Episode 19_ Welcoming the Doctor of Public Health (DrPH) degree to Canada, with Erica de Ruggiero

Welcoming the Doctor of Public Health (DrPH) degree to Canada at the University of Toronto & FAQ session, with Erica Di Ruggiero

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Show Notes

Today on the show, Sujani sits down with Erica Di Ruggiero to talk about some very exciting news for Canada!

In May 2020, the University of Toronto’s Dalla Lana School of Public Health announced the much-anticipated Doctor of Public Health (DrPH) program – the first of its kind in Canada.

The DrPH has been a topic of interest amongst our PH SPOT community members for some time now. Last year, we published a blog post written by Harman Sandhu titled “Doctor of Public Health – Isn’t that just a PhD?”. This article has continued to be one of the most-read posts on our blog, and since the launch of the DrPH program here in Canada, this post has been one of the top 5 pages visited on our website.

In order to bring you even more information about this program, Sujani sat down with the individual who spearheaded the initiative to bring the first DrPH program to a Canadian academic institution. Erica Di Ruggiero is also the interim program director of the DrPH program.

Prior to sitting down with Erica, we made sure to collect questions the PH SPOT community had about the program (thank you for those submissions, they were all great questions). When we looked at all of your questions, they fell into 7 themes: the ideal candidate/eligibility, life after a DrPH, how this program compares on an international stage; a few logistical questions about the program; some content questions regarding the program; and the most popular one, tuition and cost. As a result, this episode is framed around these 7 themes.

We hope this conversation with Erica, which is packed with a tonne of information, will help to answer questions you’ve had, and perhaps even help you decide whether you’d like to consider the DrPH program for the next fall admission, or for a future year.

You’ll Learn

  • How the initiative to introduce a Doctor of Public Health (DrPH) program began and Erica’s experience leading it
  • What is the Doctor of Public Health (DrPH) program, and how the DrPH program is different from a PhD
  • Who the ideal candidate is for a DrPH program, and at what point of one’s career this program should be considered
  • How the selection committee will be mindful in selecting a diverse cohort
  • The training path that all DrPH students will take (there will be no specializations at the moment)
  • Example courses that students will have the opportunity to take in the following areas: 1) Data & Analysis; 2) Leadership, Management & Governance; 3) Policy & Programs; 4) Education & Workforce Development
  • Integration, care and focus within the program on Indigenous issues and racism
  • Types of opportunities one can expect upon completing a DrPH program
  • Whether we are setting up future leadership opportunities to require higher qualifications, like a DrPH
  • The ongoing discussions taking place at the faculty around tuition costs and opportunities for financial support
    • Tip: Details around tuition costs are still being discussed, and answers are not yet available. However, don’t let the cost deter you completely from applying. If you are interested and know you want to do the DrPH program, apply. Once you are admitted, there are discussions you can have with the faculty around financial support.
  • How the University of Toronto’s Doctor of Public Health (DrPH) program compares to other programs, internationally
  • Why one might want to consider or give the University of Toronto’s DrPH program more attention and as a top choice
  • What Erica foresees as the future of public health in terms of education and workforce, here in Canada and globally

Access the list of
Doctor of Public Health (DrPH) programs
around the world

This tool compares 51 DrPH programs across 27 variables.
This is the tool you need to get started on your application.

 

Today’s Guest

Dr. Erica Di Ruggiero

Erica is currently the Interim Program Director of the Doctor of Public Health (DrPH) program at the Dalla Lana School of Public Health, University of Toronto. She spearheaded the initiative to bring the first DrPH program to a Canadian academic institute.

At the University of Toronto, Erica is also the Director of the Centre for Global Health and Director of the Collaborative Specialization in Global Health, an Associate Professor in the Division of Social and Behavioural Health Sciences and holds a non-budgetary cross-appointment as Associate Professor in the Institute of Health Policy Management and Evaluation. She is also an Associate Member of the School of Graduate Studies. Prior to her role at the University of Toronto, Erica spent 15 years in different leadership roles at the Canadian Institutes of Health Research-Institute of Population and Public Health (CIHR-IPPH). Full bio and more about her work can be found here.

Resources

Other PH SPOT resources:

Before you go…

  • Do you have a topic that you would like us to cover or a guest we should sit down with? Tell us using this form.

Access the list of
Doctor of Public Health (DrPH) programs
around the world

This tool compares 51 DrPH programs across 27 variables.
This is the tool you need to get started on your application.

Episode Transcript

Erica 0:00
The DrPH and why doesn’t Canada have one came up and, and I realized that good ideas take time to take hold. And so fast track to I guess about 2018 where I was finding myself at the School of Public Health and asking similar questions. And I think the time was- was better now.

Sujani 0:24
Welcome to PH SPOTlight, a community for you to build your public health career with. Join Us Weekly right here. And I’ll be here too, your host Sujani Siva from PH SPOT.

