MD-MPH Program Offers ‘Broader Picture’

Tuesday, July 1, 2014

By Jane Erikson

The College of Medicine – Tucson’s MD-MPH program marked a milestone in May when it awarded its 50th MD-MPH degree. The recipient: Alex Perry, a Glendale native who this month will begin his residency in internal medicine, with plans to focus on infectious disease, at Oregon Health & Science University.

“I actually was hesitant to do the MPH,” says Perry, who earned his bachelor’s and master’s degrees in bioengineering from Arizona State, before starting medical school. “It means an extra year of school and an extra year of debt. But by the second half of my MPH year, I realized this is one of the best things I’ve ever done.

“I feel I’m better trained to practice medicine, and that’s really what I want – to be the most competent doctor I can be.”

Now in its 15th year, the UA MD-MPH program began as one of 12 in the country; now there are about 75.

The increased interest coincides with the realization that focusing only on individuals is not a cost-effective way to treat disease.

“A doctor can take a bigger view of things and say, ‘I’m seeing one diabetic patient after another. Instead of just trying to control their diabetes, perhaps I can start a nutrition program or begin an exercise program to prevent diabetes from developing in the first place,’” says Hal Strich, associate director of the MD-MPH program.

“Our program gives students a set of skills they can draw on to help them be leaders in health care, and design effective programs to prevent disease in the communities they serve.”

MD-MPH students take one public health course each semester of their first two years of med school. Their third year includes a public health internship on a project of their design. They then complete their final two years of medical school.

Perry focused his internship on the Shubitz Clinic, a College of Medicine CUP (Commitment to Underserved People) free clinic where he volunteered to care for refugees and other low-income patients. He and fellow med student Joe West, who graduated with separate MD and MPH degrees in 2013, renewed the clinic’s participation in the federal Vaccines for Children program. Perry recalls when the costly HPV vaccine became available, and “we could immunize children at no cost to the families.”

Perry and West also implemented an electronic medical records system for the clinic, to streamline documentation in medical records. Perry additionally conducted a chart review on more than 400 patients who made about 1,600 clinic visits in seven years. The result was a massive spreadsheet full of important data on the patients’ age, country of origin, diagnoses, treatment – and whether it worked - and so on.

Lane Johnson, MD, MPH, got his public health degree at Berkeley before he enrolled in the College of Medicine Class of 1983. Now professor of Family and Community Medicine and director of the MD-MPH program, Johnson notes the variety of students’ internship projects. “They include a domestic violence prevention program; a program to evaluate a new emergency center in Nogales, Sonora; a cultural competency program at the College of Medicine; a cough clinic for TB screening in a rural community in Nicaragua; an evaluation of primary care clinics in Afghanistan, and others,” Johnson says.

In 2009, Siri Gardner, MD-MPH, Class of 2012, spent four months living and working next to a 40-acre garbage dump in Guatemala City. The dump is a source of income for impoverished families who dig through the garbage for scrap metal and other materials they can sell.

Gardner was there as a volunteer with Safe Passage/Camino Seguro, a non-profit based in Maine that provides education, medical care and other services to help Guatemala City families out of poverty. Her mission was to create a sustainable health education program for children and families.

“It was intense and wonderful,” Gardner says. “The poverty was more extreme than I could comprehend, even after witnessing it. The most striking thing I learned is that people’s similarities far outweigh their differences, and that even those living in extreme poverty seek the same things in life that I do – beauty, love, friendship, color, pleasure, purpose – just as soon as their most basic needs are met.”

Gardner, now halfway through her four-year ob-gyn residency at UCSF, will spend part of her third year in Uganda – her first time as a doctor in a developing country. After her residency, she plans to practice general ob-gyn in the U.S., but spend some time overseas each year. “I would like to have some focus on women’s health policy and advocacy. And I often return to the idea of volunteering in Guatemala.”

Photo: Siri Gardner and Guatemala City Student