in the following areas: leadership, team building, multidisciplinary problem solving,
meeting planning, interagency collaboration, project management, and negotiation. The end
result will be that students’ have enhanced leadership skills and be able to apply them in real3
world settings.
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Rotations, Electives, and mini-courses
1. Mini-courses
 Students will be encouraged to take the “Introduction to Public Health mini-course”
during the spring of either 1st or 2nd year.
2. Rotations
 During either 3rd or 4th year, students will be required to take Public Health Field
Practicum (MSELCT 5858) as described below. Students may opt out with the
permission of the AOC Director if they have had an equivalent experience.
MSELCT 5858
Goals: 1) learn how to diagnose and investigate health problems and health hazards in the
community; 2) experience community-level interventions that affect the lives of your patients; 3) see
how to apply public health experience to improve your clinical abilities.
Format: This elective is a hands-on public health practicum that is appropriate for 3rd and 4th year
medical students. Prior public health experience, while useful, is not required. Under faculty
guidance, students will work with a public health professional on a wide variety of core public health
functions. These may include: disease surveillance and early warning; communicable disease
control including outbreaks and food safety; environmental health (air, water and ground); disaster
preparedness, planning and response; health policy and planning; vector and pest control; and
applied epidemiology. Students will spend time at the Health Department and other agencies in the
county that perform related work. In addition, students will spend a substantial amount of time in the
field. Specifics of the activities will vary depending on site and student interest. Students wishing to
develop their own field-placement opportunity may arrange alternative sites with the advance
approval of the course director.
In addition, students will participate in a series of focused seminars on public health topics,
presented on one half-day per week:
Week 1: Introductions, elective expectations and discussion of public health practice.
Week 2: Understand 'causation' from a public health perspective.
Week 3: Learn about the intersection of clinical medicine and public health and how to use this to
your advantage.
Week 4: Final presentation and paper
A short presentation and paper (3-5 pages) summarizing key aspects of the experience are also
required. Through these activities, students will gain the opportunity to work closely with
experienced public health professionals, and to develop a fuller understanding of the intersection of
clinical medicine and public health. If a student wishes to pursue a PH practicum that is not
MSELCT 5858, the student must have the practicum approved by the AOC Director at least five (5)
weeks prior to start of the practicum period.
3. Electives
 Students will also be encouraged to utilize 1 – 2 elective blocks for additional
research and/or writing of their Public Health Scholarly Project (if needed).A
prospectus approved by the scheduling advisor and the mentor must be received by
the Scholarly Project office not later than five (5) weeks prior to start of the research
period. The SP committee will grant or deny scheduling the month for credit.
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Self evaluation
Goals: 1) provide students an opportunity to reflect on their growth and future; 2) provide
administrators information for continual AOC improvement.
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Format: All students in the PH AOC will submit to the AOC Director a self-evaluation following
completion of all AOC requirements. The evaluation will be a 1 page reflection on: the student’s
knowledge of PH research and practice before beginning the AOC; the student’s knowledge of
PH research and practice after completing the AOC; the student’s career plans; and the
student’s opinions on aspects of the AOC that were and were not beneficial to the student’s
training (including recommendations for AOC modifications). This feedback will allow students
and faculty to improve the AOC for future students.
Definitions
The Physician as Public Health Professional
From 2007 IOM Report: “Public health physicians are physicians whose training,
practice and world view are based in large part on a population focus rather than individual
practice, that is, on assuring the availability of essential public health services to a population
using skills such as leadership, management, and education as well as clinical interventions.”
(From: Gebbie and Hwang, 1998)
Public Health Practice
ASPH has defined public health practice as "the strategic, organized, and
interdisciplinary application of knowledge, skills, and competencies necessary to perform
essential public health services and other activities to improve the population’s health." (From:
Demonstrating Excellence in Academic Public Health Practice. Association of Schools of Public
Health. June 1999)
Disaster Medicine and Public Health Preparedness
Disaster medicine is a system of study and medical practice associated primarily with
the disciplines of emergency medicine and public health. Disaster medicine is concerned with
the health and medical and emotional issues of disaster casualties. To provide care efficiently,
however, the health care provider must be familiar with several elements of disaster
management, including planning, mitigation, assessment, response, and recovery. (From
Hogan and Burstein, “Disaster Medicine”)
Conservation Medicine
Conservation medicine is an emerging field that focuses on the intersection of the
environment, human and non-human hosts, and pathogens. At its core, conservation medicine
champions the integration of techniques and partnering of scientists from diverse disciplines.