Sujani 0:36
Hey, what’s up everyone. Thank you for joining me today on another episode of PH SPOTlight, a space for you and me and everyone else in public health to share our stories and inspire each other. My name is Sujani Siva, I’m the host of PH SPOTlight and I’m here to help you build your public health career. So today on the show, I have someone who I’m very excited to speak to for the first time about a very exciting news. You may have seen that in May of 2020, the University of Toronto in Canada Dalla Lana School of Public Health announced the much anticipated Doctor of Public Health Program, which is the first of its kind in Canada. The DrPH in short, has been a topic of interest amongst our PH SPOT community members and we know this because we’ve been watching the stats on a blog post published last year titled “Doctor of Public Health, isn’t that just a PhD?”, it was a well researched and written post by Harmon Sandhu, someone part of our community, and has continued to be one of the most read posts on our blog. Since the launch of the DrPH program here in Canada, this post has been one of the top five pages visited on our website. So we thought we could help you guys out by bringing you even more information about this. I sit down with Dr. Erica Di Ruggiero, who spearheaded the initiative to bring the first doctor of public health program to a Canadian Institute. She’s also the interim program director of the DrPH program. In addition to some other roles that she plays at the university, including the director of the Center for Global Health, and the director of the collaborative specialization in global health. She is also an associate professor in the Division of Social and Behavioral Health Sciences, and holds across appointment as Associate Professor in the institute of health policy management and evaluation. She is also an associate member of the School of Graduate Studies, you may have seen her on Twitter under the handle @edforsocialchange, which is my favorite part. Before sitting down with Erica, we reached out to the PH SPOT community, which was you guys and asked you guys what questions you’d like answered. So thank you for those submissions. There were some really great ones. And essentially, when we looked at all of the questions, they fell into seven themes, who is the ideal candidate and some eligibility questions, what does life after the Doctor of Public Health program look like, how does this program compare on an international stage, a few logistical questions about the program, some content questions regarding the program, and the most popular one was around the tuition and the cost of getting this degree. We did manage to get through all of these themes. And so I want to say thank you to Erica for her willingness and patience. And so without further ado, let’s jump into it. Because this is an episode that’s just jam packed with a ton of information. So if you’re considering the doctor or public health program for the next fall admission, or for a future year, this is an episode worth listening to.

Sujani 3:47
Hi, Erica, thank you so much for joining me on PH SPOTlight on this Friday morning to talk to me about the doctor public health program.

Erica 3:57
Oh, it’s really my pleasure. Thanks for the opportunity. Sujani.

Sujani 4:01
And I must say it’s- it’s an honor for me. I’ve been following your work on Twitter, mostly and just feel very honored and privileged to sit down and speak to you. And so yeah, almost like a fan moment for me.

Erica 4:14
Oh, well, that’s very kind. And, you know, I, I appreciate that. I feel like Twitter is full of a community of learners. So it’s amazing the kind of connections we make through Twitter. So I appreciate that. Thank you.

Sujani 4:28
Yeah. So I think you know, I see it as a monumental moment for the University of Toronto to be the first in the country to offer this program. And from what I understand you spearheaded this initiative. So just that thank you from all of us who are excited about this. And I thought it’d be interesting to start off by hearing from you how this initiative kind of began, in your experience leading the creation of the doctor public health program.

Erica 4:56
Sure, yeah. So if you can indulge me and a very brief history as to why I was very passionate about this. So even before coming to Dalla Lana School of Public Health, I had the privilege about 10 years ago to chair a Public Health Human Resources Task Group, which reported in those days to the conference of deputy ministers. And around that table, we had the opportunity to identify what were some of the major public health human resource needs for the country. And so it was post-SARS, of course, at that time, and a number of issues were coming out both in terms of enumerating the public health forces, so who constitutes the public health force, do we have the right mix and distribution of public health human resources, we also, we’re at a time where there was a bit of a what I’d like to call a little mini pandemic of mph programs. So you’ve chi- certainly had had some program, a program and a few other universities. But then we saw this explosion and response from the academic community and offering more mph programs. And so it was in that context, said the DrPH, and why doesn’t Canada have one came up and, and I realized that good ideas take time to take hold. And so fast track to I guess, about 2018, where I was finding myself at the School of Public Health and asking similar questions. And I think the time was, was better now. And so I just wanted to offer that very brief historical perspective from my angle. And so it was really, I think, a privilege to be given the opportunity, I definitely raise the issue and the timing was good. So we undertook a rather lengthy process, because it does take a lot of time to get a new program off the ground at a university. I think the one thing I wanted to mention beyond it being the first in Canada is that it’s the first new program for the School of Public Health that really brings together both sides of the Dalla Lana school. And so we have a Public Health Sciences graduate unit. And we have IHPME, also known as the Institute of Health Policy, Management and evaluation. So this program really spans and really builds on the assets and faculty from both sides of the house. And so I think that was a really great opportunity to work with fabulous faculty to co construct this program, and to also get input from alumni and and so we engage both Alumni Associations associated with a school in its development, as well as the broader public health community, meaning, you know, public health units, national public health agencies, just to find out is there a need for a program like this, does it resonate, is this a good time, and I think that gave us a really good foundation for starting to build the program.

Sujani 8:07
And that’s interesting that you say that that is it a good time was one of those questions and what- what sort of thoughts came about when deciding whether this was the year to launch a program like this?

Erica 8:21
Oh, yeah, I think that’s a great question. Interestingly, this was being conceived pre COVID. Because as I mentioned, a program like this does take a long time to get off the ground and to also get a go through all of the rigorous assessments that you need to go through the peer review process. So we were- our program was assessed by two independent assessors from the US that had long standing history, running DrPH programs. That was John Hopkins and Boston University. So a lot of that takes, you know, it was probably almost two years. And interestingly, we got it approved right smack in the middle of this pandemic. So I think what it underscored for me and others is that now more than ever, we need a program like this that is really helping to equip public health professionals with an advanced professional education and skills development opportunity to really lead to improvements in our public health and health care systems here in Canada, but we also believe that, that it will also be of interest to astute perspective students in other countries. So I think it’s really responding to an education gap, to equip professionals with doctoral level education to really confront the kinds of changes in our systems. It really privileges not just the generation of knowledge all you know, it is a PhD so there is still going to be a thesis component to it. But it’s really putting the emphasis on the applied nature of evidence and how it can be best translated into policy and practice decision making contacts.

