The Leaders in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) Fellowship, a Novel Training Program in Public Health for Infectious Diseases Physicians.

The severe acute respiratory syndrome coronavirus 2 pandemic demonstrated a critical need for partnerships between practicing infectious diseases (ID) physicians and public health departments. The soon-to-launch combined ID and Epidemic Intelligence Service fellowship can only address a fraction of this need, and otherwise US ID training lacks development pathways for physicians aiming to make careers working with public health departments. The Leaders in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) fellowship is a model compatible with the current training paradigm with a proven track record of developing careers of long-term collaboration. Established in 2017 by the ID Society of America, Society for Healthcare Epidemiology of America, Pediatric ID Society, and supported by the Centers for Disease Control and Prevention, LEAP is a single-year in-place, structured training for senior trainees and early career ID physicians. In this viewpoint, we describe the LEAP fellowship, its outcomes, and how it could be adapted into ID training.

Evaluation of the first two Frontline cohorts of the field epidemiology training program in Guinea, West Africa.

BACKGROUND: The 2014-2016 Ebola virus disease outbreak in West Africa revealed weaknesses in the health systems of the three most heavily affected countries, including a shortage of public health professionals at the local level trained in surveillance and outbreak investigation. In response, the Frontline Field Epidemiology Training Program (FETP) was created by CDC in 2015 as a 3-month, accelerated training program in field epidemiology that specifically targets the district level. In Guinea, the first two FETP-Frontline cohorts were held from January to May, and from June to September 2017. Here, we report the results of a cross-sectional evaluation of these first two cohorts of FETP-Frontline in Guinea. METHODS: The evaluation was conducted in April 2018 and consisted of interviews with graduates, their supervisors, and directors of nearby health facilities, as well as direct observation of data reports and surveillance tools at health facilities. Interviews and site visits were conducted using standardized questionnaires and checklists. Qualitative data were coded under common themes and analyzed using descriptive statistics. RESULTS: The evaluation revealed a significant perception of improvement in all assessed skills by the graduates, as well as high levels of self-reported involvement in key activities related to data collection, analysis, and reporting. Supervisors highlighted improvements to systematic and quality case and summary reporting as key benefits of the FETP-Frontline program. At the health facility level, staff reported the training had resulted in improvements to information sharing and case notifications. Reported barriers included lack of transportation, available support personnel, and other resources. Graduates and supervisors both emphasized the importance of continued and additional training to solidify and retain skills. CONCLUSIONS: The evaluation demonstrated a strongly positive perceived benefit of the FETP-Frontline training on the professional activities of graduates as well as the overall surveillance system. However, efforts are needed to ensure greater gender equity and to recruit more junior trainee candidates for future cohorts. Moreover, although improvements to the surveillance system were observed concurrent with the completion of the two cohorts, the evaluation was not designed to directly measure impact on surveillance or response functions. Combined with the rapid implementation of FETP-Frontline around the world, this suggests an opportunity to develop standardized evaluation toolkits, which could incorporate metrics that would directly assess the impact of equitable field epidemiology workforce development on countries' abilities to prevent, detect, and respond to public health threats.

Perspectives on the Future of Epidemiology: A Framework for Training.

Over the past century, the field of epidemiology has evolved and adapted to changing public health needs. Challenges include newly emerging public health concerns across broad and diverse content areas, new methods, and vast data sources. We recognize the need to engage and educate the next generation of epidemiologists and prepare them to tackle these issues of the 21st century. In this commentary, we suggest a skeleton framework upon which departments of epidemiology should build their curriculum. We propose domains that include applied epidemiology, biological and social determinants of health, communication, creativity and ability to collaborate and lead, statistical methods, and study design. We believe all students should gain skills across these domains to tackle the challenges posed to us. The aim is to train smart thinkers, not technicians, to embrace challenges and move the expanding field of epidemiology forward.

An evaluation of the global network of field epidemiology and laboratory training programmes: a resource for improving public health capacity and increasing the number of public health professionals worldwide.

BACKGROUND: Given that many infectious diseases spread rapidly, across borders and species, there is a growing worldwide need to increase the number of public health professionals skilled in controlling infectious epidemics. Needed also are more public health professionals skilled in non-communicable disease surveillance and interventions. As a result, we surveyed all 57 field epidemiology training programmes (FETPs) that are members of the Training Program in Epidemiology and Public Health Interventions Network (TEPHINET), to evaluate the progress of the FETPs, the only global applied epidemiology network, toward increasing public health capacity globally. METHODS: Data on the FETP programmes and the training they provide were abstracted from TEPHINET membership surveys and verified with FETP directors for all FETPs that were members of TEPHINET in 2012. Data on abstracts submitted to the recent TEPHINET Global Scientific Conference, on recent accomplishments by each FETP, and on quality improvement were also compiled to provide a worldwide view of the public health human resource capacity produced by these programmes. RESULTS: A total of 6980 public health professionals worldwide have graduated from an FETP or from the Center for Disease Control and Prevention's Epidemiology Intelligence Service (EIS). FETP residents and graduates participate in key public health prevention, control, and response activities. Each FETP has adapted its curriculum and objectives over time to align with its country's public health priorities. FETPs are well integrated into their national public health infrastructures, and they have many partners at the national, regional and global levels. CONCLUSION: FETPs are a competent and diverse source of highly skilled public health professionals who contribute significantly to public health's global human resource needs. This finding is evidenced by 1) the training curricula that were adapted over time to meet public health's human resource needs, 2) the FETPs' continued support from internal and external partners, 3) the increasing number of FETP residents and graduates and their increasing contribution to effective public health work, and 4) the increased quality improvement initiatives facilitated through the FETPs membership in one global network, TEPHINET.

