As federal officials determine when and how to reopen the country, numerous public health experts fear that the United States is significantly short of the public health workers needed to mitigate another occurrence and properly perform contract tracing.
On April 8, 2020 JAMA published an editorial co-authored by Dr. Josh Sharfstein and Dr. Howard Bauchner proposing a public health response to the COVID-19 pandemic by electively suspending medical education for the medical students of the class of 2024 and implementing a National Service Program for interdisciplinary graduate students.
Dr. Jamar Slocum, on behalf of the Beyond Flexner Alliance, recently sat down with Dr. Josh Sharfstein, to discuss his recent editorial and its impact on medical education. Dr. Sharfstein is the current Vice Dean for Public Health Practice and Community Engagement for the Bloomberg School of Public Health and Director of the Bloomberg American Health Initiative. He previously served as Principal Deputy Commissioner of the U.S. Food and Drug Administration, Commissioner of Health for Baltimore City, and health policy advisor for Congressman Henry A. Waxman.
This discussion has been edited for length and clarity.
Can you tell me a little about how some of the ideas in this paper originated?
It has become increasingly obvious that we are going to need a very strong public health response to the coronavirus pandemic. It is not enough to just slowly reopen society. Dr. Bauchner reached out to me because he was thinking where are we going to find these people? So we decided to write about a National Service Program that could serve a really important function with the outbreak. We didn’t write solely about medical students,and there could be other students involved. The bolder idea is to not have an incoming class of medical students and offer all of the medical students a chance to join the National Service Program. This would get you about 20,000 people if they all signed up.
Thus far, you have assembled an impactful career in all facets of public health. Why focus on the student workforce during this pandemic?
All the time I work with a lot of great medical, nursing, and public health students. They are incredibly motivated, enthusiastic, and may have the ability to spend a year doing something that could influence their careers over the long term. In addition, it could be very impactful for our country in the short term.
Do you think that this type of program could continue even after the COVID pandemic?
I think a National Service Program for Public Health can be a great thing. People can get involved from different disciplines and backgrounds. We have vast needs in the field of public health and healthcare. We don’t have the workforce needed. I think it will be great for the work that they can do, but it will also open people’s eyes. As a result, I think you will end up with better doctors. Ultimately, you will have doctors who understand the complexities of health and wellness.
As you know, the Beyond Flexner Alliance is a national movement committed to transforming health professions education to achieve a more just and equitable health care system for all. Do you think there is a role for educating students with a health equity lens?
Absolutely, I think to do this kind of public health work well, you need to have an appreciation of health equity. What produces health? What underlines health? It is very important during the COVID-19 pandemic because you cannot tell someone to isolate if they are homeless or live in a crowded apartment. You have to be able to address the underlying problem.
What advice would you give aspiring health professionals that want to get involved with public health prior to graduate school?
Even if what we proposed does not come to pass, there will be many new opportunities in public health as a result of the COVID-19 pandemic. In various directions, states across the country will hire more people. Some people may think of this as a year off, but I think of it as taking a year to do something exciting and interesting while saving lives.
Read the JAMA article by Dr. Sharfstein and Dr. Bauchner, “A Bold Response to the COVID-19 Pandemic Medical Students, National Service, and Public Health” here.
Dr. Jamar Slocum