Sujani 10:04
Absolutely. And I think I mentioned this when we were chatting a little bit before we set up this call that there’s been quite a bit of interest in our PH SPOT community, at least, for this program. And I think it was almost a year and a half ago, a student, an MPH student, actually had done some research comparing the Ph. D. in the Doctor of Public Health, and he published a blog post on our website, which he had his director who had completed a doctor public health, I think it was in the US somewhere, she’s a director of the program in McMaster, kind of review it. And that blog post, despite it being a year and a half old, continues to be one of the most popular posts. And soon as the University of Toronto announced, the Doctor of Public Health Program, it continues to be one of the top five pages visited on our website. And I think it’s because people are looking for other options beyond the PhD for that level of training. And, you know, when I, when I read on the website or other blog posts like this one, you get that distinction between the program, you know, training for more of a practice based type of career pursuing a senior leadership role versus training for a research career becoming an academic, but I’d like to hear kind of, in your words more about that distinction, especially for those individuals who are on the fence between deciding to choose a PhD, or a doctor or public health program.

Erica 11:29
Well, I think you did a brilliant job explaining already. And I’m not just saying that because I like you. It’s no, I think you did do and, you know, it’s a it’s a great question, because it is, of all the inquiries I get, it’s probably the most frequently asked question, as people are contemplating their next step, they’ve had a master’s. And so you know, in talking through that with individuals, you know, at the end of the day, of course, it’s a personal decision and better understanding, where does this- how does this help me move to the next step, but I tend to sort of ask, you know, where does the person see themselves being, you know, if they’re really interested in being in a research intensive university, actually doing research, most of the time, this probably isn’t the program for them. Because we, as you know, offer a number of research intensive doctoral level programs in a range of disciplines, from Social Behavioral Health Sciences, to health policy to epidemiology. And so I think that’s an important distinction in terms of the end goal, first of all. Secondly, I think among the major competencies, this DrPH program really emphasizes leadership is key. And while it doesn’t mean that you don’t learn leadership skills in other PhD programs, it’s very explicit as part of that. So I think it prepares not just in terms of the coursework, but also in terms of the thesis itself, in terms of the opportunities to engage with practice and policy settings. And to be embedded in those settings. It really, I think, sets people up to be reflecting as if they were trying to facilitate change in the health system, for example. So that’s, I think, a key- key distinction. And, you know, we are fortunate at the University of Toronto, and at the School of Public Health to have a number of those options to provide. And that’s what’s I think, particularly exciting about this program, we were seeing a gap that was emerging, we were being contacted. And I know many of my program director colleagues can attest to this, that there were many students who would reach out, but the existing, you know, PhD offerings weren’t quite fitting their needs. And so this really, you know, from a school perspective, though, on a school perspective, helps to round out what we call sort of our lifecycle of offerings, and really complement nicely what we already offer and continue to offer. So we’re really thrilled about that. And it’s explicitly mentioned in our academic plan, which is hardening and, and so we’re, I think, you know, we’re very, very keen to see and to welcome the first cohort, which will be about a year from this September.

Sujani 14:41
So okay, so so we have someone who decides that, you know, the doctor public health option is the route that they want to take. And when we look at the eligibility, I think the program is looking for a minimum of five years of experience after you’ve got to Masters level of training. So- So wondering if you could paint a picture for individuals that are maybe early on in their career for what they should focus on, so that they can prepare for a doctor or public health once they hit that minimum level of experience? Or even maybe those who are within that five year range? Like, who are you thinking is the ideal candidate?

Erica 15:20
Yeah, I mean, that’s a, I think there are many ideal candidates. And I mean, I would say, you know, there are, it depends on the individuals trajectory. So, while you know, I’ve observed certainly at the school that many of our mph students are coming right from an undergraduate degrees, so they wouldn’t have necessarily acquired the kind of management and leadership opportunities in the same way, someone who’s been out for a bit longer. However, there are people who have done an undergrad have worked and got some of that kind of experience, then made a decision to come back and do an MPH or another Masters of Health Science, or administering Health Administration. And then, of course, there are many healthcare professionals in the various disciplines who would have had different training. So I think it, it does vary. In terms of when that experience is acquired. I guess that’s the first thing I wanted to highlight. Secondly, you know, the reason we set that minimum is two fold. First of all, we really do want to distinguish it from master’s level offering and what a typical Master’s would get you. And the reason we also wanted to do that is, while you know, we’re, I think, really privileged to have amazing faculty who will mentor students in this program, the cohort itself is a major resource. And so having people who come in and have had a bit of lived professional experience in a relevant field is, I think, quite critical to the learning. And we are really working hard to make sure that some of the cohort building activities that I think allow for the networking and learning both within the classroom, but for the DrPH program choral- cohort, are enabled. And so I think having candidates who have at least comparable experience, some will have far more, right, because they’ve been waiting to have a program like this. And for all sorts of reasons, we’re not able to go abroad. And actually, that’s one of the things I’ve been hearing from many people who have contacted me to learn more about the program, that they’re thrilled. And it’s finally here in Canada, because for personal or family or other reasons, they’re, you know, much, it’s much easier for them to access the program at home.

Sujani 17:50
Absolutely. And, you know, I was going to talk about the cohort and a little bit about that a little bit later. But I think it’s a good time to bring it up as well. Do you have a sense of what the class size or the cohort size is going to look like it?

