Training Future Public Health Physicians

When Dr. Lloyd Douglas considered a career in medicine, public health was not on his radar. After training as general practitioner at the University of the West Indies in Jamaica, he knew that he wanted to focus on something broader than individual patients.  

“The idea of population health and doing work to promote and protect health at the population level was quite appealing,” he says. Today, Dr. Douglas works as a Public Health Physician seconded from the Thunder Bay District Health Unit to the Sioux Lookout First Nations Health Authority.  

As a public health physician, he works with organizations and communities to develop a public health system for the Sioux Lookout area First Nations. Dr. Douglas provides public health education and contributes to health promotion, emergency preparedness, public health surveillance and more. A typical day may include work on all or none of the above.  

Having completed his residency in Public Health and Preventive Medicine (PHPM) at NOSM University in 2021, Dr. Douglas says the program prepared him for some of the realities of working as a public health professional serving First Nations communities and organizations. 

PHPM is a five-year residency program that includes “direct patient care, graduate studies, and training in population-level care at public health agencies,” says Dr. Emily Groot,  Program Director. Focusing on disease prevention and health promotion at the population level, PHPM specialists support equitable health outcomes for all members of society.  

In addition to technical expertise in public health, Dr. Douglas says that having soft skills and knowledge about building relationships are critical to the work of public health physicians. He is working with the program to incorporate more applied training opportunities for residents. “Residency should be a true apprenticeship,” says Dr. Douglas.   

He has first-hand experience of this through his work with First Nations and remote Northern communities. “It’s about understanding the complexities of the population that lives in two worlds and being an ally,” Dr. Douglas says. “Every resident at NOSM University should spend some time in the Far North. That’s the best way to learn.”    

PHPM residents train across Northern Ontario and outside the region to get a broad range of experiences. With just 10 residents, the small program provides a tight-knit learning community with two streams: a PHPM-Family Medicine stream in Sudbury and a PHPM stream in Sault Ste. Marie. This provides residents with a variety of experiences and learning opportunities.  

Dr. Lyall Pacey is a third-year PHPM resident currently based in Thunder Bay. He also serves as the chief resident for the PHPM program. “Part of why I chose NOSM University was the opportunity for clinical training,” he says.  

“I wanted to work where my clinical and public health training could converge and have some rural and remote perspectives. NOSM University gave me one of the best opportunities for that.” He has trained in Sioux Lookout, Moose Factory, James Bay and other remote and fly-in communities and describes these experiences as the best part of the program.  

“The training I’ve enjoyed the most has been our experiential learning experiences,” he added.” Touring mines, meeting occupational medicine physicians, and simulated emergency management training have provided invaluable learning.  

The NOSM U PHPM program also supports scholarly work in public health. Recently, NOSM University residents Dr. Oscar Pico Espinosa won the CAME Rising Star Certificate of Excellence award and Dr. Kasunka Kankanam Gamage received a 2024 NAPCRG Distinguished Trainee Research Award.   

PHPM is a dynamic and continually changing specialty as it involves working with multiple aspects of the medical profession. “You might provide direct patient care while also working on health policy. One day, you might be managing an outbreak, and the next you might work on a report summarizing health issues in your region. You interact with a broad range of other public health professionals like epidemiologists, public health nurses, public health inspectors, data analysts, health promoters, and policy analysts,” Dr. Groot says.  

Individuals with an interest in the specialty are encouraged to connect with Medical Officers of Health and other PHPM specialists. Actively seeking out insights and information from these professionals will provide valuable knowledge and a deeper understanding of the field. 

Dr. Douglas encourages people to be true to themselves overall. “Understand what type of medicine you want to practise. Understand the challenges that you are going to face, the type of life involved and see if it is a fit,” he suggests.  

Learn more about the PHPM program on the NOSM University website.