The doctor of public health (DrPH) degree is currently receiving a resurgence of attention in schools of public health (SPHs), including the establishment of new degrees and the revision of existing degrees. In an effort to increase understanding of the degree, the Association of Schools of Public Health (ASPH) conducted studies in 1993 and 1999. In 2003, the DrPH degree was a topic of the 2003 ASPH Associate Deans' Retreat. Following a preconference survey, the associate deans were divided into breakout groups to discuss and make conclusions addressing four areas of interest to the DrPH degree: (1) general issues, demand, and accreditation; (2) program admission criteria; (3) didactic course content; and (4) field experience, examination, and capstone/dissertation requirements. The conclusions of these associate deans led to a series of general questions for further consideration in the evolution of the DrPH education and may offer guidance to the recently begun ASPH DrPH competency development project (available from: URL: http://www.asph.org/document.cfm?page=1004) as well as individual programs.
INTRODUCTION
Many accredited schools and colleges of public health award the DrPH degree as an advanced professional practice degree designed to prepare graduate students for careers as senior-level administrators, applied researchers, policy makers, and educators providing leadership to protect and improve the public's health. Palmer Beasley, the former dean of the University of Texas School of Public Health in Houston, Texas, identified the DrPH as the defining characteristic of SPHs.1 However, these DrPH degree programs vary widely with regard to mission, admissions criteria (including prior degrees and prerequisite coursework), curriculum requirements, generalist vs. specialist orientation, program length, required fieldwork, culminating requirements such as dissertations and capstone projects, and competencies. There is not even consistency in the abbreviation for the degree, with different SPHs using Dr.P.H., DrPH, and DPH abbreviations for their degrees. (For the purposes of this article, we are using the abbreviation DrPH.) With the growth in the number of currently accredited and developing SPHs awarding the degree, as well as universities without SPHs exploring the degree, a greater understanding of the degree's history, application, and plans for the future is warranted.
As a means to introduce the DrPH degree education, this article describes the DrPH programs in the home institutions of the article's four authors.
The George Washington University School of Public Health and Health Services, Washington, D.C.
The DrPH degree is the terminal degree in the professional discipline of public health. Consistent with this advanced professional orientation, the DrPH program will prepare future public health leaders to apply critical thinking and rigorous research methods to the complex, practical problems facing practitioners and policy makers in public health practice. The DrPH program is designed to both follow and promote the principles of academic public health practice.2
The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
The DrPH degree is a school-wide, advanced professional degree program designed for the student who has a master of public health (MPH) degree or its equivalent and who intends to pursue a leadership career as a public health professional. The mission of the DrPH program is to prepare graduates to advance the public's health through the integration and application of a broad range of knowledge and analytical skills in leadership, practice, policy analysis, program management, and professional communication, coupled with preparation in a specific discipline of public health. The DrPH program prepares graduates to apply these skills and methods within both academic and nonacademic settings, as well as in public-agency or private-sector settings that emphasize improving the health of the public.3
University of Illinois at Chicago School of Public Health, Chicago, Illinois
The DrPH degree is a professional degree conferred in recognition of a candidate's command of a comprehensive body of knowledge in the field of public health and the candidate's proven ability to initiate, organize, and pursue the investigation and resolution of significant problems in public health practice. The DrPH curriculum is designed to prepare public health leaders by ensuring expertise in the conceptual foundations of public health, research methods, leadership and communication skills, and a substantive area of specialization. Students are eligible for conferral of the DrPH degree upon demonstrating mastery of the DrPH competencies through a combination of coursework, independent study, prior experience, and completion of a thesis project.4
University of Kentucky College of Public Health, Lexington, Kentucky
The DrPH degree is an advanced professional practice degree designed to prepare students as senior-level administrators and policy makers, providing leadership to protect and improve the health of the public. The DrPH is the highest degree attainable for the public health practitioner. While public health comprises many clinical and professional disciplines, it has a unique focus on entire populations rather than individual patients. Utilizing a multidisciplinary approach, the DrPH professional program will provide broad knowledge of five public health disciplines (biostatistics, environmental health, epidemiology, health services management, and health behavior) along with focused knowledge in the student's area of interest.5
Commonalities and differences
Common characteristics of the descriptions of these four degree programs include practice, leadership, and application of broad generalist public health knowledge. Inclusion of descriptions from other SPHs would demonstrate many variations such as DrPH degrees in individual disciplines rather than a single school-wide generalist degree, opportunities to blend general public health with a core disciplinary concentration, degrees with a specific focus in an area such as leadership outside of the traditional core disciplines, variation in field experience and culminating (dissertation/capstone) degree requirements, and degrees with varying similarities and differences when compared with doctor of philosophy (PhD) curricula awarded in the same school. In addition, a trend appears to be developing in which the degree is now being offered in universities without accredited SPHs.