Erica 18:04
Yeah, I mean, I, of course, have to always give this with some tentative caveats. But you know, we in putting together the proposal, we had a target number in mind. And so we’re aiming to recruit and of course, it depends on interest, quality of the pool, eligibility requirements, etc. But we’re, you know, we’ve roughly assessed the first year cohort is at being at about 10. And students.

Sujani 18:34
And that seems fairly comparable to some of the international schools as well, it seems.

Erica 18:39
Yeah. And also other PhD sort of cohorts, they, you know, they do vary, and some are a bit larger, again, depending on the year. And, of course, they have more history with implementation. But yes, that’s kind of what we’re hoping for. And it’s also I think, you know, when a cohort gets very large, that cohesiveness is a little bit more difficult to, to ensure.

Sujani 19:04
And you mentioned a little bit about this, where the selection committees hoping to ensure that you bring in a diverse group of individuals from a professional background, at least, I’m wondering if you’re looking into ensuring other forms of diversity, just to make sure that it’s representative of the Canadian population. Has any thought been put into that in terms of cohort selection?

Erica 19:28
Yeah, well, as part of our proposal, we actually, and this is not specific to this program, but it’s actually a commitment that the school is making is to create a learning environment that’s inclusive. And so I would say there are many calls to action that we are very, very attuned to, but the, you know, the two that I’d really like to highlight is, first of all, the call to action for Canadian institutions and other sectors to the Truth and Reconciliation Commission, around indigenous health, and, of course, the many, many calls to really look at offering programs that really pay attention to anti-racism, and therefore also ensure that we equip students with the best possible tools to help to promote equity and conclude, inclusion. This is absolutely important, not just in a learning environment, but in preparing the future leaders, I think equipping them with the kind of knowledge and skills and insights and reflection is absolutely critical. One of the guiding, I guess, statements that we use at the school is a statement on equity, diversity and excellence. And so we’ve articulated in that statement, a number of these principles, I don’t think we’ve arrived yet, I think we never will. It’s an ongoing journey. And so I think that’s a strong commitment that our- our leadership has made. That will trickle down to all our programming recruitment efforts, including this one, but not exclusively, this one. I would also add that I think in the content that we’ve put forward for courses, as part of this program, we paid particular attention to that are indigenous health scholars who are at the school have been- have been identified as faculty who are very interested in being involved in this program, which we were thrilled about and have been engaged in the program development. And so those are some of the ways in which we’re ensuring that, that some of those principles are upheld. And of course, in the course offerings themselves, for example, course offerings on social determinants of health, but many other opportunities that students will have both in terms of the core curriculum, but also some of the electives they may choose to take.

Sujani 22:11
Oh, that’s wonderful to hear. I feel like with just that one response, you answered almost three or four people’s questions around whether this program would really, really hone in on training leaders well versed in indigenous issues, you know, anti racism. So it sounds like you’ve already given that a lot of thought, which is great. So my understanding is that everyone in the cohort would kind of take one training path and not have any specializations. Is that accurate understanding of the program?

Erica 22:43
Yeah, I’m glad you asked the question because I know that when you’re in a university like ours in our school, and there’s so many different programs are to sort of what’s what. So just to clarify, if I may, the DrPH program is one program. However, we actually do have specializations at the school that students may choose to take on top of the DrPH. So what I mean by that is, we’ve had we have a specialization in indigenous health, we have one in global health, which I direct women’s health, addictions. And these are Penn University collaborative specializations. Also community development, so depending on the student’s needs, or public policy, so there are opportunities for students to come out with a DrPH, and also a specialization in one of those topics. Those opportunities are already available to our PhD and master students, in many cases, if I speak about the global health one, and so I think that allows students to still go through the common training path for the DrPH program. But if they so choose, this is optional, of course, they can get some greater depth and exposure to courses, usually through their electives, because these add ons do not require a longer time at the school. They’ve been developed to ensure that they integrate with existing Masters or PhD program.

Sujani 24:19
Okay, so that makes sense. And typically, if someone was going into this full time, how many courses per semester are they expected to take?

Erica 24:30
So the first year is sort of- sort of what we call three and a half, half credits, and an applied research project. So in the fall, that would typically translate into three half courses. Those are usually core courses, you know, some public health research, but more applied. Another course that we’ve put on the docket is a historical, ethical and philosophical for both foundations of public health, and contemporary approaches to population health and health equity, these are very foundational. And then in the next term, this is where students will have the opportunity to select from a menu of research courses that really align with, with their applied research interests. So, you know, unlike, you know, traditional PhD programs, we haven’t pre determined which methods courses students should take. So if they’re more aligned to qualitative research, or if they want to do mixed methods or more of a quantitative course, we have a number of methods courses at the school. And so that I think will be up to them. We will also ask students to take a critical appraisal and use of evidence course, higher leading high performing health systems, which really sort of speaks to the leadership, competency. And we’ve designed a brand new course on global health policy, which I’ll be offering with a colleague, Suzanne Skipsea, who’s at our Scarborough campus. And that will be online. And that’s actually something I wanted to mention, before the pandemic hit, we had already started to design this program with the idea that some people may be working part time, and so wanted to at least offer some courses online. So that would be an example of one, the critical appraisal one would be another. And then of course, it depends on electives they’d choose. So hopefully that gives you sort of a sense of the first year, if you will. And I don’t know if you want me to continue and describe sort of the rest of the program at this point, or if that helps answer your question.

Sujani 26:51
I think that’s not a bad idea to maybe even mentioned some just very different courses that you’re thinking people would be interested in hearing. I mean, like, I think you’ve covered all of the competencies that’s mentioned on the website. Maybe the education and workforce development one is especially interesting.

