PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE Public health and Preventive medicine (PhPm) is the branch of medicine concerned with the health of populations. These specialists use population health knowledge and skills to play leading and collaborative roles in the maintenance and improvement of the health and well- being of the community. The public health and preventive medicine specialist measures the health needs of populations and develops strategies for improving health and well-being, through health promotion, disease prevention and health protection. A public health and preventive medicine specialist demonstrates skills in leadership; development of public policy; design, implementation and evaluation of health programs and applies them to a broad range of community health issues. It is a broad specialty that includes the fields of general preventive medicine, public health and occupational medicine. It requires knowledge and expertise in: management skills; epidemiology; health education/promotion/policy; nutrition; biostatistics and health services administration. These specialists work in a number of settings, such as public health departments, hospitals, universities, family practice settings, public agencies, industry and non-governmental organizations. Most public health and preventive medicine specialists have little contact with individual patients. Instead, their ‘patient’ is the community and their focus is on measuring health needs, addressing primary causes of disease (including behaviour and lifestyle factors) rather
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PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE
Public health and Preventive medicine (PhPm) is the branch of medicine concerned with the health of populations. These specialists use population health knowledge and skills to play leading and collaborative roles in the maintenance and improvement of the health and well-being of the community. The public health and preventive medicine specialist measures the health needs of populations and develops strategies for improving health and well-being, through health promotion, disease prevention and health protection. A public health and preventive medicine specialist demonstrates skills in leadership; development of public policy; design, implementation and evaluation of health programs and applies them to a broad range of community health issues. It is a broad specialty that includes the fields of general preventive medicine, public health and occupational medicine. It requires knowledge and expertise in: management skills; epidemiology; health education/promotion/policy; nutrition; biostatistics and health services administration. These specialists work in a number of settings, such as public health departments, hospitals, universities, family practice settings, public agencies, industry and non-governmental organizations. Most public health and preventive medicine specialists have little contact with individual patients. Instead, their ‘patient’ is the community and their focus is on measuring health needs, addressing primary causes of disease (including behaviour and lifestyle factors) rather
than on treating symptoms and developing methods for improving the community’s health level. These practitioners are heavily involved in influencing public policy and public health issues. After completing medical school to become a public health and preventive medicine specialist it requires 5 years of approved residency training. This includes: - 1-2 years of basic clinical training; - 3 years in a Royal College-approved, university-sponsored program that includes course
work in the sciences of community medicine and experience and responsibility in community medicine;
- 1 further year of training, in a Royal College-approved, university-sponsored program which may include residency in a clinical specialty relevant to the practice of public health and preventive medicine (normally internal medicine, pediatrics, obstetrics or psychiatry); or with selective clinical experiences related to disease prevention and health promotion for specific populations or groups.
Many complete 2 years of clinical training through the Family Medicine Residency Program, leading to eligibility for certification in family medicine (CCFP). Also required are a minimum of 1 academic year of courses in community medicine and a minimum of 1 year of community medicine field placement.
PUBLIC HEALTH AND PREVENTIVE MEDICINE PROFILE
For more detailed information on the training requirements go to: http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route The Canadian Public Health Association (CPHA) www.cpha.ca
Public Health and Preventive Medicine specialists by age and gender in Canada, 2015
Source: 2015 CMA Masterfile
Female 48% Male
52%
Gender
34 and under 5%
35 - 44 20%
45 - 54 23%
55 - 64 34%
65 and over 18%
Age Group
Public Health and Preventive Medicine specialists by age and gender in Canada, 2015
Source: 2015 CMA Masterfile
14
63
69
61
21
9
33
42
99
67
34 and Under
35-44
45-54
55-64
65 and over
Female Male
Main work setting of Public Health and Preventive Medicine specialists in Canada, 2014
Source: 2014 National Physician Survey. CFPC, CMA, Royal College
56%
10%
8%
8%
6%
5%
4%
Free-standing Lab/Diag Clinic
Academic Health Sciences Centre
Admin/Corp office
Community Clinic/Health-centre
Nursing home/ long term care facility/ seniors’ residence
University
Private Office/Clinic
Practice organization for Public Health and Preventive Medicine specialists in Canada, 2013*
Source: 2013 National Physician Survey. CFPC, CMA, Royal College
* 2014 data for this specialty is not available. Contrary to the 2014 survey, the 2013 survey did not include “hospital-based practice” as an option to choose from.
