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March 2003
Contents
1. Introduction
5
Places of employment and work tasks
6
History of the specialty of public health medicine
..6
Number of specialists in public health medicine
6
Collaborators
7
Related specialties
..7
2.
Structure of the specialist training programme for public health medicine
..7
Theoretical and skill-building modules
.8
3.
Objectives, strategies for learning and assessment
8
Guidance on the description of the objectives for public health medicine
..8
Introductory programme
.8
Main programme
.9
The seven roles
9
Definitions and interpretation of strategies for learning and assessment
.
..9
Assessment.
11
Training scheme and training
plan
.
..12
4.
Theoretical courses and research training
13
Interdisciplinary courses
.13
Courses specific to public health medicine
.13
Research training
13
5.
Competencies required
15
Medical expert general competencies
..15
Medical expert administrative medicine
17
Medical expert social medicine
..19
Medical expert clinical competencies
21
Medical expert research methods
.25
Communicator
..27
Collaborator
..29
Manager and
administrator
31
Disease preventer and health
promoter
..33
Academic
..35
Professional
..36
Annex 1. Proposal of the Danish Society for Public
Health for structuring the specialist training programme for public health
medicine
..37
1. Introduction
Public health medicine is a medical specialty focusing on the
relationship between societal conditions and the health of the population.
The specialist training programme for public health medicine combines medical knowledge and clinical experience with knowledge and skills within public health, administration and research.
Fields within public health medicine include:
living conditions and health;
environment and health;
psychosocial conditions, lifestyles, health, development and
socialization;
the structure, organization and functioning of health and social care;
legislation that regulates matters related to health and some social
matters;
economic relationships and priority-setting in health care; and
research methods in public health medicine.
Public health medicine has two major divisions: social medicine and
administrative medicine. Most specialists in social medicine work at the
individual level with tasks related to social medicine among individual
patients. Tasks in administrative medicine are usually related to the group
level, with selected population groups or the overall society. Specialists in
public health medicine can work at all three levels in carrying out tasks
related to monitoring, maintaining and improving the health status of the
population.
Specialists in public health medicine use knowledge and skills from
clinical medicine together with knowledge and skills from law, social sciences,
sociology and sociological and epidemiological methods. The specialist training
programme for public health medicine therefore contains both theoretical and
practical learning and training from clinical hospital departments and education
and training outside the clinical hospital realm.
Broad clinical knowledge and clinical skills are prerequisites for being
able to carry out work directly related to patients within clinical social
medicine (such as rehabilitation, the tasks of community health physicians and
substance abuse) and being able to carry out tasks with clinical implications
and tasks requiring knowledge of the organization and development of the health
care system (such as planning tasks, processing patient complaints and health
surveillance). Through training at clinical hospital departments and in general
practice, the physician obtains knowledge and skills related to diagnosis,
treatment, development and prognosis for common diseases and knowledge on
preventing disease from progressing further, including opportunities to
rehabilitate patients with chronic diseases. The specialist training programme
further gives the physician a broad understanding of the organization of the
health care system at all levels. Attaining these competencies requires that the
clinical training of the specialist in public health medicine be considerably
greater in scope and content than the graduate rotational internship. The
clinical training assigns the physician tasks and responsibility at least at the
level of junior doctors in introductory positions or junior doctors in training
programme for family (general practice) medicine at relevant department,
including having the physician participate in a regular duty scheme. The
physician in specialist training should have the opportunity to follow the
progress of patients from admission to discharge.
Employment as a specialist in public health medicine enables the
physician to independently be able to carry out tasks in public health medicine
in which medical knowledge and skills are integrated with administrative
practice in health care, health law and research methods in public health
medicine.
Places of employment and work tasks
Specialists in public health medicine work in both public and private
institutions and organizations.
Places of employment and work tasks include:
medical offices of health (such as environmental medicine, surveillance
of communicable diseases and surveillance of health care personnel);
regional administration and hospital management (such as health and
hospital planning, quality development, assessment of health care technology and
promoting health and preventing disease);
municipal administration (such as working with children and adolescents,
working with elderly people and promoting health and preventing disease;
institutions of social medicine (such as treatment of substance abuse and
rehabilitation);
the National Board of Health (such as health planning, quality
development, pharmaceutical statistics, health technology assessment, promoting
health and preventing disease, supervision of health care personnel and
educational programmes in the health professions);
sectoral research institutions such as Statens Serum Institut, the DSI
Danish Institute for Health Services Research and the National Institute of
Public Health; and
international organizations and organizations with international
relations such as the World Health Organization, Danish International
Development Assistance and nongovernmental organizations.
History of the specialty of public health medicine
Denmarks specialist training programme for public health medicine was
established in 1982 with the main divisions of administrative medicine and
occupational medicine. Social medicine was added as a third line in 1987. Public
health medicine was further divided into two independent specialties in 1994:
occupational and environmental medicine and public health medicine, since
administrative medicine and social medicine were integrated into the specialty
of public health medicine.