Erica 27:09
Yeah, I’m glad you mentioned that, because I think one of the design considerations for this program was to look at the Council of Education for public health domains and competencies, and it’s called C for short. And it’s the accrediting body for schools and programs in public health. So we took into account what they have developed, based on years of experience working with schools of public health, who already offer DrPH programs. And so some of the courses I’ve already mentioned, kind of fall into the data and analysis policy and program categories, touched on leadership management and governance. But another example of governance would be a new course on governance and financial leadership. And also a course on comparative health systems and policy, which would fall more in the policy and program sort of category. And in terms of other courses, they’re all- I would say, the education and workforce one sort of is woven through a number of courses, there is not necessarily a standalone unless someone chooses to take a specific course on that. And then we have a number of courses that will use case studies in health policy where I would say, you know, workforce issues would come up, for example, in the courses, so those are- that gives, hopefully, your listeners a flavor of the kinds of courses that would be required. And then students would also have the opportunity to take a couple of electives as well, that may fit more within their substantive content area, if they’re very interested in mental health or whatever. I think there’s some flexibility there in terms of the electives that they can take.

Sujani 28:57
I think- I think that gives a really nice overview of what the program is and what they can expect. And so I guess, naturally traveling from application to the program, and then once an individual graduates from the program, I thought, you know, talking about what life would look like after that Doctor of Public Health, we touched on it a little bit when we were distinguishing between a PhD and a Doctor of Public Health and, you know, geared towards individuals interested in those senior leadership roles. But maybe from what you’ve seen, and I’m sure you have colleagues in internationally WHO may have taken like the Doctor of Public Health route, what sort of opportunities are we looking at once they graduate from a doctorate public health programs?

Erica 29:45
Yeah, I mean, if I may just back up a minute to say how we’re going to set them up for that kind of courses in the orientation of the program. A couple of features which are part of PhD programs, so this is still a PhD, is that the kind of comprehensive exam that we’re thinking we would require students will actually help them apply theory and methods to a field oriented challenge, which is a bit different from traditional PhDs that you know, that test comprehensively knowledge of theories or knowledge of methods or both. So that’s, I think, an example of how we’re, we’re trying to simulate, if you will, real world conditions. So you have these, this methodological or theoretical knowledge, how do you actually practically apply it to a real challenge. Another feature of the program is an applied research project, which, you know, it’s not too dissimilar for those listening, and who have gone through an MPH like a practicum kind of idea. But that applied research project really feeds directly into their thesis, so it’s not going to be disconnected. And the thesis itself, of course, is going to be driven by an applied practice problem, or policy problem. And what I, you know, I’m very excited about in terms of the thesis is, in addition to the scholarly work that a student would produce, they would actually also develop alongside a leadership and implementation plan, which really would be around saying, okay, I’ve generated this knowledge in response to the supplied problem. How does that problem get moved into practice? So it really emphasizes, I think, mastery in knowledge, translation skills, but also developing recommendations with a change orientation. And so that requires, I think, a strong connection to practice into policy, which leads me to your actual question. Sorry, for the lead up, but I just thought I wanted to kind of back up to say how we’re sort of setting someone up. It I think, helps them to maintain strong connections to a practice or policy setting, which could turn into a new job opportunity. I think it also helps to sensitize students to what opportunities look like with the kinds of new skills that they are developing through a program like this. And some and, and it varies, I think it depending on the student, but some students who have, who may enroll in the program next year, have said, you know, it may actually give me a new opportunity within my own organization, or actually give me what I need to pivot and completely change careers. And so I think, you know, there are lots of lots of opportunities for- for students. And I think by having those strong connections with practice, and policy settings, helps to set them up for that kind of success.

Sujani 32:56
For sure. And I guess, like one of the questions that’s been running in my head, just thinking about how the MPH program has evolved in Canada over the past 10 years, I think, when I enrolled in it, probably almost 10 years ago, there wasn’t as many programs and now we have a lot more opportunities. And when you look at job descriptions, sometimes the- the minimum requirement is an MPH. So one of the questions we had was do you first see kind of that shift where senior leadership positions, they’re going to have a preference for a doctor or public health degree? Or do you see that shift happening anytime soon?

Erica 33:40
Yeah, I think it’s too soon to say I mean, it’s a really good question. But I would I would say that, you know, it’s a discussion that we’ve had with other DrPH program leaders and other countries about monitoring where your grads go, see what kind of rolls they’re getting. And, you know, at the end of the day, I- It kind of reminds me of discussions we were having at that task group I mentioned at the beginning of our discussion, where, you know, on the one hand, you know, credential creep. Be actually a highly problematic in that, you know, it- it puts more onus on the individuals to have that higher learning. And so it’s really about, you know, what do we want our public health systems to look like, who’s best served to be in which roles, which roles weren’t, that kind of expertise. And so to me, that’s very important questions that an academic institution should not answer alone, but really, it’d be discussing with key leaders in the health system. I mean, I’ll have to say that one of the things that we really, really worked hard at in developing this program was to make sure that we had the input and support from key health system leaders ranging from the Ontario Hospital Association to local public health organizations, etc, to get their input on this. And so, you know, I think many of them were very interested, you know, being the first program in Canada, I think gives us a really privileged opportunity. But it is something that we have to continue to work at and monitor to make sure that a program like this also responds to needs the practices actually given its orientation to practice.

Sujani 35:35
Yeah, absolutely. And yeah, I wasn’t expecting that all the answers were

Erica 35:40
No, no. But I mean, to me, it’s a it’s a great question. And it’s, you know, a great monitoring, you know-

Sujani 35:46
Yeah.

