Community health programs in Canada

In view of the Walkerton calamity, the anthrax scare in the United States and the threat of chemical and biological warfare, I think we should look again at the education of physicians in the specialty of community (public) health.

When I joined the Toronto School of Hygiene in 1956 the program covered 10 subjects: chemistry in relation to hygiene and sanitation, epidemiology and biometrics, hospital administration, hygiene and preventive medicine, viral infections, experimental cytology, parasitology, physiological hygiene, public health administration and public health nutrition. At the time, the Diploma in Public Health program in microbiology was the best in the country.

When the Master of Health Sciences degree was established at the University of Toronto in 1979, training in microbiology disappeared. I submit that this was a mistake. Physicians who specialize in public health should be well acquainted with all agents of disease, be they biological, chemical, social or environmental. They should know about the effects of war, famine and natural disasters. Public health is not merely an exercise in statistics and administration.

The skeleton of a school of public health exists at the University of Toronto. A somewhat more complete program in public health is available at McGill University, which has departments of epidemiology and biostatistics, occupational health, human genetics, microbiology and immunology, nutrition and food, and social studies in medicine, a Centre for Studies in Aging, a Centre for Host Resistance and a Centre for Tropical Diseases. In Canada there is nothing like the Harvard School of Public Health or the London School of Hygiene and Tropical Medicine.

We need a broadly based graduate program in community health jointly supported by academe and the Royal College of Physicians and Surgeons of Canada. Schools of graduate studies favour rather narrowly focused master's level programs, but that will not work for the specialization in question.