BACKGROUND OF THE DrPH DEGREE
The DrPH degree was first established in 1919 by the American Public Health Association Committee of Sixteen on the Standardization of Public Health Training. Consistent with the institutional mission, some U.S. SPHs award the doctor of science or PhD degrees in addition or as an alternative to the DrPH degree. Typically, the DrPH degree may be categorized in the cohort of professional degrees including the doctor of education, doctor of social work, doctor of business administration, and doctor of psychology degrees. Differentiation of these professional degrees from the PhD is based upon three characteristics of professional education: (1) an underlying discipline or basic science component upon which the practice rests or from which it developed, (2) an applied science or “engineering component” from which many of the day-to-day diagnostic procedures and solutions are derived, and (3) a skills and attitudinal component that concerns the actual performance of services to the client, using the underlying basic and applied knowledge.6 Peterson distinguished this relationship in psychology, differentiating the demands of researchers from practitioners.7
Professor Milton Roemer wrote extensively about the DrPH degree, describing the degree as offering an extensive battery of courses based on the body of professional public health knowledge and integrated with extensive supervised field experience as part of the academic training linking theory with practice.8–13 Roemer proposed that didactic work address four fields of study: basic tools of social analysis, health and disease in populations, promotion of health and prevention of disease, and health-care systems and their management. Roemer stated that “the DrPH graduate is far better equipped for the sorely needed public health leadership in America and elsewhere in the world than the customary MD [doctor of medicine], MPH graduate.”14
A variety of factors have resulted in the growth of DrPH education. In recent years, there has been growing attention to public health issues in the U.S. and rapid growth in the number of ASPH-member SPHs. In addition, in 2005 the Council on Education in Public Health revised its accreditation criteria for SPHs, requiring a school to increase the previous expectation of one doctoral degree to “at least three doctoral degree programs that are relevant to any of the five areas of basic public health knowledge.”15 In 2007, ASPH Education Committee outgoing chair, Dean Stephen Shortell, and incoming chair, Dean John Finnegan, established a Task Force to study the DrPH, chaired by Dean James Raczynski. This followed two previous ASPH efforts addressing the DrPH education in 1993 and 1999. In 1993, Venezia developed a series of case reports describing each of the 18 existing DrPH degrees by objective; a series of governance, admissions, concentration, process, and enrollment characteristics; and a narrative analysis of DrPH programs.1 In 1999, Clark surveyed DrPH programs and summarized the state of DrPH education using four key points: (1) programs have diverse prerequisites and core requirements; (2) program length and academic credit differ substantially, as do areas of concentration; (3) in a review of 17 programs, 12 did not require field experience and the remaining five required fieldwork only in selected disciplines or for students with limited work experience; and (4) all schools required a DrPH dissertation (Unpublished data, Clark NM, ASPH, 1999).
ASPH ASSOCIATE DEANS' RETREAT
Reviewing the existing DrPH degree programs and the work of both Venezia1 and Clark (Unpublished data, Clark NM, ASPH, 1999), it is clear that over the past decade, there has been both growth and an evolution in the purpose and curricula of the DrPH degree. In view of the increasing attention to the DrPH degree, this topic was placed on the agenda for the 2003 ASPH Associate Deans' Retreat. In preparation for the retreat, academic affairs associate deans from various universities were surveyed about their DrPH programs. Among the noteworthy findings were four questions demonstrating the diversity of attitudes concerning DrPH programs (Table) (Unpublished data, Helsing KL, Clark NM, ASPH, 2004).
Table.
Pre-retreat survey questions and responses
DrPH = doctor of public health
CEPH = Council on Education in Public Health
SPH = school of public health
Following a presentation of descriptive information summarizing current DrPH programs and attitudinal results of the survey, the associate deans in attendance at the 2003 retreat were randomly divided into four breakout groups to address a set of questions concerning DrPH education and to present discussion results to the group as a whole. The questions and conclusions of each group are presented in Figures 1–4.
Figure 1.
Breakout Group I: DrPH general issues, demand, and accreditation
DrPH = doctor of public health
MPH = master of public health
SPH = school of public health
CEPH = Council on Education in Public Health
PhD = doctor of philosophy
ASPH = Association of Schools of Public Health
Figure 2.
Breakout Group II: DrPH program admission criteria
DrPH = doctor of public health
GRE = Graduate Record Examination
MPH = master of public health
SPH = school of public health
MHA = master of health administration
MSW = master of social work
MBA = master of business administration
Figure 3.
Breakout Group III: DrPH didactic course content
DrPH = doctor of public health
PhD = doctor of philosophy
MPH = master of public health
SPH = school of public health
Figure 4.