Erica 35:47
Evaluation question putting on my evaluation. It’s, it really is key. And, you know, I think some of the, the opportunities that, that people in this program might get is also in terms of how they think about hiring in the future, and what their roles might be in, given the potential leadership functions leaving holes.

Sujani 36:14
Yeah, I think what I liked, especially the perspective that you provided, kind of what kind of senior leaders do we want to see in our country? And how do we want to make sure we we set up the right foundation for that. And I think that’s an ongoing conversation and happy that it’s happening with all levels of public health kind of organization. So that’s good.

Erica 36:35
Yeah. And I think it speaks to your important question about diversity as well. So diversity in terms of different lived experiences, but diversity and disciplines?

Sujani 36:46
Yeah.

Erica 36:46
You know, I think just really thinking holistically about what we mean by diversity in the kind of leaders that we have in the health system, the gender balance, I mean, they’re another ethnoracial considerations, we have a lot of work to do in this country. You know, and we’re not alone. And so I think, you know, keeping our eye on that ball is really, really important. In, you know, in further developing a program like this, and ensuring that it stays in tune with those needs of the system, right, but more broadly, some of the major commitments that that we are making to do better, right, in terms of improving equitable access to opportunities for our- for Canadians, and for the, as you said earlier around the population, right, that reflects our demographics.

Sujani 37:47
Yeah. And I guess, sticking with the theme of not having all of the answers, I thought maybe we could shift gears a little bit and just want to say right off the bat, that you may not have all the answers to some of the questions around the tuition and costs. So I just want to say thank you for willing to even tackle them with me here. But it’ll kind of, I guess, give you a sense of what individuals were thinking. So to recap, I mean, the tuition is estimated to be at about 25 to $30,000 per year, kind of taking it to that 100,000, $220,000, potentially a little bit higher, if you add the incidental administrative fees. And this is for domestic students. And then for international students, of course, that increases a little bit. So I think there was a little bit about how individuals could get some support there. So whether that’s talking to their employers about subsidizing tuition costs, or scholarships and award opportunities, which I guess could be discussed upon acceptance. So maybe we could start with the employer. One, could you maybe tell us a bit about those options for- especially for individuals who have never heard about that option? Maybe at their work? How they could approach a conversation like this with their employer?

Erica 39:09
Yeah, well, first of all, I just want to acknowledge that, you know, it’s a- it’s a very important question. And, you know, part of the reason just in case, your listeners are not aware that, that there are different tuition rates, depending on the type of program and because this is a professional program, you know, is tuition is higher, and, you know, those are sort of more, you know, guidelines that- that, that academic institutions owe. I’m not trying to excuse it, but it is the reality because of the type of program we’re talking about, first of all, and in terms of approaching employers, and certainly we’ve had informal discussions with you know, prospective students, you know, part of that can come in, you know, couple of ways. We’ve certainly seen that with other even more expensive programs like MBAs where students do get either time in lieu but they don’t use their status within their organization, they could actually be working still at an organization, but maybe work on a project not directly in their unit as part as their thesis. So there’s, you know, a return on the investment that the employer might be making in their tuition to the organization itself. So I think there are these kinds of options. We are very committed and have had discussions with our advancement already about this. This program’s very much on their radar, about identifying scholarship and award opportunities for those who would be in financial need of that. And of course, we need to demonstrate that. And so that’s actually being worked on. I just can’t give you specifics at the moment. And so I think those are some of the ways in which I think students can or prospective students can think about tuition as well.

Sujani 41:06
And I know it says that scholarships and award opportunities could be discussed upon acceptance. So would you recommend that if someone’s interested, fully qualified, and maybe funding might be a problem, they still go ahead and apply and then work to find opportunities to support the funding?

Erica 41:26
Yeah, I mean, I think if you- if you don’t, if you don’t put your toe in the water, you won’t be concerned. Right? So I think, yes, it is, otherwise you- you wouldn’t be considered at all. And you know, you still have to go through an admissions process and review process. So I would encourage students to at least consider it and certainly have discussions with her employers about this to see what kind of support might be possible as one option, for sure. And but yes, because it’s a brand new program, we just weren’t, we’re providing information and keeping the website up to date as much as we can. And, you know, we’ve just actually updated our FAQs just in the last few days to provide more details about the application process. And the deadline for that. So, you know, in the first year, there are these, you know, first that we have to post, we’re doing our best to do that. You know, our hope is that, that perhaps donors and others who really feel this is an important gap that we’re filling with this kind of program will also help to step up and support some of our students. So as I said, we’re doing our level best make sure that the- there are scholarship and award opportunities for those who need them.

Sujani 42:49
No, that’s good to hear. Maybe just a couple more questions around the funding or funding, I guess, have there been any discussions on the international student front and whether there could be support from those coming from low income countries, perhaps?

Erica 43:06
I think some of the similar considerations would apply, in some cases, what is possible, and of course, it really depends on the region of the world, where students are coming from, where they actually are able to apply for funding from, you know, a funding body within their own organization that is actually trying to or sorta country, I meant to say, that is trying to facilitate exchanges. You know, U of T prides itself as being a global university. And so I think there are, there are definitely many considerations of international students support as well. So I think it’s part of the same kind of dialogue as well, that, that we are considering we are, you know, it’s hard to say, you know, in the first year of implementation, how much interest we will have from international students. I mean, judging from the many inquiries that I have gotten, we certainly had quite a number from and so, you know, it’s- it remains to be seen, you know, of the 10 we do accept roughly how many may be international students. And I think with COVID, and the uncertainty surrounding it, that may be in the short term, a hindrance, right for some to applt. But, you know, it’s only the first year. So the future opportunities.