Shifting the gaze of the physician from the body to the body in a place: A qualitative analysis of a community-based photovoice approach to teaching place-health concepts to medical students.

Medical practitioners, trained to isolate health within and upon the body of the individual, are now challenged to negotiate research and population health theories that link health status to geographic location as evidence suggests a connection between place and health. This paper builds an integrated place-health model and structural competency analytical framework with nine domains and four levels of proficiency that is utilized to assess a community-based photovoice project's ability to shift the practice of medicine by medical students from the surface of the body to the body within a place. Analysis of the medical student's photovoice data demonstrated that the students achieved structural competency level 1 proficiency and came to understand how health might be connected to place represented by six of the nine domains of the structural competency framework. Results suggest that medical student's engagement with place-health systemic, institutional and structural forces deepens when they co-create narratives of their lived experiences in a place with patients as community members during a community-based photovoice project. Given the importance of place-health theories to explain population health outcomes, a place-health model and structural competency analytical framework utilized during a community-based photovoice project could help medical students merge the image of patients as singular bodies into bodies set within a context.

A curriculum for training healthcare workers in the management of highly infectious diseases.

The SARS epidemic, the threat of bioterrorism, and recent examples of imported highly infectious diseases (HID) in Europe have all highlighted the importance of competent clinical and public health management of infectious disease emergencies. Although the European Union of Medical Specialists in Europe and the Infectious Diseases Society of America have developed curricula for training in infectious disease medicine, neither of those mentions training in the management of HIDs. The European Network for Infectious Diseases (EUNID, http://www.eunid.com) is a European Commission co-funded network of experts in HID management, created to help improve the preparedness for HID emergencies within Europe. One of EUNID's agreed tasks is the development of a curriculum for such a training. Between April 2005 and September 2006, EUNID developed a curriculum and accompanying training course on the basis of a questionnaire that was sent to all country representatives and discussion, followed by amendment of drafts shared through the project website, and a final consensus meeting. The resulting curriculum consists of a two-module course covering the core knowledge and skills that healthcare workers need to safely treat a patient who has, or who may have, an HID. The first module introduces theoretical aspects of HID management, including disease-specific knowledge, infection control, and the public health response, through didactic teaching and class-based discussion. The second module involves a "skill station" and a clinical scenario, and equips trainees with relevant practical skills, including the use of specialised equipment and teamwork practice in patient management. Together, the curriculum and course contribute to the creation of a common framework for training healthcare professionals in Europe, and although they are designed primarily for clinicians that are directly involved in patient care, they are relevant also to public health professionals and others who may be involved in HID management and emergency response.

Applied epidemiology and public health: are we training the future generations appropriately?

To extend the reach and relevance of epidemiology for public health practice, the science needs be broadened beyond etiologic research, to link more strongly with emerging technologies and to acknowledge key societal transformations. This new focus for epidemiology and its implications for epidemiologic training can be considered in the context of macro trends affecting society, including a greater focus on upstream causes of disease, shifting demographics, the Affordable Care Act and health care system reform, globalization, changing health communication environment, growing centrality of team and transdisciplinary science, emergence of translational sciences, greater focus on accountability, big data, informatics, high-throughput technologies ("omics"), privacy changes, and the evolving funding environment. This commentary describes existing approaches to and competencies for training in epidemiology, maps macro trends with competencies, highlights an example of competency-based education in the Epidemic Intelligence Service of Centers for Disease Control and Prevention, and suggests expanded and more dynamic training approaches. A reexamination of current approaches to epidemiologic training is needed.

Epidemiologic approaches to quality assessment.

Hospital epidemiologists have an opportunity to apply their skills to hospital quality problems other than infection control. Soon, hospitals will be required to collect and report numerous quality indicators, whose results will require epidemiologic interpretation. For those who choose to make the transition into quality management, careful assessment and planning are needed to succeed.

Certification in infection control and epidemiology-a celebration of 15 years!

Certification in infection control has been available since 1983. In this, the 15th anniversary of the Certified in Infection Control examination, it seems appropriate to examine how the program was developed, how it has evolved, and future opportunities for Certification in Infection Control and Epidemiology. This article was written to provide a brief history and an update on the current status of the Certified in Infection Control program.

[Methodological problems of training epidemiologists at institutes for physician advanced training]. / Metodicheskie voprosy podgotovki vrachei-épidemiologov v institutakh usovershenstvovaniia vrachei.

The system of raising the qualification of epidemiologists at the chair of epidemiology of the Kiev Institute for Advanced Medical training is described.

[Sanitary and epidemiologic wellbeing of children and adolescents and training programs for physicians]. / Sanitarno-épidemiologicheskoe blagopoluchie detskogo i podrostkovogo naseleniia i podgotovka vrachebnykh kadrov.

New requirements to sanitary and epidemiological conditions of the population life which are to be introduced according to the law of the Russian Federation demand comprehensive knowledge of general hygiene, epidemiology, nutrition, labor hygiene, human ecology, etc., by general practitioners. The network of existing prophylactic, educational and scientific centers should not be destroyed, but improved to train skilled specialists.

[Training physicians in medical prevention specialty: problems and prospects]. / Problemy i perspektivy podgotovki vrachei po spetsial'nosti "mediko-profilakticheskoe delo".

Trained personnel makes effective activities of our country's state sanitary-and-epidemiological service and its promising development. Hygienists and epidemiologists have been trained at specialized faculties for more than 70 years. The state sanitary-and-epidemiological service has recently taken measures to preserve and train highly qualified specialists. In accordance with the continuous trade education concept, postgraduate training is an essential link in the moulding of a well-educated physician who can work under the present conditions. Analyzing how the current governmental educational standard in the medico-prevention specialty is met has revealed some substantial shortcomings and sets a task to correct it in the context of better training.