Number of specialists in public health medicine
In 2002, about 200 physicians were certified as specialists in public
health medicine. Of these, 125 were active physicians registered in the Medical
Certification Registry of the National Board of Health with public health
medicine as the last specialty acquired.[1][1] Several were also certified in another specialty.
Nearly half the specialists were employed as medical offices of health, about 25% within social medicine, 15% within hospital or health care administration and about 10% within the National Board of Health and sectoral research institutions.
Public health medicine has the capacity to train six-eight specialists
per year, and this has always been utilized fully. The demand for specialists in
public health medicine is expected to continue to increase, especially within
clinical social medicine and municipal physicians and in niches within regional
health care administration and the Copenhagen Hospital Corporation. Denmark has
130 physicians currently employed as community health physicians, and about 12%
of these are specialists in public health medicine.
Collaborators
Many specialists in public health medicine serve as links between various
sectors and functions and often have many collaborators. Examples of
collaborators are other physicians, other health and social care personnel,
statisticians, lawyers, economists and other partners with social science
degrees.
Related specialties
The competencies of public health medicine overlap somewhat with those of
occupational medicine and family medicine within the fields of social medicine
and promoting health and preventing disease. Research competencies further
overlap with those of occupational and environmental medicine.
2. Structure of the specialist training programme for
public health medicine
Many of the competencies physicians training to become specialists in
public health medicine should attain in the course of their training are
cognitive objectives that should be achieved by participating in courses and
through independent study, since undergraduate medical education covers these
briefly or not at all. Examples include epidemiology and biostatistics, health
economics, health law and health planning. The Annex to this description of
objectives outlines the proposal of the Danish Society of Public Health for the
structure of the specialist training programme for public health medicine.
The main training programme weights the actual public health medicine
part of the programme and clinical training at hospitals and/or in general
practice equally.
The modules after the rotational internship include the introductory
training (employment) programme and the main training programme.
Introductory training programme. This is 1 year of employment in public health
medicine. Some of the competencies may be achieved in an introductory position
in occupational and environmental medicine.
Main training programme. This is 4 years of employment that ensures as a whole that the
competencies listed in the description of objectives are achieved. These may be
acquired through employment at:
various clinical hospital departments and/or in general practice; and
various places of employment in public health medicine;
and through intensive short term (few weeks) internships in public health
medicine.
Research employment, international work and occupational and
environmental medicine or another main or introductory clinical training
programme may be part of the specialist training programme as long as the
competencies in the description of the objectives are attained and the learning
is supervised.
Theoretical and skill-building modules
Four weeks of general interdisciplinary courses in communication and
information technology, educational theory and management, administration and
collaboration.
Six weeks of theoretical courses specific to public health medicine and
12 weeks of integrated research training and research methods that are completed
as part of an overall theoretical and skill-building training programme combined
with preparation of a project. The programme is assessed by preparation of
papers in the theoretical courses and by preparation and approval of the project
prepared individually or in groups with the use of theory and skills achieved in
this programme.
Research training is primarily placed in the part of the programme
focusing on public health medicine, and the rest of the courses may be dispersed
over the whole programme.
3. Objectives, strategies for learning and assessment
Guidance on the description of the objectives for
public health medicine
This section describes the competencies a specialist in public health
medicine should possess at the end of the introductory programme and the main
programme, respectively. These are minimum competencies, which means that all
future specialists in public health medicine should have achieved all the
competencies, regardless of how they are distributed in the course of the
programme. The competencies may be achieved in various ways depending on the
profile of the individual training programme. Thus, all specialists in public
health medicine are expected to develop competencies within parts of the
specialty that exceed the minimum competencies.
The list of competencies is divided into three columns: competencies and
objectives, learning strategy and strategy for assessment. Competencies and
objectives describes the objectives themselves: the minimum competency of the
physician. The strategy for learning and strategy for assessment provide methods
by which the relevant competency can be learned and how to assess whether the
competency has actually been attained.
Introductory programme
The competencies that should be acquired at the end of the introductory
programme are listed specifically under each field of competence. The objectives
are listed in the shaded cells.
The purpose of the introductory programme is to provide the physician
insight into public health medicine, such that the choice of specialty is
qualified. The objectives cover the key functions of the specialty. The
physician collaborates with the adviser in assessing the physicians choice of
specialty and the physicians suitability for the specialty before the
introductory programme is completed.
Main programme
The purpose of the main programme is to acquire the competencies that a
specialist in public health medicine should have. These are minimum competencies
that all future specialists must acquire. A signed log book confirming that all
objectives have been achieved is a prerequisite for obtaining the title of
specialist in public health medicine.
The seven roles
The specialist in public health medicine should have skills within the
following seven roles:
1) medical
expert
2) communicator
3) collaborator
4) manager
or administrator
5) preventer
of disease and health promoter
6) academic
7) professional.
All seven roles are important in the specialty of public health medicine,
and the roles of communicator, collaborator, administrator and preventer of
disease and health promoter are part of the expert role of the specialist in
public health medicine. All these roles are described independently to make
visible the emphasis on the seven roles.
The field of competence of medical expert is divided into general
competencies and into four themes:
administrative medicine
social medicine
clinical competencies
research methods.
