Epidemiology and the new public health; implications for training

It is currently believed that epidemiology should play a much greater part in the research and practice of public health medicine. Although epidemiology has much to offer in this field, the nature of the scientific method is often in conflict with the pragmatic and incremental responses of public health medicine, particularly at the district level. This should not prevent the development of collaborative work in public health practice, but it does require some re-orientation of attitudes, and there are implications for training. It is suggested that the training of public health epidemiologists should be based in academic departments and have two major components, (a) an ongoing programme of scientific study in the academic environment, and (b) involvement in a range of collaborative service projects which will also provide general experience of public health medicine. This arrangement should help to maintain the scientific skills and judgement of the public health epidemiologist when faced with the need to modify traditional methods of investigation.