There is a very important interface between public health and primary care clinical practice¹². It has been established that the health of a population is directly related to the availability of primary care services³. Delivery of primary care services is an important determinant of health and is therefore a global public health priority. Family physicians and other primary care clinicians are at the frontline of public health in terms of identifying emerging public health problems, promoting healthy lifestyles, screening appropriate patients for disease, advocating for patients and discharging public health initiatives to their patients4. These individual-level services skillfully provided by primary care clinicians can be improved and enhanced by equipping those same clinicians with the population-level knowledge and skills offered by an MPH degree program5.
The MPH FCM consists of a set of core courses and practicum covering both the area of public health as well as enhanced primary care and faculty development skills. There are plenty of elective opportunities, enabling the learner to take additional public health and family medicine courses to satisfy their learning objectives.
The solid grounding in public health that is provided with an MPH will give family physicians and other primary care health professionals knowledge and skills that could be employed in future professional work related to public health. The degree will also assist learners in becoming more effective educators, scholars, and leaders in their respective clinical areas.
16-24 months full-time, up to 6 years part-time
The Family and Community Medicine field of the MPH is intended for family physicians and other primary care practitioners (PCP) (limited to regulated health professionals or equivalent). The Family and Community Medicine field of the MPH is intended for licensed and regulated primary care clinicians currently working in their field. This program is not intended to assist applicants in becoming licensed health practitioners in Canada.
- Train family physicians and other primary care practitioners to optimize their impact on the health of their communities by applying public health-related knowledge and skills to the individuals, families, and communities that they serve;
- Provide opportunities for learners to develop skills in primary care leadership and scholarship;
- Provide opportunities for learners to pursue an area of special interest (i.e. Health Education, Research, Global Health).
A. The Family Physician as a community-based resource to a defined practice population (Community-oriented primary care-COPC and primary health care):
Assess the health status/social determinants of health/health needs of their practice population (including vulnerable populations) as well as the broader community and address/strategize interventions targeting these needs and issues of inequity.
- (i) Health Assessment:
- Utilizes appropriate methods for assessing their practice;
– Demographic assessment (Health profile)
– Quality assessment (QA) and evaluation
- Prepares for disease outbreaks and other emergency/disaster situations;
- Recognizes and reports significant diseases/disease patterns to public health
- (ii) Addressing Health Needs:
- Implements quality improvement (QI) strategies within their clinical practice;
- Implement infection control practices to minimize risk to staff/physicians/other patients;
- Meaningful communication/collaboration/engagement with public health professionals and other community partners.
B. The Family Physician as a skilled clinician harnessing the power of the doctor-patient relationship:
- (i) Primary Prevention:
- Identify and mitigate risk factors at the individual and community level, including environmental
and occupational risks;P
- romote healthy development through the family life cycle including identifying and managing maternal-child challenges;
- Accesses and articulates the evidence base behind recommended clinician-driven primary prevention strategies (such as immunization, smoking cessation, physical activity);
- Advocate for policy changes relevant to primary care in order to reduce inequities and promote health/prevent disease and injury in the population.
- (ii) Secondary Prevention (eg. screening):
- Accesses and articulates the evidence-base behind recommended screening strategies;
- Understand the required characteristics of effective screening strategies.
- (iii) Tertiary Prevention:
- Improve evidence-based chronic disease mgmt to minimize complications from chronic disease;
- Considers the spectrum of individual to population-based interventions and for the wide range of models of care- (solo v. team-based, clinic v. home-based).
Based on Boyer’s taxonomy of scholarship, MPH equips students to better engage in the scholarships of discovery, application, integration, education and social responsibility.
- Engages in regular reflective self-directed learning and CPD;
- Understands research methods and employs the knowledge to critically appraise research;
- Teaching of the above competencies to FM residents/other
D. Leadership, Management and Administration:
Graduates are expected to play a leadership role in their professional practice environments.
- Understands how Canada’s health system is organized and how it compares to other countries;
- Appreciates the issue of resource allocation;
- Skilled in interprofessional collaboration;
- Demonstrates that above skills are portable (ie global health work);
- Leaders in best practices in primary care, including technology, and resources to primary care colleagues and public health officials.
1. Harvey B. The issue of public health. Canadian Family Physician 2009;55:1057.
2. Sutcliffe P. Prescribing for health-a “wide angle” view. Ontario Medical Review 2012 (Dec): 20-22.
3. Starfield B. Is primary care essential. Lancet 1994;344:1129-1133
4. Sikora C and Johnson D. The family physician and the public health perspective. Canadian Family Physician 2009;55:1061-3.
5. Zweifler J and Evans R. Development of a residency/MPH program. Family Medicine 2001;33(6):453-8.
Rather than preparing you for a career change, the MPH FCM field aims more for career enhancement. This degree will prepare primary care practitioners to increase their teaching, scholarly and leadership opportunities and effectiveness. Of course, such knowledge and skills might result in adjusting and taking on new roles within the health arena.
We advise all prospective students to review the general admission requirements prior to submitting an application.
An undergraduate statistics course is recommended. To fulfill this admission requirement, applicants should have successfully completed this course during their undergraduate education, prior to the application deadline.
A valid license in a regulated health profession in Canada, or equivalent, is also required.
If you are a regulated health professional currently working in your field and you consider yourself to be a primary care provider, are interested in gaining knowledge and skills that will enable you to think more broadly about your patient population, and aim to impact the health of your community in ways other than direct patient care, then you are eligible to apply for the MPH (FCM).
Students are required to complete 10.0 Full Course Equivalents (FCE) within the maximum time limit of 3 years as a full-time student. Most full-time students complete their degree within 2 years. The table below outlines the required courses and practicum.
The Required Medical Education Practicum in Family Medicine (CHL5620Y) provides an opportunity for learners to apply and reflect on the theory and knowledge gained in coursework by engaging in new academic projects in their professional settings.
Learners are required to spend a minimum of 320 hours involved in an appropriate practicum to earn the 1.0 FCE credit. Students must also identify and meet regularly with a practicum field supervisor and all practicum projects require the approval of the Program Director.
Because the practicum involves the hands-on application of knowledge obtained via coursework, the practicum activities must be new endeavors that are related to either an area of academic core competency1 or one of the Faculty of Medicine’s faculty promotion planks2 to which the learner has been exposed during previous or concurrent MPH coursework. See references below for specific examples.
Throughout the practicum it is essential for learners to reflect on and record their experiences and to engage in regular discussions with their practicum field supervisor about their practicum progress. The practicum evaluation is based on the student’s record of experiences; a 2-3 page scholarly, analytical and reflective report based on the overall experience; and ideally a presentation to their classmates.
It is important that you remember to enrol in CHL5620Y on ROSI. Though the practicum is listed as a “continuous” course, we recommend that you aim to have the practicum completed and work submitted to the Program Director within 12 months of starting the practicum. The CHL5620Y Practicum is graded CR/NCR.
Students are encouraged to take elective courses that will enhance their learning experience and/or provide focused study on a particular topic. Please check the DLSPH timetable for a list of courses available each academic year. Below is a list of potential electives.
If you have any questions about the appropriateness of a course, please speak with the MPH (FCM) Program Director.
1. Harris D. et al. Academic competencies for medical faculty. Family Medicine 2007;39(5):343-350.
2. Faculty of Medicine, University of Toronto, Academic Promotions Manual 2008-2009. Available at: http://www.facmed.utoronto.ca/Assets/FacMed+Digital+Assets/Promotions/Academic+Promotions+Manual+2013.pdf