Definitions and interpretation of strategies for
learning and assessment
Several concepts used under the strategy for learning are defined here.
Independent study
The future specialists in public health medicine, independently but
encouraged by their adviser, are expected to study the basic textbook material
within public health medicine and to seek and study the necessary documentation,
legislation and other material within their own field of work. Independent study
is a part of normal work. The studying can be made visible by having the
physician keep records of articles, textbooks, legislation and other material
read. Discussions with the adviser are expected to include independent study,
and proposals for continued reading may be discussed. Since the general
political, social, economic and other trends in society play such a great role
in the work of public health medicine, the independent study is not limited to
narrow scientific material but also includes the obligation to keep abreast of
trends in Denmark and the world.
Assignment of tasks and cases during employment
The training institution is obligated to delegate work tasks that ensure
progression in the development of competence, such that the work tasks are
delegated considering both the requirements of training and the needs of the
place of employment. Learning requires that the work tasks be supervised and
that both positive and negative feedback be given on the tasks.
Theoretical instruction and participation in
theoretical courses
This typically occurs in connection with the courses specific to public
health medicine and courses in research methods. Participating in the course
requires independent efforts in addition to attendance. Acquiring the necessary
competencies requires that the physician be prepared, participate actively in
discussions and carry out the required assignments.
Logging various matters
Relevant patient record events, other events and the like are recorded in
the log book with the aim that it be submitted as case presentations and
reviewed with the adviser. All material that can be traced to individual people
should be kept in anonymous form. The physician is required to reflect on
knowledge, legislation used, clinical skills and other matters included in the
cases. This reflection is recommended to be put into writing to support the
discussions with the adviser.
Case presentation
Case presentation means that the physician presents a case that has been
completed to the adviser and/or mentor with support from the written material
prepared in connection with the case. Thus, this does not necessarily mean
preparing an independent paper or the like. Case presentations are part of the
log book (see previously). A case presentation of at most two A4 pages should be
prepared for each of the competencies required to be attained during clinical
employment. Case presentations should emphasize describing the physicians own
role in the patients course of treatment, working together with collaborators
and the organization around the patient.
Reflection on practice
Reflection on practice means that the physician makes independent
considerations on a completed case related to the course of events, the theory,
legislation and other factors used in solving the task executed, the societal
context in which the challenge should be seen and others. The physician reflects
on the perspectives involved and on his or her own competencies and potential to
develop these. Reflection may be written in the learning diary in the log book
and may be discussed with the adviser and/or mentor. The learning diary is for
the physicians own private notes and should not be submitted to the adviser.
Discussions with colleagues and the adviser
Reflection on the tasks executed is often not an absolute truth that can
be assessed but rather the ability to develop and gain perspective from work
situations. This requires a forum in which to discuss informally and developing
ones own thoughts.
Feedback from people who have participated in ...
The place of training is required in some areas to have formalized
feedback mechanisms for participants related to collaboration processes,
communication and others. If this is not the case, the training institution
should prepare a procedure for feedback that can be integrated into the learning
process in the form of either direct verbal feedback or written feedback that
can be included in discussions with colleagues and advisers.
Quality development
This means using the method of quality development, typically executed at
the place of employment with a topic assigned by the adviser or found in
collaboration with the adviser.
Execution of a project
The specialist training programme for public health medicine requires the
physician to execute a project as part of research training. The physician
should learn to develop his or her own methods among many solutions and
determine his or her attitudes. Quantitative and/or qualitative methods in
public health medicine may be used.
Intensive internships in public health medicine
Most of the competencies listed in the description of objectives may be
acquired through employment at workplaces related to public health medicine as
well as clinical workplaces at hospitals and in general practice. Some are
learned during theoretical courses and in connection with research training (see
Chapter 4).
Some competencies may be learned in practice in public health medicine
without actual employment within the relevant field. To ensure that all
competencies are obtained, the main training programme may include intensive,
short-term internships (such as 2 weeks) at workplaces that cover fields in
which the physician has not obtained experience in the introductory or main
training programme.
The physician participates during such intensive internships in the daily
work in the institution without independent administrative responsibility and
while continuing to be employed at the usual department during the main training
programme.
The workplaces that offer intensive internships in public health medicine
are required to prepare a programme for the internship including a programme for
the associated theoretical reading material. The description of objectives lists
requirements for specific documented competencies that may be attained during
these intensive internships.
The specific agreements on intensive internships at clinical departments
or in general practice are entered into by the mentor or main adviser and the
physician and with the place of internship.
Assessment
Assessment of the physicians competencies is differentiated from the
assessment of the framework for learning.
Assessment of the physicians competencies
The method used to assess competencies should be able to determine
whether the physician has or has not
acquired the relevant competency. The competency requirements are therefore
formulated such that the recommended methods of assessment can be used to
determine whether the physician has obtained the relevant competency or not.
Competencies are assessed regularly during the course of the specialist
training programme with the aim of documenting, assessing and perhaps amending
the specialist training programme as it progresses. It is important that the
competencies assessed broadly reflect the competencies required of a specialist
in public health medicine.