14%
23%
63%
Solo Practice
Group Practice
Interprofessional Practice
Hours worked per week (excluding on-call) by Public Health and Preventive Medicine specialists in Canada, 2014
Source: 2014 National Physician Survey. CFPC, CMA, Royal College
Activity Hours worked per week
Direct patient care without teaching component 4.2
Direct patient care with teaching component 1.7
Teaching without patient care 3.9
Indirect patient care 2.9
Health facility committees 3.1
Administration 12.0
Research 5.0
Managing practice 2.0
Continued professional development 2.9
Other 3.6
TOTAL HOURS PER WEEK 41.3
Remuneration for Public Health and Preventive Medicine specialists in Canada
3%
44%
16%
31%
6%
Primary payment method1 in 2013
90% + fee-for-service 90% + salary
90% + other* Blended
NR
* Other includes capitation, sessional, contract and other methods
Average gross clinical earnings for all medical specialists in 2013/14 (those earning at least
$60,000) = $339,5662
Average percent overhead reported by all medical specialists in 2010 = 20%3
1 National Physician Survey, 2013, CFPC, CMA, Royal College 2 National Physician Database, 2013/14, CIHI 3 National Physician Survey, 2010, CFPC, CMA, Royal College
Satisfaction among Public Health and Preventive Medicine specialists in Canada, 2013
7%
7%
2%
1%
11%
17%
7%
22%
37%
38%
36%
14%
Current professional life
Balance of personal & professional commitments
NR Very dissatisfied Dissatisfied
Neutral Satisfied Very satisfied
Source: 2013 National Physician Survey. CFPC, CMA, Royal College
Public Health and Preventive Medicine specialists who are Royal College, CFPC or CMQ certified in Canada, 2014
100%
33%
22%
5%
Royal College CFPC CMQ Outside Canada
Note: Physicians could indicate more than one certification body.
Source: 2014 National Physician Survey. CFPC, CMA, Royal College
Number of Public Health and Preventive Medicine specialists who retired during the THREE year period of 2012 to 2014
Source: CMA Masterfile – year over year comparisons Note: “Retired” is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their licence but may return to practice at a later date.
1 1
10
12
1
3 3
7
< 35 35-44 45-54 55-64 65 + Total
Age Group
Males Females
Faculty of Medicine
Ministry funded
Total Faculty of Medicine
Ministry funded
Total
Memorial U N&L 0 0 McMaster U 8 8
Dalhousie U 0 0 UWO 0 0
U Laval 7 7 NOSM 7 7
U Sherbrooke 13 13 U Manitoba 5 6
U Montréal 9 9 U Sask 5 5
McGill U 6 6 U Alberta 8 8
U Ottawa 10 10 U Calgary 15 17
Queens U 9 9 UBC 14 14
U Toronto 20 21 Canada 136 140
Total and Ministry funded postgraduate MD trainees in 2014/15 – Public Health & Preventive Medicine
Source: 2014/15 Annual Census of Post-MD Trainees, CAPER
8 9
12 10
0
12
24
First year Exits frompostgrad
Female
Male14
11
6
8
0
12
24
First year Postgradexits
IMG
GCMS
First year and exiting postgraduate MD trainees in 2014/15 – Public Health and Preventive Medicine
Source: 2014/15 Annual Census of Post-MD Trainees, CAPER
IMG – International Medical Graduates GCMS – Graduates of Canadian Medical Schools
• Total of 20 first year Public Health and Preventive Medicine trainees representing 15% of all Public Health and Preventive Medicine trainees.
• Total of 136 Public Health and Preventive Medicine trainees representing 1% of all Ministry funded trainees.
• Total of 2 visa trainees in Public Health and Preventive Medicine.
• Total of 19 Public Health and Preventive Medicine trainees completed postgraduate training in 2014.
Postgraduate-MD trainees in 2014/15 – Public Health and Preventive Medicine
Source: 2014/15 Annual Census of Post-MD Trainees, CAPER
1
4
5
1 1
2
1
0
3
6
Location of 2013 Postgraduate-MD exits in 2015 – Public Health and Preventive Medicine
Of the 15 exits in 2013, 14 (93%) were known to be practising in Canada
Source: 2014/15 Annual Census of Post-MD Trainees, CAPER
Stress associated with finding employment at end of residency
6%
7%
20%
43%
50%
42%
25%
8%
Other spec res
FM resident
NR/NA Not stressful Somewhat stressful Very stressful
Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College
Links of the organizations supplying information for this document
National Physician Survey http://www.nationalphysiciansurvey.ca Canadian Medical Association http://www.cma.ca/pdc Association of Faculties of Medicine of Canada http://www.caper.ca/ Royal College of Physicians and Surgeons of Canada http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route
College of Family Physicians of Canada http://www.cfpc.ca Canadian Institute for Health Information http://www.cihi.ca
