JUNE 2001 - UCLA School of Public Health

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There is a national shortage of physicians
trained in general preventive medicine and public
health, according to recent Congressional testimony
presented by the Association of Schools of Public
Health. At UCLA, that shortage is being addressed
through several programs that sponsor physicians
pursuing public health degrees. Ko is part of UCLA’s
Robert Wood Johnson Clinical Scholars Program,
which develops researchers interested in the nonbiological
aspects of health care.
“Physicians are in a unique position to bridge
the gap between patient care and population health,”
says Dr. John Chang. While in medical school at
Northwestern University in the early 1990s, Chang
had a summer job in which he helped conduct
epidemiologic research in the elderly. “I was working
with a woman who had an M.P.H., and as she was
showing me the ropes I was thinking, ‘This is something
I should learn,’” he explains. So Chang took
a break from medical school to get his M.P.H. at
Yale, returned to complete his M.D., finished his
internal medicine residency in 1999, and is now in
the Ph.D. program at the UCLA School of Public
Health, funded by a National Research Service
Award training grant.
He intends to become an academic general
internist, with a research focus on chronic disease
prevention and improving quality of care for the
elderly. “We have an aging society, and it’s becoming
increasingly important to help elderly in the
community stay as high-functioning as possible,”
Chang asserts.
Dr. Ruth Hertzman-Miller also became interested
in public health while in medical school. “I
tried bench research, but it didn’t grab me,” she says.
Two summer jobs did — one in the Department of
Occupational Medicine at George Washington
University, screening boilermakers for hearing loss,
and another at the Food and Drug Administration,
looking at vaccine safety. Drawn to the clinical
research, Hertzman-Miller applied to the Clinical
Scholars Program after completing her internal
medicine residency, and is now an M.P.H. candidate
in the School’s Department of Epidemiology.
For many M.D.’s, public health education can
be an eye-opener. Dr. Mary Ann Limbos (M.P.H.
’97) had just completed a pediatrics residency when
she entered the School’s Child and Family Health
Program in 1995. The program provides interdisci-
plinary training in maternal and child health practice,
research and policy analysis for health professionals.
“Before I got the M.P.H., I was very much a
physician who focused on treating individual children,”
says Limbos. “That program really broadened
my scope of thinking by helping me to realize that
with the interventions that could come out of that
training, you affect an entire population.”
Limbos is now at Children’s Hospital in Los
Angeles, splitting her time between seeing patients
and doing research on injuries in the Los Angeles
Unified School District (see page 16). “The first
time I ever heard of injury prevention as a science
was when Dr. [Jess] Kraus [Professor of Epidemiology
at the School] gave a guest lecture in one of
my epidemiology courses,” she recalls. “Suddenly, it
all made sense to me, and I realized that as a pediatrician,
this was something I could play a role in.”
Although some amount of public health is
taught in medical schools, the M.D.’s interviewed
for this story agree that the curriculum is so packed
with biomedical and clinical subjects that core concepts
of community and
environmental health,
health services, epidemiology
and biostatistics
tend to get lost.
Ko is reminded of
this when he gives presentations
to surgeons
across the country. “I
talk about how much
we spend on health care
in the United States and
how, compared with
other countries, our care
falls below the median
in a lot of categories,” he
says. “This is all very
basic knowledge for a
public health student.
But to these world-famous surgeons, it’s very new
— and surprising.
“I’ve learned from my public health education
that we can’t depend on physicians who treat individual
patients to improve what’s wrong with our
system. It will also take people trained in public
health.”
“I’ve learned
from my public
health education
that we can’t
depend on
physicians who
treat individual
patients to
improve what’s
wrong with our
system. It will
also take people
trained in public
health.”
—Dr. Clifford Ko
feature UCLAPUBLIC HEALTH