Assessment of the educational framework
The educational framework means the framework that determines the
educational environment and processes of learning. Examples include the
framework created by the culture of employment, human resources, culture of
education, working hours and organizational factors.
The section on strategy for
assessment uses the following concepts, which are hereby defined.
Structured collegial assessment
This means a preliminary assessment and later follow-up on practical
competencies that the physician has demonstrated in the execution of work tasks.
The training institution optimally prepares a structure for this feedback in the
form of checklists or the like for specific competencies. A prerequisite for
feedback is that the work be organized in such a way that the adviser and
colleagues can observe the physician executing work tasks.
Structured discussions with the adviser
This is a discussion (not an examination) to assess case presentations,
provide feedback on observations, review the log book, discuss reflection and
discuss other matters.
This is not the regular daily correction and advice for which everyone is
responsible at a workplace that is also an training institution but structured,
planned discussions with a designated adviser and/or the main adviser or mentor.
Assessment of course work
Benefiting from a course requires active participation, including
independent and active contribution to group work, presentation of group work
and preparation for course sessions. Obtaining credit for theoretical courses
therefore requires active participation: that is, being present, relevant
preparation and active participation in discussions, completing assignments,
etc. Theoretical courses may also have an actual examination at the end. The
people responsible for courses assess the degree of active participation.
Theoretical courses are oriented towards using the theory learned in
employment in public health medicine. The assessment of theoretical knowledge
therefore includes a review of relevant theoretical knowledge related to the
challenges of public health medicine. The adviser in public health medicine is
required to assess the degree to which the physician can apply the skills
obtained in theoretical courses.
Training scheme and training plan
Each individual training programme requires the preparation of a training
scheme based on the description of
objectives. The training scheme should indicate the elements of specialist
training in which the individual competencies are required to be attained. The
training scheme should include a section on the educational framework, including
defining the function of the adviser. Training schemes should specify that the
educational framework should be assessed.
An training plan is prepared
for each individual training programme in collaboration between the adviser and
the physician based on the training scheme and the prerequisites of the
individual physician. The training plan is revised regularly as the training
progresses.
4. Theoretical courses and research training
Interdisciplinary courses
Specialist training programmes for physicians include mandatory
interdisciplinary courses in communication, learning, advising, administration,
management and collaboration. These courses support the specialist training
programme for public health medicine, and the public health medicine learned
during employment and in theoretical courses specific to public health medicine
is often based on the foundation created by the interdisciplinary courses.
The description of objectives does not directly list the
interdisciplinary courses as a strategy for learning under individual
competencies (except for the communicator), since the specific content of the
courses is not yet known. Competencies obtained during courses are required to
be assessed during employment within public health medicine and clinical
workplaces. The courses are only significant if they support the competencies
listed in the description of objectives, and these competencies are therefore
the ones that should be assessed. The same applies to the courses specific to
public health medicine.
Courses specific to public health medicine
The guidelines for the courses specific to public health medicine
normally set aside 30 days with 7 hours each for course activity for the courses
specific to public health medicine. The content of the courses is established
based on the description of objectives for the specialty of public health
medicine within the fields of: health law, management of communicable diseases
and environmental problems as well as social legislation; medical sociology;
public health (also internationally) and strategies for preventing disease and
promoting health; evaluation of health programmes; the organization and
management of the health care system (also internationally); and quality
development and health technology assessment (advanced in relation to the
interdisciplinary course).
The courses are organized from among the possible courses offered such
that the courses support learning the broadest possible set of the competencies
of public health medicine. The Danish Society of Public Health is responsible
for this. The courses have previously been organized in cooperation with the
Danish Society for Occupational and Environmental Medicine in a joint course
committee. If this cooperation is not continued, the responsibility will be
delegated to the Public Health Medicine Specialist Training Working Group of the
Society.
As the last paragraph indicates, the Society will strongly seek to take
advantage of existing courses offered at the university level if this covers the
course needs of the specialty.
This trend in the specialtys theoretical courses means that specifying
the courses in detail in the description of objectives potentially may
excessively bind the organization of the courses. The key parameter in the
courses offered is the competencies listed in the description of objectives,
just as the strategy for learning often indicates that the courses offered
should cover key theoretical competencies.
Research training
Specialists in public health medicine should be skilled in using
quantitative epidemiological methods and questionnaire techniques as detailed in
the description of objectives. In addition, specialists should be able to
critically analyse and assess research results based on social science methods
within sociology, organizational theory and health economics. A very broad range
of research methods is required of specialists in public health medicine because
social science research methods are largely absent from undergraduate medicine
and epidemiological methods are little emphasized. This places great demands on
qualifying specialists in public health medicine in research theory.
The future specialist in public health medicine should be able to prepare
a project relevant to public health medicine in connection with the main
training programme on a topic that is determined together with the mentor and/or
the designated project adviser. Among others, this project should demonstrate
skills related to:
preparing a project protocol;
epidemiological methods;
basic biostatistics;
scientific ethics;
communicating the results in writing (reports or scientific publications);
and
further important skills mentioned in the description of objectives
within public health, disease prevention, questionnaire techniques, qualitative
methods, health economics, organizational theory, quality development and others.
