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College of Medicine Alumni Magazine - Fall 2015 The MD/MPH Program: Influencing and Informing Health Policy

As the health care environment continues to evolve in the United States, an increasing number of physicians are pursuing medical careers that enable them to influence public health policies. Students are finding that Drexel's MD/MPH degree program, offered jointly by the College of Medicine and the School of Public Health, provides strong interdisciplinary training in clinical practice, prevention, hygiene, education and policymaking, built on a foundation of health and human rights.

Physicians are pursuing medical careers that enable them to influence public health policies.

Drexel MD/MPH graduate Laura Urbanski, '15, was inspired to pursue the dual degree program by her prior experience with the Peace Corps, when she spent two years in Kosrae, Federated States of Micronesia. Her primary assignment was health education and prevention related to obesity and communicable diseases, two of the largest health threats on the islands. While working with girls in the local high school, she could see the important role that public health plays in preventing sexually transmitted diseases, lowering rates of teen pregnancy and increasing self-esteem.

At Drexel, Urbanski chose the community health and prevention track for her dual degree. During a research project involving a needs assessment for Congreso, a social services organization in North Philadelphia, Urbanski made "an overwhelming discovery" about the huge impact that trauma has on the lives of the women and their children.

"We noted that the Congreso providers also suffered vicarious trauma from hearing their clients' stories of domestic abuse and gun violence," she relates. "As a result, we modified the curriculum used to teach women at Congreso, adding short interventions such as mindfulness to reverse some of the physiologic effect of trauma."

This experience reinforced Urbanski's commitment to become a family physician. "In family medicine, you can take a holistic approach, and delve into the contributing social and biological factors that affect the patient's health. With a dual degree, I can think simultaneously about the patient in front of me as well as the greater population and what could be done for them," she notes.

A qualitative research project in postpartum depression motivated Allison Myers, MD/ MPH ’12, to pursue a dual degree. Myers recalls the experience of interviewing women in their homes about their experiences with the mental health system. “It was such a rich way to get data and look at a problem, and it hooked me. I really wanted to keep looking into public health,” she relates.

A newly minted attending and faculty member in family medicine and community health at the University of Pennsylvania, Myers says, “Public health informs what you do all the time. Having that training gives you a broader lens to look at health and how you approach and think about problems. Even when you’re ordering tests, you think about the cost and the impact it has on not just this one patient but the whole system. You carry the public health training with you every day. It changes the way you think about health on a population level.”

"You carry the public health training with you every day"

Zach Risler, MD/MPH ’13, became interested in public health while doing community service work during his undergraduate studies. “There was a large Somalian population in Lewiston, Maine, where I went to college,” he explains. “Many people in the community were wary of medical personnel, so we tried to teach some health literacy so they would be more willing to seek health care.” Now chief resident in the Drexel/Hahnemann Emergency Medicine Residency program, Risler says he continues to teach health literacy to patients.

MD/MPH students typically complete the rigorous program in five years: three years in the College of Medicine, one year in the School of Public Health, and the final year in medical school. During his year in the School of Public Health, Risler pursued the health management and policy track. “I learned how health is a much bigger issue than seeing patients in an office, how decisions about public health are made on a broader scale and the politics behind it. Many people are developing policies and passing laws in Congress who don’t have medical knowledge, so health care advocacy is very important.”

Risler hopes to become an attending physician in emergency medicine and ultimately pursue a hospital leadership role.

Halima Amjad, MD/MPH ’09, is currently completing a three-year clinical and research fellowship in geriatrics at Johns Hopkins. Through her work, she has seen firsthand that dementia is a huge health policy issue that must be addressed. “You need both a clinical and a public health background to address this critical issue for our aging population, so I view my dual degree as a definite advantage,” she says.

In her primary research, Amjad is exploring safety issues in older adults with dementia, such as driving, managing medications and finances, and living alone. “We’re using survey data on over 8,000 Medicare beneficiaries from the National Health and Aging Trends Study. For those who screen positive for dementia, we are observing what kinds of things they are doing in the community and, over time, if these activities are causing them to visit the ER or hospital more often [or have] other negative outcomes.”

Amjad hopes that this research will lead to a safety screening tool for primary care providers to use in older people with dementia as well as patients who meet the criteria for dementia but don’t yet have the diagnosis. “From a public health policy viewpoint, we need to determine how to pay for the needs of older adults with dementia and what is covered,” she notes. “A lot of home health care is not covered by Medicare in certain situations. We hope to create opportunities to make adults with dementia safer in the community as opposed to needing nursing home care.”

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