WHAT IS PUBLIC HEALTH?

The Public Health Doctor (SP) focuses his professional activity on three essential pillars: health promotion, disease prevention and the extension of a healthy life.

To achieve these goals, SP physicians must develop training and competence in the 10 essential public health operations (EPHO), defined by WHO Europe.

The College of Specialty in Public Health also characterizes the skills of a specialist in Public Health:

Describe, analyze, interpret and technically communicate the health level of a population and the groups that comprise it

Design action plans and health intervention programs, participate in their implementation, execution, and evaluation

Watch and monitor phenomena and events that may interfere with or endanger the health of the population

Supervise programs or activities whose purpose is to defend, protect and promote the health of the population

Auditing health services, programs and projects, with reference to national and international technical and accreditation standards

Investigate health problems with population repercussions and their determining factors

Collaborate with health services in the analysis and transfer of data and health information, namely with public health services at other levels

Collaborate with community institutions whose activity is relevant to health

Communicate relevant health information to the population

Associate knowledge of public health disciplines with specific technical information on the health profile of the population, with a view to influencing health policies that defend, protect or promote public health

Use computer tools to support planning, surveillance, intervention and research in health

Exercise the power of health authority when appointed to do so

A Public Health (SP) physician goes beyond his experience in clinical practice, using his medical knowledge in the health of populations. For this, a SP doctor must be able to play several roles: epidemiologist, biostatistician, health manager, health economist, consultant in health law, etc. Language and rationale change drastically from conventional clinical practice. Public health physicians identify and intervene in large-scale health problems, trying to resolve them before they appear through scientific evidence and health policy. For example, instead of treating patients with hypertension, the focus of Public Health intervention is to reduce salt intake (eg BREAD.COME ).

A KIND DAY IN PUBLIC HEALTH…

The professionals' working hours ( 40h/week for interns ) must coincide with the opening hours of the Public Health Unit. It is expected, according to the regulations in force, that professionals have an hour structure with an average of 8h/day, with a mandatory lunch hour, on the 5 working days of the week.

Public Health, either by conception or by assigned competences, does not contemplate a daily clinical activity,  per se . However, over the course of a typical week at work, we not only see patients several times (eg for the issuance of warrants for driving to the Psychiatric Emergency, in order to assess the need for compulsory hospitalization, at the Traveler's Consultation or, in a case of Compulsory Notifiable Disease or Collective Food Poisoning or Alert and Appropriate Response System - meningitis in a school; for issuance of certificates for Disability Assessment, in the Unit or at Home) , as above all, we have to apply clinical knowledge on a daily basis, to interpret and decide.

The clinic continues to be fundamental for the correct performance of the Public Health Physician's role . It just has a different expression from the one that is typified, either in the minds of patients or in the secular pedagogy of pre-graduate medical teaching institutions.

SPECIALIZATION COURSE IN PUBLIC HEALTH, IN DETAIL

The 2nd year of the Medical Internship in Public Health (IMSP) consists of a Specialization Course in Public Health (CESP), which corresponds to the curriculum of a Masters in Public Health. During CESP, you continue to receive your salary and the Course is paid by the ARS/ULS where you are placed. You have 3 possible choices in Portugal: ISPUP (Porto); IHMT (Lisbon) and ENSP ( Lisbon )

You can choose any external training location as long as they have training equivalent to that required for CESP in Portugal, in this case, any University that has a Masters in Public Health or Master in Public Health course(MPH) or Master of Science in Public Health (MSPH/MSc). It will be up to the College of Public Health of the Ordem dos Médicos to assess the suitability of the location and the equivalence of the master's program. Some classmates went to the following schools:

1. London School of Hygiene and Tropical Medicine (UK)
2. Imperial College London (UK)
3. The University of Edinburgh (UK)
4. Maastricht University (Netherlands)
5. Umeå University (Sweden)

Harvard TH Chan School of Public Health (United States of America)

​Johns Hopkins Bloomberg School of Public Health (United States of America)

The choice of location for external training depends above all on the curriculum. Each University has its own topics and interests, often dependent on the Departments and academic staff that constitute it. The choice between locations necessarily has to be balanced between cost (there are very large variations) and the programs and curricular areas that most interest you. For example, the Univ. de Maastricht is particularly dedicated to the area of ​​Prevention and Health Promotion and Health Policy . English Universities ( Imperial College or the London School ) or Dutch Universities are historically very strong in Epidemiology, Statistics, Health Planning.

If you decide to take the CESP abroad, the fee is entirely up to you. Currently, in English universities the tuition fee is around 10,000 euros and in North American universities it varies between 30,000€ and 60,000€ a year (in North American universities it is possible to apply for a merit scholarship at the respective institutions, which can lower or eliminate the fee amount). On the other hand, there are European universities where there are no tuition fees (eg Sweden) or where the fees are much more affordable.

If you decide to do external training for CESP, it is very important that you start with the application process as soon as possible. Most of these programs have an academic calendar from September to September, while CESP in Portugal runs from January to January. So, as soon as you enter SP, if you want to do the 2nd year abroad, you have to start dealing with the bureaucracy right away:

Application to the foreign university program of your choice

Request for a 1-year external training authorization (authorized by the Advisor, USP Coordinator, Internship Coordinator, CRIM Norte, CNIM, Colégio SP da OM, ACSS)