For further information, see the competencies and objectives related to
research methods listed in the description of objectives.
Working on the project in public health medicine requires the
collaboration of workplaces in public health medicine. They need to help by
providing suitable projects and by providing the necessary support for executing
the project both in backing the project and in the form of resources (time) to
write the project papers, collect data and other tasks. The projects normally
comprise part of the work and development tasks of the workplace, and much of
the project can therefore be accomplished during working hours. Formulating a
project and at least preparing the project protocol are required to be executed
in connection with the courses taken. Further project work is executed at the
workplace as part of the physicians work or on leave from this work.
Project preparation is supported by courses on research methods within:
epidemiology and biostatistics;
questionnaire techniques;
methods in health economics and organizational theory; and
sociological methods, including qualitative methods.
The courses related to theory specific to public health medicine and to
research methods are suggested to be integrated into a course package that may
be offered by the master of public health programmes in Denmark or by other
institutions with corresponding academic teaching credentials and fields of
interest. The specific details related to this must be agreed with the National
Board of Health within the framework established by the National Council for
Specialist Medical Training. As indicated, a further requirement is that
formulating a project and at least preparing the project protocol for research
training be prepared in connection with the courses taken.
5.
Competencies required
Medical
expert general competencies
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, to be able to manage administration
in fields related to important disease categories in the context of public
health medicine |
In
the introductory position, tasks are assigned that require the use of
knowledge on public health and Discussion
with colleagues and the adviser and Case
presentation in the log book |
Structured
collegial assessment and Structured
discussions with the adviser |
|
Being
able to explain and identify the societal and cultural factors that
influence the health and illness of the population and to place this
knowledge in a historical and cultural context |
Theoretical
instruction |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to manage administration related to overall political priorities and
programmes related to health |
Assignment
of tasks that require knowledge on political priorities and programmes and Reflection
on practice |
Structured
discussions with the adviser |
|
Being
able to manage administration based on the principles of public
administration |
Assignment
of tasks that require knowledge on public administration and Reflection
on practice |
Structured
discussions with the adviser |
|
Being
able to explain various principles in the structure, funding and
organization of health systems for treatment, disease prevention and
health promotion |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to carry out simple analyses in health economics |
Assignment
of tasks that require knowledge on health economics and Reflection
on practice |
Structured
discussions with the adviser, including assessment of the task executed |
|
Being
able to explain the most important health problems, factors causing
disease and initiatives promoting public health in relation to public
health in developing countries |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain the most important factors that have led to problems with
refugees and the significance of these problems for public health |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain the significance of immigration for public health in
Denmark |
Theoretical
instruction |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to use methods related to quality development and to explain the most
important concepts and their scope of application |
Participation
in at least one quality development task including the concepts and
methods mentioned and Case
presentation in the log book |
Structured
collegial assessment and
Structured
discussions with the adviser |
|
Being
able to explain methods and theories related to health technology
assessment |
Theoretical
instruction |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
Medical expert administrative medicine
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, being able to plan and manage a case |
Assignment
of cases, which are managed under supervision and Discussion
with colleagues and the adviser and Case
presentation in the log book |
Structured
discussions with the adviser, including assessment of the cases assigned |
|
Being
able to explain the principles of the legally mandated collaboration
related to the regional health plans and municipal health reports |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain important interest groups in Denmarks health care
system |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to act in accordance with the principles of legislation |
Managing
administration under supervision |
Structured
discussions with the adviser |
|
Being
able to make decisions, advise on and make recommendations in individual
cases in accordance with legislation and administrative practice in a
given field |
Managing
administration under supervision and Case
presentation in the log book |
Structured
collegial assessment and Structured
discussions with the adviser, including assessment of the cases managed |
|
Being
able to explain the principles in legislation significant for public
health |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain the principles of combating communicable diseases and for
preventing the dissemination of infection in cases of outbreak of
communicable diseases |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain important factors in environmental medicine |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain the legal basis and scientific and theoretical basis for
emergency management planning and for tools for managing the tasks of
specialists in public health medicine in connection with emergency
management planning and the specifics of emergency management |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain general theories of organization and various principles of
the structure and functioning of organizations and various theories on the
effects of organizations |
Theoretical
instruction with the use of cases and group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to prepare a decision proposal for a political or administrative
forum in the relevant language and form |
Under
supervision, preparing a decision proposal for a relevant forum |
Structured
collegial assessment |
Medical expert social medicine
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, being able to explain the
significance of social inequality in health and the opportunities for
efforts in this field |
Independent
study, participation in conferences and meetings and Discussions
with colleagues based on specific cases |
Structured
discussions with the adviser |
|
Being
