Student Perspectives From a COVID-19 Epicenter: Bridging Educational Training and Public Health Practice

Our impetus for returning to school after years in the workforce was to improve public health by improving ourselves. We chose to pursue the practice-oriented doctorate of public health (DrPH) degree because we knew that understanding theory does not necessarily translate into effective practice.¹ Technical expertise alone, although important, cannot move public health sufficiently forward without effective leadership, communication, organization, and management skills. Therefore, our goal in returning to academia was to bridge the gap in our experience between theory and practice.

Returning to the classroom allowed us to reflect on past failures and successes in public health practice. We sought to learn how to holistically manage public health issues, as linear solutions to complex problems often do not suffice.² We learned the importance of thinking about the entirety of health systems, what the role of effective leadership is, and the essentialness of collaboration in public health.

Then the worst pandemic of modern times unfolded in front of our eyes. Following the World Health Organization’s declaration of coronavirus disease 2019 (COVID-19) as a public health emergency of international concern in March 2020,³ our university made expedient and drastic changes to our learning environment. In a matter of days, our in-person classes stopped. We witnessed a complete paradigm shift in our social interactions. Our vibrant city streets emptied seemingly overnight, leaving an eerie silence for those of us who stayed behind. Abruptly, our otherwise highly social educational pathway turned into a distant and lonely journey, with no assurance of seeing our colleagues again. Although quality coursework is vital, it is the people that we learn with and from that make an education like ours worthwhile.

In the former COVID-19 epicenter, New York City, we desperately tried to keep our education intact while making split-second decisions about whether to leave the city before states or nations closed their borders, how to best support family and friends, and how to simultaneously retain our professions. Many of us became directly involved with the COVID-19 response, investing our personal, professional, and academic efforts into providing clinical services and supporting clinical research; engaging in epidemiological and contact-tracing efforts; assisting with food distribution; and coordinating donations of personal protective equipment.

OUR VISION AND VIEWPOINTS

COVID-19’s abrupt and devastating impact on our lives shed light on the essential characteristics of a successful public health practitioner: the ability to adapt to sudden changes, the skills to manage uncertainty, and the resilience to meet high demands. COVID-19 brought academia to its knees. Machinery usually slow to turn its wheels, many academic institutions adapted usually rigid in-classroom structures to dynamic online learning environments in a matter of days. We wonder, must we wait for a crisis to emphasize the importance of flexibility and creativity in our training, or can we steer our education toward more adaptable practice without a crisis?

The speed at which COVID-19 infections spread globally highlighted the uncomfortable fact that public health issues are ruthless—they seldom affect people equally—and interventions can seem controversial. Public health issues also illustrate that no one is immune to clinical or socioeconomic consequences, not even world-renowned virologists or aspiring doctors of public health.⁴

With the firsthand experience of enduring and responding to the pandemic in one of the world’s former epicenters, we offer our vision for and perspectives on the future of public health. Our vision is that public health education will emphasize interdisciplinary practice so that on completion of degree programs, public health practitioners will be better equipped to translate public health theory into effective practice by applying clear communication, efficient management, and intentional strategies, allowing adaptive leadership and the execution required for addressing dynamic public health issues.

STRENGTHEN OUR PUBLIC HEALTH WORKFORCE

We have been in a public health workforce crisis for quite some time. In 2008, the Association of Schools and Programs of Public Health predicted a shortfall of a quarter million people in the public health workforce.⁵ COVID-19 validated this. Not only do we need more people, but our educational training needs an overhaul. During this pandemic, we witnessed numerous departures of public health officials. As we contemplate the requirements for these roles, we ask ourselves the following: How can our educational training better serve the public’s health needs?⁶ How can we enhance our skills to more efficiently work with peers and other non–public health stakeholders? How do we more effectively voice evidence-based opinions in volatile geopolitical contexts? How can we piece together the fragmented public health system? COVID-19 has demonstrated that public health practitioners require, in addition to discipline-specific schooling, concrete training in systems thinking, dynamic settings, political decision-making processes, business management, communications, and strategy.

INTERDISCIPLINARY COMMUNICATION AND LEADERSHIP

The challenges of the COVID-19 response highlight the importance of interdisciplinary practice. Obstacles prevent universities from teaching students to become highly integrated, communicative, and collaborative public health practitioners. While providing rigorous training in discipline-specific methodology, institutions should identify and make available basic toolkits for individuals to be more successful in practice.

As public health leaders, we must be versatile and adaptable. We must improve our communication with policymakers and at all levels of practice: the public, the media, and the business community. We need high-quality opportunities to train alongside experts in different professions to learn how to tackle interdisciplinary problems earlier in our careers. We must learn to think reflexively. Together, we will go beyond learning lessons to adequately acting on them.

REMEMBER WHO WE ARE SERVING

There remains an artificial divide between the public health community and the people we intend to serve. COVID-19 has disproportionately affected many, in our city and around the world, who were already facing public health and socioeconomic challenges. We should not take significant fear and stigma associated with public health measures lightly.⁷ We need our academic training to include teaching us to better understand, assist, and, most importantly, collaborate with those we are trying to serve. We need guidance earlier in our careers on how to conduct more empathic and effective outreach. We must become active listeners and better at receiving feedback from our communities so that we can achieve more robust integration of our public health and academic efforts into the larger society. Without these criteria, we will not sufficiently reach the people we intend to serve.

THE FUTURE OF PUBLIC HEALTH

Although we are frustrated with the many missed opportunities to effectively curtail this global public health crisis, we remain committed to our careers, and we are inspired to take this as an opportunity to grow as individuals and to improve public health as our field of study. Our ability to adapt to sudden changes, skills to manage uncertainty, and resilience to meet high demands are intimately linked to our training. We believe that public health organizations can address these qualities by strengthening educational practices tied to preparing our workforce, practicing interdisciplinary communication and leadership, and working alongside our communities.

COVID-19 has pushed our academic and professional training to its limits. Most importantly, it has reminded us that our knowledge of public health is only as good as our ability to apply it.