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Back to Basics, 2015POPULATION HEALTH

Dr. Nicholas BirkettSchool of Epidemiology, Public Health and

Preventive Medicine

The Plan (1)

• Sessions will cover a wide range of topics in– Public Health– Community Health– Occupational/Environmental health– Epidemiology/Biostatistics– Immunization/Infectious disease control

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THE PLAN (2)Tues, Mar 17 1300 – 1700 Intro; Epidemiology methods (Dr. N. Birkett)

Thurs, Mar 19 1030 – 1200 Health Care System (Dr. T. Arnason)

1500 – 1630Occupational & Environmental Health (Dr. M. Afanasyeva)

Fri, Mar 20 1300 – 1700 Health Promotion  (Dr. T. Arnason)

Immunization & Communicable disease control (Dr. N. Birkett)

Tues, April 7 1500 – 1700

Health determinants, prevention in theory (Dr. I. McDowell)

Wed, April 8 1300 – 1530

Vital statistics (Dr. N. Birkett)

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Structure

• Lectures with discussion & some trial MCQs.

• Interrupt if things aren’t clear– These sessions are for you benefit– I have no fixed agenda

• Covers topics included in theToronto Notes, as well as other things

CANMEDS roles (1)

• CANMEDS is a framework for medical education

• Developed by the Royal College of Physicians and Surgeons of Canada in 1996

• Defines essential physician competencies• Being integrated into medical education

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CANMEDS roles (2)

• Seven roles have been defined:– Medical Expert (central Role); – Communicator;– Collaborator;– Health Advocate;– Manager;– Scholar;– Professional

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CANMEDS roles (3)

• Population health content links to 3 main roles:– scholar; – advocate; – manager

• MCC now mapping all its objectives onto CanMeds roles.– Questions should be clinically relevant to a CanMeds role

• These may be the themes underlying some questions. – “You see a patient who is hesitant to have her child

vaccinated. Which of the following would form a good example of a public health advocacy approach to address this issue?” etc.

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MCC QE, Part I• Revised objectives arose from many discussions

over Public (or Population) Health competencies for physicians (much of what UOttawa covers in SIM)

• MCC content now named Population Health, Ethics, Legal & Organizational topics (PHELO).

• This has absorbed some earlier CLEO and C2LEO topics (Culture, communication, legal, ethics, organization)

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MCC QE, Part I• Aim is to merge population health & some

CLEO objectives into main pool of questions, showing clinical relevance of prevention, etc., rather than keeping separate.

• Many C2LEO topics are included in Part II of the exam.

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MCC MCQ format• Questions generally include a clinical scenario• One correct answer & 4 plausible distractors

– No “except” questions. No “all of the above”– Sometimes: correct = the better answer– Management: often “What is your best next step?”– Try to avoid “factoids”

• which is the second most important cause of death in Canada?

• Key features – each question tests one concept

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LMCC Objectives (1)

Population Health• Concepts of Health and Its Determinants (78-1)• Assessing and Measuring Health Status at the Population

Level (78-2)• Interventions at the Population Level (78-3)• Administration of Effective Health Programs at the

Population Level (78-4)• Outbreak Management (78-5)• Environment (78-6)• Health of Special Populations (78-7)

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LMCC Objectives (2)

• We will not be able to cover every objective in detail.

• Sessions will be based around MCC Objectives for Qualifying Examination.

• Emphasis is on core ‘need to know’ rather than on depth and justification

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LMCC Objectives (3)

78.1: CONCEPTS OF HEALTH AND ITS

DETERMINANTS (April 7)

• Define and discuss the concepts of health, wellness,

illness, disease and sickness.

• Describe the determinants of health and how they affect

the health of a population and the individuals it comprises.

• Lifecourse/natural history

• Illness behaviour

• Culture and spirituality

14March 2015

LMCC Objectives (4)

78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS

• Determinants of health include:– Income/social status– Social support networks– Education/literacy– Employment/working conditions– Social environments– Physical environments

15March 2015

LMCC Objectives (5)

78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS

• Determinants of health (con’t):– Personal health practices/coping skills– Healthy child development– Biology/genetic endowment– Health services– Gender– Culture

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LMCC Objectives (6)

78.2: ASSESSING AND MEASURING HEALTH STATUS AT THE POPULATION LEVEL (March 17, April 8)

• Describe the health status of a defined population. • Measure and record the factors that affect the

health status of a population with respect to the principles of causation

– Principles of Epidemiology, critical appraisal, causation, etc.

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LMCC Objectives (7)

78.3: INTERVENTIONS AT THE POPULATION LEVEL (March 20/April 7)

• Understand three levels of prevention• Concepts of Health Promotion, etc..• Role of physicians at the community level.• Impact of public policy

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LMCC Objectives (8)

78.4: ADMINISTRATION OF EFFECTIVE HEALTH PROGRAMS AT THE POPULATION LEVEL (March 19)

• Structure of the Canadian Health Care System

• Concepts of economic evaluation• Quality of care assessment

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LMCC Objectives (9)

78.5: OUTBREAK MANAGEMENT (March 20)

• Know defining characteristics of an outbreak

• Demonstrate essential skills in outbreak control

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LMCC Objectives (10)

78.6: ENVIRONMENT (March 19)• Recognize implications of environmental

health at the individual and community levels• Know methods of information gathering• Work collaboratively with other groups• Recommend to patients and groups how they

can minimize risk and maximize overall function

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LMCC Objectives (11)

78.7: HEALTH OF SPECIAL POPULATIONS (March 20)

• Specific target population include:– First Nations, Inuit, Métis Peoples– Global health and immigration– Persons with disabilities– Homeless persons– Challenges at the extremes of the age continuum

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