able to explain the concepts of health and disease within social medicine
and work with resource profiles and other specific methods of work in
social medicine |
Theoretical
instruction with the use of cases and group discussion |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to identify the societal, cultural and subjective factors influencing
the current life and illness situation for children, adolescents, adults
and elderly people at the societal and individual levels |
Theoretical
instruction with the use of cases and group discussion and
Execution
of tasks during employment (optional) |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain the life conditions of children and adolescents and the
development of childrens personality with the aim of being able to use
the existing opportunities for intervention in the lives of children with
special needs |
Theoretical
instruction with the use of cases and group discussion |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to contribute to identifying resources among individuals and to
prepare action plans based on insight into health, psychological and
social factors in collaboration with the individual and other specialist
physicians |
Execution
of tasks in social services administration, a social institution, general
practice or a hospital department (an optional intensive internship in
public health medicine) and Case
presentation in the log book |
Structured
collegial assessment and Structured
discussions with the adviser, including assessment of the case
presentation |
|
Being
able to contribute to solving challenges in social medicine related to
people with reduced functional ability, including socially excluded people
and people with illness that cannot be explained by medical science |
Execution
of tasks in social services administration, a social institution, general
practice or a hospital department (an optional intensive internship in
public health medicine) |
Structured
collegial assessment |
|
Being
able to prepare a patient record in social medicine |
Execution
of tasks in social services administration, a social institution, general
practice or a hospital department and During
employment or intensive internships in public health medicine, writing a
diary and entering this into the log book (as a case presentation) |
Structured
collegial assessment and Structured
discussions with the adviser, including assessment of the case
presentation |
|
Being
able to explain the principles of record-keeping in social medicine cases |
Theoretical
instruction |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to identify children who are vulnerable mentally, socially and
somatically and being able to participate in collaboration related to the
vulnerable child |
Execution
of tasks in social services administration, a social institution, general
practice or a hospital department and Case
presentation in the log book |
Assessment
by colleagues and the adviser of the execution of tasks during clinical
employment and The
advisers assessment of the case presentation |
Medical expert clinical competencies
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
Being
able to independently diagnose, initiate treatment when needed and carry
out relevant referral or require the necessary assistance for acute
conditions requiring treatment |
Execution
of practical clinical work with acute patients in general practice or at a
hospital department, including participating in a regular duty scheme and Case
presentation of courses of treatment in the log book |
Assessment
by colleagues and the adviser of the execution of tasks during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to independently carry out clinical tasks related to the most common
diseases in internal medicine,
including:
being able to receive patients, diagnose and present further plans
for diagnosis and treatment
being able to begin treatment, monitor the effects of treatment and
carry out adequate adjustment and follow-up
being able to follow the course of illness with active
participation in all phases, including follow-up control and/or referral
back to the primary sector |
Independent
and supervised execution of practical clinical work in general practice or
at a department of general medicine at a hospital and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to independently carry out clinical tasks among patients with the
most common diseases of the nervous
system, including:
being able to receive patients, diagnose and present further plans
for diagnosis and treatment
being able to begin treatment, monitor the effects of treatment and
carry out adequate adjustment and follow-up
being able to follow the course of illness with active
participation in all phases, including follow-up control and/or referral
back to the primary sector |
Independent
and supervised execution of practical clinical work in general practice or
at a hospital department and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to independently carry out clinical tasks among patients with mental
symptoms, including:
being able to receive patients, diagnose and present further plans
for diagnosis and treatment
being able to begin treatment, monitor the effects of treatment and
carry out adequate adjustment and follow-up
being able to follow the course of illness with active
participation in all phases, including follow-up control and/or referral
back to the primary sector |
Independent
and supervised execution of practical clinical work in general practice or
at a hospital department and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to independently carry out clinical tasks among patients with
suspected or confirmed cancer,
including:
being able to receive patients, diagnose and present further plans
for diagnosis and treatment
being able to begin treatment, monitor the effects of treatment and
carry out adequate adjustment and follow-up
being able to follow the course of illness with active
participation in all phases, including follow-up control and/or referral
back to the primary sector |
Independent
and supervised execution of practical clinical work in general practice or
at a hospital department and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to independently carry out clinical tasks among patients with the
most common symptoms in the fields
of surgery and gynaecology, including:
being able to receive patients, diagnose and present further plans
for diagnosis and treatment
being able to begin treatment, monitor the effects of treatment and
carry out adequate adjustment and follow-up
being able to follow the course of illness with active
participation in all phases, including follow-up control and/or referral
back to the primary sector |
Independent
and supervised execution of practical clinical work in general practice or
at a hospital department and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to independently carry out clinical tasks among patients with musculoskeletal
symptoms, including:
being able to receive patients, diagnose and present further plans
for diagnosis and treatment
being able to begin treatment, monitor the effects of treatment and
carry out adequate adjustment and follow-up
being able to follow the course of illness with active
participation in all phases, including follow-up control and/or referral
