Education and knowledge exchange perspectives and challenges Dr Punam Mangtani MSc Epidemiology Co-Course Director Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine Improving health worldwide

Importance “if epidemiology is conducted properly, it becomes a valuable asset for the determining the etiology of a disease and for evaluating intervention. This field of study uniquely can and has contributed significantly to our understanding of the causation of human health and disease” [Wynder EL AJE 1996]

Training: aims To provide sound training of investigators with medical/biological backgrounds, aptitude or experience in -quantitative research -application of rigorous methods for public health Epidemiology is a necessary quantitative science along with several other disciplines for public health (eg medical statistics, demography, health economics)

Training: who 1 Often taught at postgraduate level But increasingly being taught at undergraduate level -eg BScs in Public Health, intercalated MSc during medical studies, before applying to do Medicine Mostly via MSc/PhDs/DrPHs -variations: joint MD PhDs, post docs in laboratory sciences who then do MSc epidemiology,DrPHs

Training: who part 2 Students from a variety of academic backgrounds to work as epidemiologists in higher education, research institutions, the pharmaceutical industry, central and regional government and national health services. epidemiologists, clinical trialists, clinical or laboratory researchers

Training: where Are a number institutions (Next talk by Ursula) The Mission of LSHTM is to improve health worldwide -One way is via the pursuit of excellence in postgraduate teaching and advanced training -MSc core learning in term 1, advanced modules (15 credits each)in terms 2 and 3 (in an institution with 100 modules on offer), summer project/thesis LSHTM along with others uses e-learning -Virtual campuses eg MSc Clinical Trials, mobile technologies, podcasts

Training: when The changing nature of Higher Education is for flexible and open learning The European Credit Framework System (The Bologna Process) All main taught provision in Europe credit-rated. Awarded through assessment and achievement of a minimum level -allows building up of an award -similar quality and outcomes Distance based learning and virtual learning environments.

Training: what Specific skills for professional development -From short 5 day courses to short study periods with a mentor -More formal: masters (eg epi) onwards, certificates (eg pharmacoepi), short courses (eg missing data, vaccine evaluation) Advanced epidemiological knowledge requiring -Analytical epidemiologists to learn novel techniques -Classroom based skills learning -Modern thematic (diseases etc) training -Hands-on research work. -Peer and group learning -Flexibility and understanding. As part of a large student body and international institutions, the student is one of many cultures

Challenges and developments 1 Risk factors with small effects compared to large order associations -Application of the Bradford Hill Criteria is even more important. -The need for large simple RCTs -meta-epidemiology (sys reviews) Increasing sophistication/ specialisation -Clinical Trials -One Health (ecology, veterinary epidemiology, behavioural determinants), -Behavioural determinants-complex interventions

Challenges and developments 2 Emerging and re-emerging infectious diseases -Associated skills in transmission dynamic modeling from the population biology world -Collaboration with lab: immunology, pathogen genomics Newer statistical methods informing epidemiological knowledge -eg causal modeling, multilevel modeling, Bayesian statistics

Education and training responses Integration of epidemiological and statistical methods takes time and training -MSc project/thesis increasingly important A one year masters is just a start -Streaming within MScs. eg advanced analytical stream, thematic stream -PhDs/DrPHs Continuing professional development -Wellcome Trust funding post MSc+18 months field work. - Expectation that learning (eg field work, data collection, writing papers) also should and would occur with mentoring at work and “occasional studies” -Involve stakeholders in training (eg joint PhDs, short courses ECTE)