1. March 20151 Back to Basics, 2015 POPULATION HEALTH Dr. Nicholas Birkett School of Epidemiology, Public Health and Preventive Medicine

2. 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 March 20152

3. 3 THE PLAN (2)

4. March 20154 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 the Toronto Notes, as well as other things Toronto Notes

5. 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 March 20155

6. CANMEDS roles (2) Seven roles have been defined: –Medical Expert (central Role); –Communicator; –Collaborator; –Health Advocate; –Manager; –Scholar; –Professional March 20156

7. 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. March 20157

8. 8 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).PHELO This has absorbed some earlier CLEO and C 2 LEO topics (Culture, communication, legal, ethics, organization)C 2 LEO

9. March 20159 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 C 2 LEO topics are included in Part II of the exam.

10. March 201510 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

11. March 201511 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)

12. March 201512 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

13. March 201513 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

14. March 201514 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

15. March 201515 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

16. March 201516 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.

17. March 201517 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

18. March 201518 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

19. March 201519 LMCC Objectives (9) 78.5: OUTBREAK MANAGEMENT (March 20) Know defining characteristics of an outbreak Demonstrate essential skills in outbreak control

20. March 201520 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

21. March 201521 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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