back to the primary sector |
Independent
and supervised execution of practical clinical work in general practice or
at a hospital department and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to explain the aetiology and epidemiology of and course of illness in
substance abuse and explain relevant acute and follow-up treatment options
for substance abuse |
Participation
in theoretical courses in public health medicine and execution of
practical clinical work in general practice or at a hospital department or
at a substance abuse clinic |
Assessment
of course work and Assessment
by colleagues and the adviser of the execution of tasks during clinical
practice and/or public health medicine employment |
|
Being
able to advise on and assess the need for rehabilitation in chronic
diseases |
Independent
and supervised execution of practical clinical work in general practice or
at a hospital department and Case
presentation of a patients case in the log book |
Assessment
of the execution of tasks by colleagues and the adviser during clinical
employment and Assessment
of case presentation by the adviser in public health medicine |
|
Being
able to use clinical knowledge and skills in public health medicine
practice |
Tasks
requiring medical insight are assigned in employment within public health
medicine |
Structured
discussions with the adviser, including assessing the tasks executed |
|
Being
able to manage administration in public health medicine work based on
knowledge and experience of the organization of, collaboration on and
other practical aspects of the work at various clinical departments of
hospitals or general practice |
Tasks
requiring medical insight are assigned in employment within public health
medicine |
Structured
discussions with the adviser, including assessing the tasks executed |
|
Being
able to manage administration in public health medicine work based on
knowledge and experience with the language and paradigms for records at
clinical departments of hospitals or general practice |
Tasks
requiring medical insight are assigned in employment within public health
medicine |
Structured
discussions with the adviser, including assessing the tasks executed |
|
Being
able to synthesize medical information and being able to draw conclusions
on the role of public health medicine |
Tasks
requiring the use of this competency are assigned in employment in public
health medicine |
Structured
collegial assessment, including assessing the tasks executed |
Medical expert research methods
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
Being
able to explain the principles of developing and using important
registries that are significant for public health medicine and understand
the principles, opportunities and limitations of linking registers |
Theoretical
instruction in research methods |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
In
project work, being able to use selected qualitative and/or quantitative
methods |
Carry
out an independent project as part of research training using quantitative
and/or qualitative methods that are relevant to public health medicine and
on a topic relevant to public health medicine and presenting this in the
form of a relevant summary report or articles |
Assessment
of a completed project by the adviser and an external examiner |
|
Being
able to use a data-processing program to prepare relevant statistics to be
used in explaining problems in public health medicine |
Carry
out an independent project using a data-processing program |
Assessment
of a completed project by the adviser and an external examiner |
|
Being
able to explain the most important concepts in epidemiology and important
concepts related to
quantitative research methods and how they are used |
Theoretical
instruction in research methods |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain the most important concepts in statistics and how they are
used |
Theoretical
instruction in research methods |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to use selected descriptive and analytical methods and to present the
results thereof |
Theoretical
instruction in research methods reviewing the individual topics and
execution of individual and/or group-based assignments with independent
study |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to explain relevant methods in social science research that are used
in medical sociology and organizational theory |
Theoretical
instruction in research methods with group-based and/or individual
training in preparing questionnaires and execution of tasks that require
knowledge of certain social science methods |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to prepare a questionnaire |
Theoretical
instruction training in preparing questionnaires, individually or in a
group |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to assess the usefulness of screening tests based on information on
sensitivity, specificity and predictive value |
Theoretical
instruction in research methods using group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to critically explain research results and to assess the validity and
usefulness of epidemiological studies in relation to specific challenges |
Theoretical
instruction in research methods using group work |
Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
Being
able to assess challenges in scientific ethics, including whether a
project needs to be approved by an ethics committee, being able to select
a relevant study design, relevant data-collection procedures and methods
of analysis and being able to interpret data, including assessing bias |
Carry
out an independent project |
Assessment
of a completed project by the adviser and an external examiner |
|
Being
able to prepare a research protocol |
Carry
out an independent project |
Assessment
of a completed project by the adviser and an external examiner |
Communicator
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, being able to assess a specific
communication situation |
Assignment
of tasks that require communication at both the individual and group level
and both orally and in writing Further
training of contact between the physician and the patient at
interdisciplinary communication courses |
Structured
collegial assessment and Structured
discussions with the adviser and Assessment
of course work and The
advisers assessment of the explanation of relevant theoretical
knowledge |
|
After
the introductory training programme, being able to disseminate medical
information |
Assignment
of tasks that require this dissemination |
Structured
collegial assessment |
|
Being
able to plan and carry out dissemination |
Assignment
of relevant dissemination assignments and Feedback
from recipients and Case
presentation in the log book |
Structured
discussions with the adviser |
|
Being
able to establish and carry out a relevant and professional discussion in
communication with individuals |
Assignment
of tasks during clinical employment or during employment in public health
medicine that include communication with individuals and Feedback
from participants in this communication |
Structured
collegial assessment |
|
Being
able to establish and manage discussions in situations with serious
diagnostic and prognostic situations and in crisis situations |
Assignment
