W. S. Hercule1, A. L. Kushner3, S. M. Wren2 1Stanford University,Palo Alto, CA, USA 2Stanford University School Of Medicine,General Surgery,Stanford, CALIFORNIA, USA 3Surgeons OverSeas,New York, NY, USA
Introduction:
Global health initiatives have traditionally focused on communicable disease (CD) treatment and management. Worldwide health gains are now calling into focus the role that non-communicable diseases (NCD) have on premature, under age 60, deaths. NCD such as cancer, cardiovascular disease, injury, and diabetes often require surgery for diagnosis, treatment, or palliation. A Masters of Public Health (MPH) degree focuses on preparation for a public health career. This study examines MPH curricula for course offerings in CD, NCD, and surgery to see if education has kept pace with the increasing role of NCD and the need for surgical care.
Methods:
The top 10 US News and World Reports (2016) ranked MPH programs’ online curricula offerings were key word searched for CD, NCD, and surgery (table 1). Search terms included the most common CD causes of death (6) and prevalent NCDs (14). Courses were categorized (CD or NCD). Surgery related courses were highlighted. Summary data were reported only for institutions with complete course listings. All 10 programs websites and curricula were searched for the key words (surgery or surgical) in a separate analysis.
Results:
Of the 10 programs 4 (UMN, UC-Berkley, Harvard, UW) had incomplete course listings or descriptions and 6 (JHSPH, UNC, UMICH, Columbia, Emory, BU) had complete listings. Five of six institutions offered more courses in NCD than CD. On average there were 32.0 NCD courses and 26.7 CD courses. There was significant variability in total number of courses queried from a low of 29 (UNC) to 112(JHSPH). Overall there were 160 courses on CD and 192 on NCDs between the programs. Only 2 institutions (JHSPH and UW) had course content on surgery (2 of 112 total JHSPH courses). Website searches of the other 8 programs’ materials could not identify the words “surgery” or “surgical” even when course title words such as cancer, injury, and trauma were key content areas for discussing the role of surgery.
Conclusion:
Top tier US MPH degree programs have mirrored the emergence of NCD impact on global health while maintaining CD education. The role of surgery in public health, especially in NCD, is still sorely lacking even in institutions with global surgical leaders. Surgery is still not featured in searchable online courses and curricula in all but 2 of these institutions. We recognize that there are limitations to using online searches to examine content since full course syllabi cannot be assessed and surgical content may have been missed. Even with this limitation it is still clear that surgery as a key content area has not yet reached core or elective curricula in MPH programs and remains the “neglected stepchild of public health.”