Sujani 44:40
Yeah, certainly lots of first to consider. And I guess the other question was around, you know, obviously, a lot of individuals might try to stay- with stay, kind of, I guess, employed during their doctorate public health program and reading some of the FAQs, I think there’s a little bit about how to go about the part time course load route. But I think the- the confusing part for a few people that submitted the questions was, why there was a need to still pay the full time fee. And I think it’s worded in such a way that you could take the part time course load, but the full time fees would still apply. I don’t know if you can shine some light on that.

Erica 45:26
Yeah. I’m a little reluctant to go down that path, just partly because I don’t want to say the wrong thing.

Sujani 45:33
Yeah, no.

Erica 45:34
Memory serves for even if you are doing a PhD, and a degree- higher degree, part time, in the first few years, you still have to pay full time fees. That’s not our stipulation as a school, but I believe that’s a School of Graduate Study sort of stipulation university wide. And so, you know, it would be the same for other programs. But that’s the- thank you for raising that we can certainly have another look at that FAQ and try to clarify it a little bit more. What we’re trying to do is to give people the flexibility to continue to work part time many of our students work part time as well, even when they are enrolled full time.

Sujani 46:18
Yeah.

Erica 46:19
And the program can be completed in four years, you know, if you follow a fairly tight timeline, but it could take up to six years. So I think it really will depend on the individual.

Sujani 46:34
Okay. Yeah, I think if there’s a bit of clarity around that, maybe even on the website, as- as your team unravels those questions that will be helpful for a lot of them.

Erica 46:45
Okay, thank you for that.

Sujani 46:47
Okay, so just shifting gears a little bit, you know, up until this year, individuals in Canada who are interested in going down this Doctor of Public Health route, they would have had to look elsewhere, whether that’s the US or internationally, and then those looking for a doctor public health program from another country, they wouldn’t even have had Canada as an option. So now that we do have an option to consider Canada, which is, in my opinion, great. Are you able to comment on how the University of Toronto’s program compares to other programs and why someone should consider or give more of intention to the University of Toronto’s program, if you will, as one of their top choices? Maybe comment on similarities or differences to other programs in the world?

Erica 47:35
Yeah, it’s a great question. I mean, I should mention to your listeners that in developing the program, at U of T, we reviewed about a dozen doctors of Public Health at other universities, primarily in the US, and also the DrPH at the London School of Hygiene and Tropical Medicine also had a chance to visit with them and learn about their program. And I would say just going back to what I originally mentioned, which were the four domains that are in the Council of Education for public health, we use that as the overarching arc to then develop courses, or propose core courses for this program. So there are similarities in terms of the types of courses of course, every university has their own kind of imprint, and, you know, faculty put their own spin on how material is taught. And so but I would say that some of the foundational competencies and skills do align with many of those other programs that we looked at, including, you know, Hopkins ball, Boston, there’s one at UNC Chapel Hill, Harvard, I already mentioned the one in London, etc, just to look at what they were doing. We also looked at sort of the paths that they put students on. Some of the other programs do offer specializations, which may be where you got that question from, we made a deliberate decision that at this stage, it was premature. And in fact, we saw this as an opportunity to unify, you know, what tends to still get siloed, which is public health and the rest of the healthcare system. And so by bringing the strengths of both the public health sciences and HP together, under this overarching program, it allowed us to offer one program offering that- that offers, you know, courses in more public health meaning public health in the preventive sense, which was it and upstream sense versus more healthcare downstream sort of content and- and so that exposes students to both if we had done specializations, I think we might have created more cycles. We just didn’t feel we that was right for us. So that was a decision we made. Over time we may end up having specializations, but we chose not to go that route. But that would be a difference compared to I think John Hopkins University will be an example, where they’ve had some specializations in certain areas. But we made that choice, I think the other difference clearly is partly because of who we are, as an institution, and also the country we sit in. And I would argue that our attention to equity is first and foremost, very important in all of our programming. And not to say that other programs don’t do that. But that’s certainly something we’ve taken into account over time, you know, and indigenous content as well, which would, you know, not necessarily be as present in other programs. And I think, you know, bottom line, our health care system, and how it differs from most of the schools we compared ourselves to are actually in the US. And we know that things happen very differently there. So I think how we talk about health systems, within the Canadian context, certainly would be a difference. But we also, as I mentioned, have a course on comparative health systems. And so this would still give students an opportunity to think about our system in relation to others.

Erica 51:25
So yeah, I mean, I think I could go on a bit. But you know, those are some of the we certainly looked at their programs, we looked at the kinds of courses, how they mapped onto those four domains, you know, data analysis, education, and workforce development, policies and programs, and governance and management, made sure we had offerings in all of those areas. But you know, there’s going to be some diversity based on the kinds of courses we we’re not going to create, you know, all new courses, either for this program that just wasn’t on the table, or realistic or reasonable. But I think through this program development, we did, it did lead to the creation of five new courses, as well, and there are still others to come. Because I think that’s the exciting thing is that this program is also galvanizing the interest of our faculty. And so one example of that would be a course, really looking at sort of advocacy, policy and government relations. So some of those kinds of skills that you tend to learn on the job, right?

Sujani 52:34
Yeah.

Erica 52:35
But how, what might that look like, you know, if you were taught some of the, the considerations that go into depositions, and how do you advance a policy issue and advocate for change, and, and the like, so there’s actually a course under development that sort of would fit that category of topic. So I think that’s, that’s also the exciting, I think opportunity that a program like this offers.