of tasks during clinical employment or under employment in public health
medicine that include such communication with individuals and Feedback
from participants in this communication |
Structured
collegial assessment |
|
Being
able to communicate the results of a specific risk assessment |
Under
supervision, manage a risk assessment and communicate this |
Structured
collegial assessment |
|
Being
able to disseminate the results of research in public health medicine to
various target groups |
Disseminate
the results of ones own project to the relevant target group and Assignment
of tasks including the dissemination of research results during employment
in public health medicine |
Structured
collegial assessment |
Collaborator
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, being able to establish and develop
collaborative relations based on mutual respect in relation to patients or
clients and their relatives, colleagues and other collaborators |
Under
supervision, carry out tasks with some of the collaborators mentioned and Discussions
with colleagues and the adviser and Reflection
on practice |
Structured
discussions with the adviser and observation |
|
After
the introductory training programme, being able to collaborate with many
professions inside and outside the health care system with respect for
different professions |
Under
supervision, carry out tasks with many professions and Discussions
with colleagues and the adviser |
Structured
discussions with the adviser and observation |
|
After
the introductory training programme, being able to assess the degree to
which collaboration has succeeded |
Reflection
on practice and Discussions
with colleagues and the adviser |
Structured
discussions with the adviser |
|
Being
able to assess and set priorities in the choice of collaborators for a
current task |
Under
supervision, carry out tasks that require collaboration in small and large
groups with the participation of collaborators of different professions
and professional interests and various collaborative relations and Discussions
with colleagues and the adviser |
Structured
discussions with the adviser, including assessment of the assignment
executed |
|
Being
able to participate in medical and interdisciplinary collaboration on
diagnosis and treatment |
Participation
in daily functions in a clinical department and Discussions
with colleagues and the adviser |
Structured
discussions with the adviser |
|
Using
knowledge from public health medicine, being able to participate in the
interaction between primary and secondary health care, social service
administration and social institutions |
Under
supervision, carry out tasks that involve interaction between sectors and Discussions
with colleagues and the adviser |
Structured
discussions with the adviser and observation |
|
Being
able to actively participate in or lead an interdisciplinary team while
respecting the professions of other participants |
Participation
in execution of tasks in an interdisciplinary, ad hoc or permanent team
and reflection on ones own role and Feedback
from other team participants |
Structured
discussions with the adviser and observation |
Manager and administrator
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, being able to prepare an agenda and
to record and prepare minutes |
Exercises
in preparing and agenda and in recording minutes by assigning tasks under
supervision |
Structured
discussions with the adviser, including assessment of the assignment
executed |
|
After
the introductory training programme, being able to set priorities among
ones own work tasks |
Reflection
on ones own practice |
Structured
discussions with the adviser |
|
After
the introductory training programme, being able to lead group meetings |
Lead
meetings during employment and Feedback
from participants in meetings and Discussion
with colleagues and the adviser |
Structured
discussions with the adviser and observation |
|
After
the introductory training programme, being able to lead a team |
Lead
a team during employment and Feedback
from the team and Discussion
with colleagues and the adviser |
Structured
discussions with the adviser and observation |
|
Being
able to motivate and engage collaborators |
During
employment, participate in execution of tasks in groups, either as the
chair or as a participant and Feedback
from participants in meetings and Discussion
with colleagues and the adviser |
Structured
discussions with the adviser |
|
Being
able to initiate and change work procedures and to contribute to amending
administrative practice for ones own work and that of others within the
framework of existing legislation |
During
employment, participate in tasks requiring assessment of internal work
procedures and practice and Discussion
with colleagues and the adviser |
Structured
discussions with the adviser |
|
Being
able to contribute to formulating a vision and objectives and targets for
work in ones own department or institution |
During
employment, participate in tasks requiring work with a vision and
objectives and targets and Discussion
with colleagues and the adviser |
Structured
discussions with the adviser |
|
Being
able to explain the principles of project management |
Participate
in theoretical courses in organizational theory |
Structured
discussions with the adviser, including assessment of the assignment
executed |
|
Being
able to prepare a budget for execution of a limited task or project |
Under
supervision in employment, prepare a budget for a specific task (entered
into the log book) |
Structured
discussions with the adviser, including assessment of the assignment
executed |
|
Being
able to use relevant accounting techniques |
Under
supervision in employment, use the workplaces guidelines in processing
vouchers |
Structured
discussions with the adviser, including assessment of the assignment
executed |
Preventer of disease and health promoter
|
Competencies and objectives |
Strategy for learning |
Strategy for assessment |
|
After
the introductory training programme, being able to explain the most
important terms and definitions related to disease prevention and health
promotion |
Independent
study |
Structured
discussions with the adviser |
|
After
the introductory training programme, being able to administer the advising
and guidance of individuals and groups while using knowledge on the
relationship between lifestyle factors and the development of illness |
Assignment
of tasks that require this knowledge and Discussions
with colleagues and the adviser |
Structured
discussions with the adviser, including assessment of the task executed |
|
Being
able to discover and react to factors of importance for public health or
the health of individuals in which guidance, information or special
measures are required |
Execution
of tasks that result in familiarity with factors of importance for public
health and Discussions
with colleagues and the adviser based on ones own work and that of the
workplace, current publications and other factors and Reflection
on ones own work and other factors with which one becomes familiar at
the workplace, in the mass media or in society in general |
Structured
discussions with the adviser, including assessment of the task executed |
|
Being
able to explain complex concepts related to health promotion and disease
prevention |
Theoretical
instruction |
