Postgraduate training for a career in public health

Abstract

In considering postgraduate training for public health, it is pointed out that universities are trying to educate for the future, not the present. An account is given of the attempts now being made in Edinburgh to predict what a public health career is likely to be in the future. This requires a definition of public health and a view of what its responsibilities are likely to be, what it should embrace and what it should relinquish. It is suggested that, instead of distinguishing preventive from curative medicine, the real difference lies between community or social medicine and clinical medicine. A career in public health will mean the practice of social medicine. A doctor working in public health is therefore seen as an epidemiologist and he has much to offer in the field of medical care. He can be an investigator in the identification of needs and the evaluation of different methods of provision; an educator concerned with the education of clinicians and laymen necessary to achieve action in improving health services; and an innovator suggesting new ways of providing services. He should be the colleague of clinicians and not a controller. The efficiency of the health service depends on someone performing these functions, and no one is so well qualified to do so. The changing organization of the National Health Service may well integrate all clinical services, both medical and nursing, thus bringing a closer relationship between hospitals and general practitioners. Health departments and their medical officers, relieved of their remaining responsibilities for clinical services, could then concentrate on their real tasks of studying community health. A new academic course followed by supervised research training is suggested as part of a comprehensive training scheme. It is essential that a satisfactory career in social medicine should be available so that good recruits can be attracted to it.