Breakout Group IV: DrPH field experience, examination, and capstone/dissertation requirements
DrPH = doctor of public health
PhD = doctor of philosophy
SPH = school of public health
CONCLUSIONS
It is reasonable to assume that, based upon their job responsibilities, the academic affairs associate deans of SPHs reflect expert opinion concerning DrPH education issues in their schools and the workforce. Based upon their workgroup responses, the associate deans generated the following general questions for further consideration in the evolution of DrPH education:
Why do SPHs think there is market demand for DrPH graduates?
Why do students, faculty, and employers view the DrPH as not being of equal rigor to other doctoral degrees in public health?
Why do DrPH applicants select the DrPH over other doctoral degrees?
Do/should the same faculty members teach in the DrPH degree program and other doctoral degree programs offered?
If there are SPH faculty members who hold the DrPH degree, are they typically on a traditional tenure track equivalent to faculty members who hold a PhD degree?
Why have schools not offering the DrPH chosen this strategy?
If development of a DrPH degree is under consideration at an SPH, what are the reasons for this deliberation?
In addition, a series of unanswered questions relevant to those schools currently offering the DrPH degree were developed:
What are the reasons this degree was selected?
Is the DrPH awarded as a degree in the university's graduate school, as a professional degree such as medicine, or in another format?
If tuition or other benefits such as assistantships and research funding are different from other doctoral degrees in your SPH or university, what are the differences and what is the impact?
Is the DrPH degree offered as a school-wide or disciplinary curriculum, and what are the strategies for this decision?
Should DrPH programs demonstrate the same national consistency in curriculum demonstrated by other professional degrees such as medicine or dentistry?
In summary, the DrPH degree is an advanced, practice-oriented, professional degree with wide variation in purpose and structure in individual SPHs. In addition to improving understanding of the DrPH degree, the discussions of the associate deans created a number of new questions for consideration related to the degree. The establishment of a new ASPH Education Committee DrPH Task Force creates an opportunity to explore the DrPH degree and address issues presented in this article.
REFERENCES
- 1.Venezia RA. An analysis of DrPH degree programs in the United States. Washington: Association of Schools of Public Health; 1993. [Google Scholar]
- 2.The George Washington University School of Public Health and Health Services. Doctor of public health: general information. [cited 2007 Mar 7]. Available from: URL: http://www.gwumc.edu/sphhs/academicprograms/programs/doctor_public_health/DrPH_General_Overview.pdf.
- 3.Johns Hopkins Bloomberg School of Public Health. About the DrPH. [cited 2007 Mar 7]. Available from: URL: http://www.jhsph.edu/academics/degreeprograms/drph/about.
- 4.University of Illinois at Chicago School of Public Health. Student handbook: doctor of public health (DrPH) learning objectives. [cited 2007 Mar 7]. Available from: URL: http://www.uic.edu/sph/shandbook_drphgeneral.htm#drph.
- 5.University of Kentucky College of Public Health. Doctor of public health student handbook. [cited 2007 Mar 7]. Available from: URL: http://www.ukcph.org/Portals/0/DoctorofPublicHealth/Dr.P.HStudentHandbook.pdf.
- 6.Schein EH, Kommers DW. Professional education: some new directions. New York: McGraw Hill; 1972. [Google Scholar]
- 7.Peterson DR. Need for the doctor of psychology degree in professional psychology. American Psychologist. 1976;31:792–8. [Google Scholar]
- 8.Roemer MI. Schools of public health and their future role. A review. Public Health Rep. 1977;92:407–10. [PMC free article] [PubMed] [Google Scholar]
- 9.Roemer MI. More schools of public health: a worldwide need. Int J Health Serv. 1984;14:491–503. doi: 10.2190/XV3N-WFR0-H249-EBTV. [DOI] [PubMed] [Google Scholar]
- 10.Roemer MI. The need for professional doctors of public health. Public Health Rep. 1986;101:21–9. [PMC free article] [PubMed] [Google Scholar]
- 11.Roemer MI. Preparing public health leaders for the 1990s. Public Health Rep. 1988;103:443–52. [PMC free article] [PubMed] [Google Scholar]
- 12.Roemer MI. Higher education for public health leadership. Int J Health Serv. 1993;23:387–400. doi: 10.2190/P3K6-2NQJ-3CLG-ATB8. [DOI] [PubMed] [Google Scholar]
- 13.Roemer MI. Genuine professional doctor of public health the world needs. Image J Nurs Sch. 1999;31:43–4. doi: 10.1111/j.1547-5069.1999.tb00419.x. [DOI] [PubMed] [Google Scholar]
- 14.Carpenter DO, Conway JB. Optimizing professional education in public health. J Public Health Manag Pract. 1996;2:66–72. doi: 10.1097/00124784-199623000-00018. [DOI] [PubMed] [Google Scholar]
- 15.Council on Education in Public Health. Schools of public health accreditation criteria—amended June 2005. [cited 2007 Mar 7]. Available from: URL: http://ceph.org/i4a/pages/index.cfm?pageid=3350.