Sujani 53:04
And I did to assume that, you know, the context also helps. What I mean by that is, if you’re looking for a senior leadership position in Canada, learning from a Canadian institution, and where the examples all come from a Canadian setting would be helpful. And let alone having a cohort of peers that are also from Canada. I think you build that network, you could pick up the phone and chat with an old colleague or old classmate once- once you’re in those senior leadership positions. I think that also goes a long way.

Erica 53:38
Yeah, absolutely. And but you know, at the same time, it will also I think, be an opportunity for some students who are coming from other countries to learn about our system, and vice versa, students to learn about systems in the- in their home countries. And given you know, the diaspora that that is in Toronto, and across the country, I think there’s just so much lived experience that needs to be capitalized on and brought into meaningfully into the classroom. And so, for example, the use of case studies, the interactive nature of some of these forces that will be taught, I think, will be a key part of the learning, right.

Sujani 54:25
So I thought maybe, you know, I could go on and ask you a lot more questions, but maybe we could, we could wrap it up for this episode. And if we hear from our listeners a few more questions, we could maybe arrange for something else. But, you know, it’s been an interesting year, to say the least. And I think when it’s time for public health to shine, it often means that there’s something not so great going on in the world. And obviously, things will look very different when we come out of this pandemic in all aspects of our life, but specifically for public health professionals. I just I’d like to hear your thoughts. And hear your perspective on what you foresee as the future of public health in terms of education and the workforce, here in Canada, but also globally?

Erica 55:12
Yeah, that’s a great question. I think, you know, we’ve had so many flashpoints in the past, where have we, you know, the public became aware of what essentially is an invisible system. Because when it’s working, or not confronted by, you know, shocks,

Sujani 55:34
Yeah.

Erica 55:35
Pandemics, like the one we’re in, it is really taken for granted. And so what I really hope for first and foremost, is for a renewal of public health and actual investment in public health system. And part of that also then means investment in its workforce. And I know, that’s old news. Many, many reports that we can refer back to and chronicle, and many recommendations yet to be delivered on, that we can’t afford not to act on anymore. So when we return back to whatever new normal looks like, I really hope that we don’t lose sight of how stretched our public health systems were in the phase of this pandemic, and that we truly invest in prevention. Yeah and so to me, that- that is, like foundational, or anything else. Secondly, I think there’s a great opportunity to continue to strengthen linkages between academic institutions and actors in the public health system, you know, to varying degrees, we do this, you know, well, or not so well, but there’s always areas for improvement. And so this, to me is another area where we could really be, you know, excelling further, both in terms of what kind of evidence the system needs, you know, if institutions like academic institutions pride themselves at, you know, implementing, or delivering on research that matters to practice, you know, a program like the one we’ve been talking about is, I think, well positioned to do that, but not uniquely but, certainly can help to contribute to that. So I think having continued stronger ties and cooperation between academia and practice, and policy settings will hopefully also help to move the needle in the right direction.

Sujani 57:52
Now, thank you, thank you for sharing that. And I really hope that, you know, this is a pandemic that is shown a lot of non public health folks, the importance of public health, and something that we’ve never seen in our time. So I’m really hoping some of these reports kind of resurface, and we can push real change in this current, I guess, situation.

Erica 58:16
Yeah, I’m sure you’ve also had this total. Now I finally get what you do.

Sujani 58:22
Yeah, exactly.

Erica 58:25
But I think, you know, we’re, I mean, it’s, it’s bigger than public health. But I think, if I may just also add that the other really fundamental issues that public health cares about, which is really addressing the social determinants of health and health equity and the inequities that continue to persist, that were already there, and were not necessarily- they were not caused by the pandemic, but further surfaced.

Sujani 58:55
Yeah.

Erica 58:57
You know, I think if public health is doing its job, well, it’s also paying attention to the needs of vulnerable groups. And, really, we need to be paying more attention to that. And so that is actually bigger than public health, that’s really a health and all policy agenda. And that requires, you know, leadership of public health, working with other sectors outside of health to really influence you know, our social protection systems, income security, access for people who care for children, you know, we still don’t really have a solid daycare policy in this country. You know, Quebec is probably the exception where they’ve certainly, you know, have some some effort afoot. And also, you know, how we’re caring for older people and in our society, so, you know, I think we, there’s still a lot of work to do and robust, well funded, expertly trained and supported and led public health system is a cornerstone of addressing some of those upstream determinants. It’s not the only cornerstone, but it’s a key point.

Sujani 1:00:16
I hope you enjoyed that episode with Erica and felt like you had answers to some questions that you weren’t able to find online. And I also encourage you to send any additional questions you may be having a hard time finding answers to. We will do our best to find answers to these and encourage them to be added to the FAQ section of the U of T website. And we’ll also have all of the links and information mentioned in today’s episode over at pH spot.ca/podcast. So check that out. And before you leave, I wanted to let you know about a challenge that we’re having at PH SPOT. It’s the six day infographic planning challenge. So if you’ve ever wanted to try your hand at developing public health infographics, but just didn’t know whether you even had anything worth developing an infographic for, this is the challenge you need to join. Because by the end of the six days, you will have not only selected a product to work on, but you will essentially have completed the planning phase of your first infographic. So if this sounds interesting, or if any bit of it intrigued you head over to pH spot.ca/infographics. For more info and to join and until next time, thank you so much for tuning in to PH SPOTlight, and for the invaluable work that you do for this world.

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About the Show

PH SPOTlight: Public health career stories, inspiration, and guidance from current-day public health heroes

On the show, Sujani sits down with public health heroes of our time to share career stories, inspiration, and guidance for building public health careers. From time to time, she also has conversations with friends of public health – individuals who are not public health professionals, but their advice and guidance are equally important.

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