Elective in Health Policy by Edward Maile, Academic Foundation Doctor, Oxford University Clinical Academic Graduate School

I have been interested in health policy, public health and medical leadership since the start of medical school and this interest deepened after reading books by Atul Gawande (www.gawande.com), a surgeon and public health researcher. I felt that discussion of population-level approaches to healthcare delivery was lacking during my undergraduate degree. This is understandable in the context of an intensive course where producing safe junior doctors who can interact effectively with individual patients is the priority. With this in mind, when presented with the blank canvas that is the elective period it represented a golden opportunity to find out more about public health.





Harvard School of Public Health is one of the world-leading centres for public health. Therefore I set about emailing doctors there and eventually, with the help of Diagnosis' Dr. Emma Stanton, arranged a placement. This was a fantastic experience. I worked as part of a multidisciplinary team whose focus was to analyse health services and provision of care which exposed me to core disciplines of public health such as epidemiology and biostatistics. My role was to collect data on recent US health policy changes and to work with statisticians and physicians on analysis and interpretation. Additionally, I spent time with a cardiologist which provided front line context for my experience of public health. The facilities in Boston are hugely impressive but exist in a system which, like many others, faces challenges of equity of access to health services.





A particular personal highlight was the opportunity to attend seminars and conferences dealing with public health, policy, leadership and management. Speakers included Elliot Fisher, a key thinker behind the concept of Accountable Care Organisations which are an important feature of the Affordable Care Act. I also heard Gary Gottlieb speak, President and CEO of Partners which is one of the leading non-profit healthcare systems in the USA, as well as Lucian Leape, a pioneer and international leader of the patient safety movement and Joseph Newhouse, a distinguished health economist. I was able to visit the Institute for Healthcare Improvement (www.ihi.org) in Cambridge to learn about Quality Improvement (QI) and the IHI Open School which offers online courses in QI including a practicum element which walks learners through their own QI project.





There were many learning points which I took back to the UK. It was particularly interesting to observe the strong culture of medically-qualified leadership in the US, in contrast to the UK where many managers and CEOs don't have a clinical background. This led me to consider how I might develop my own management skills. I also noted a strong "can-do" attitude in the US, where no challenge is too large. I intend to retain this sentiment as I begin life as a doctor. My interests in public health, policy and medical leadership are still coalescing but I left HSPH feeling inspired, motivated and determined to learn more. I would highly recommend visiting HSPH to anyone that has the opportunity.