(From: http://www.conservationmedicine.org/wcm.htm)
Research and Translation
The application and conversion of health research into information, resources, or tools
that can be used by public health and medical professionals and by the public to improve overall
health and well-being, especially in vulnerable populations. (Modified from:
http://www.niehs.nih.gov/about/od/otr/)
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Faculty Mentorship (*Core faculty)
*AOC Director: Samuel Stebbins, MD MPH – Asst. Prof of Epidemiology; Director Center for
Public Health Preparedness
Silva Arslanian, MD – Richard L. Day Prof of Pediatrics; Director Weight Management and
Wellness Center; Director GCRC
Francis Guyette, MD MPH – Asst. Prof of Emergency Medicine; Co-Medical Director STAT
MedEvac
Judith Lave, PhD – Chair Dept. of Health Policy and Management; Director PA Medicaid Health
Policy Center; Co-Director Center for Research on Health Care
Bruce Lee, MD MBA – Asst. Prof of Medicine, Epidemiology, and Biomedical Informatics
Robert Marin, MD – Assoc. Prof of Psychiatry
*Bruce Pitt, PhD – Chair Dept. of Environmental and Occupational Health
Edmund Ricci, PhD MLitt – Prof of Sociology in Public Health; Director Institute for Evaluation
Science in Community Health
Wesley Sowers, MD – Clin. Assoc. Prof of Psychiatry; Medical Director Office of Behavioral
Health, Dept of Human Services of Allegheny County
*Jeannette South-Paul, MD – Andrew W. Mathieson Chair Dept. of Family Medicine
Joe Suyama, MD FACEP – Asst. Prof of Emergency Medicine; Medical Director Emergency
Responder Human Performance Laboratory
*Ron Voorhees, MD MPH – Chief of Epidemiology and Biostatistics, Allegheny County Health
Department
Richard Zimmerman, MD MPH MA – Prof of Family Medicine and Behavioral and Community
Health Sciences
This is a partial list and other Faculty Mentors will be added
Focus areas and faculty research interests
 Disease surveillance and early warning
 Environmental health
 Communicable disease control
 Vector and pest control
 Disaster preparedness and response
 Applied epidemiology
 Health policy, management, and
financing
 Conservation medicine
 Disease modeling and bioinformatics
 Preventive medicine
 Community psychiatry and mental health
 Toxicology and public health
 Community health organization,
planning, and evaluation
 Cultural competency
 Pre-hospital medicine systems/EMS
 Occupational health
 Sociology and behavioral aspects of
public health
 Tobacco and substance control
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Student testimonials on the need for a PH AOC
“I think that the public health AOC is a great idea. The public health resources available and the
training we receive around the subject seem splintered and weak, which is [unfortunate]
considering the very strong School of Public Health is right across the street. This could give
interested students a way to pursue public health without necessarily choosing to get a 1-year
MPH.” – MS2
“I’ve been interested in public health for some time but I don’t know where to look for resources
at Pitt. It seems like there is public health stuff going on but I don’t know what it is or where to
find it.” – MS1
“The public health training within the SOM is cursory and basically lip-service to an important
field of study and practice. Why aren’t we doing more research and coursework with the School
of Public Health, or at least having them lecture to us?” – MS1
“I wish I knew where to do public health research because I want to do research but I don’t want
to work with test tubes this summer.” – MS1
“I say YES to a PH AOC. It’s a great initiative and it’s sad it took this long for that idea to spring
up.” – MS1
“Can we do internships around here in public health? Can the medical school give us some sort
of credit for doing one?” – MS1
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