A Review of the Status of the Doctor of Public Health Dr.P.H. Degree

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A Review of the Status of the Doctor of Public
Health (Dr.P.H.) Degree Joel M. Lee, Dr.P.H.,
Associate Director for Academic Affairs,
University of Kentucky SPH, Sylvia Furner,
Ph.D., Associate Dean, University of Illinois
SPH, James Yager, Ph.D., Senior Associate Dean
for Academic Affairs, Johns Hopkins University
Bloomberg SPH, and Dan Hoffman, Ph.D.,
Associate Dean, George Washington University SPH
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The Dr.P.H. degree was first established in 1919
by the American Public Health Association
Committee of Sixteen on the Standardization of
Public Health Training. The Council on
Education in Public Health (CEPH) criteria for
accreditation of schools of public health require
award of the MPH degree and at least one
doctoral degree which is relevant to one of the
five specified areas of basic public health
knowledge. Consistent with the
institutional mission, some U.S. schools of
public health award the Doctor of Science (Sc.D.)
or Doctor of Philosophy (Ph.D.) degrees in
addition to, or as an alternative to the Dr.P.H.
degree.
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In addressing education, the IOM report Who Will
Keep the Public Healthy? (Institute of Medicine,
2003) states the basic public health degree is
the master of public health (M.P.H.), while the
doctor of public health (Dr.P.H.) is offered for
advanced training in public health leadership.
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Milton Roemer was the acknowledged authority on
public health doctoral education and the author
of numerous papers on this topic. Through a
series of published papers Dr. Roemer advocated
the professional Dr.P.H. setting it apart from
clinical and Ph.D. degrees, enhancing his model
curriculum, and advocating its adoption in SPHs.
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Peterson (1976) distinguished this relationship
offering the Ph.D. and Psy.D. degrees in
psychology differentiating the demands of
researchers from practitioners. Fottler
(1999), notes that the employers of doctoral
graduates are often dissatisfied as graduates do
not have the knowledge, skills, and abilities
required to further their missions and goals, and
with minor variations duplicate the types of
programs most of their faculty were trained in
(full-time, research oriented, highly
specialized, with limited integration of
knowledge).
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• Previous ASPH Education Committee studies
  addressing the Dr.P.H. degree
• Venizia (1993)
• 1.) A series of case reports describing each of
  the 18 existing Dr.P.H. degrees by objective, and
  a series of governance, admissions,
  concentration, process and enrollment
  characteristics, and 2). A narrative analysis of
  Dr.P.H. programs
• Clark (1999)
• Programs have diverse prerequisites and core
  requirements
• Program length and academic credit differ
  substantially, as do areas of concentration
• 12 of 17 did not require field experience, and
  the remaining 5 required it in selected
  disciplines or for students with limit work
  experience
• All schools required a Dr.P.H. Dissertation

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In view of the increasing attention to the
Dr.P.H. degree, the topic was placed on the
agenda for the 2003 Association of Schools of
Public Health Associate Deans Retreat.
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If you have seen one Dr.P.H. Program You have
seen one Dr.P.H. Program
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Dr.P.H. Session Break Out Group Questions
Group I Is there a need for a professional
doctoral degree in public health? 1. How does
the Dr.P.H. graduate differ from the MPH
graduate? 2. How does the Dr.P.H. differ from
other public health doctoral degrees? 3. Who are
the ideal candidates for the Dr.P.H. degree
program? 4. What is the demand for Dr.P.H.
Education                 a. by students?
                b. by employers? 5. How will
demand change in the future? 6. What do Dr.P.H.
graduates do upon graduation? a. What is the
market for Dr.P.H. graduates? b. What are
appropriate career paths for Dr.P.H. graduates?
7. It has been suggested that the Dr.P.H. is the
defining characteristic of an accredited school
of public health. a. Do you agree?  Why/Why not?
b. Should CEPH accreditation criteria require
all SPHs to offer a professional doctoral degree?
Why/Why not?
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Group I Summary Dr.P.H. students should have
a higher level of work experience than the
traditional Ph.D. student should.  Appropriate
applicants might include both graduates of
schools of public health and non-SPH masters
degree graduates.
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Applicants might include those working in the
insurance industry corporate settings, and health
administration as well as people employed in
traditional public health settings.  Students
might include working professionals attending on
a part-time basis, recent MPH graduates, as well
as baccalaureate and certificate graduates in
public health.  International students should
also be included.
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The Dr.P.H. is faculty driven, student driven,
and employer driven.  Demand will vary with the
interests of each of the three groups and is
subject to the push and pull of the market.  
Multiple groups including the students and
their employers generate demand for the degree. 
SPH faculty also influence future demand for
the degree as do expectations for increased
knowledge by the public health workforce,
credentialing, global demand, and the complexity
of public health problems.
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Awarding of the Dr.P.H. degree should be mission
driven and the award of the degree should not be
a requirement for either CEPH accreditation or
ASPH membership.  However, ASPH does have a
role in defining the Dr.P.H.  CEPH and ASPH
should take an active role to control/prevent the
creation of Dr.P.H. degrees in programs other
than schools of public health.
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Group II Program admission criteria 1. Is
there a standardized test (GRE) for admission,
and how do you interpret results for the Dr.P.H.
applicant? 2. Should there be work experience
requirements? 3. Is there specific prerequisite
coursework? 4. Should an earned MPH degree be a
requirement for the Dr.P.H. degree?  If not, what
other masters degrees are acceptable? 5. Is it
possible for a public health worker with a
baccalaureate degree to bypass masters degree
education and pursue the Dr.P.H? 6. Other
admission criteria?
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Group II Summary The group asked, if
different doctoral degrees should have different
admissions criteria from other degrees in a
school of public health?  The criteria for
admission to a Dr.P.H. program should include a
preference for an earned MPH however, an
alternate practice based degree such as the MHA,
MSW, MBA would be acceptable with the requirement
that a student complete the MPH core curriculum.
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• Prior public health employment is desired. 
• Grade point average should be considered in
  admissions, although the grade point average was
  not specified. 
• Applicants should also earn an unspecified score
  on a standardized examination also unspecified if
  the applicant has not earned a prior masters
  degree. 
• In addition, all applicants should submit a
  letter of goals and future intent. 
• Reference letters including at least one letter
  from a public health practitioner should be
  required. 
• An interview should also be required of each
  applicant however, it is unclear about how to
  address this for international applicants.

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• The Group also presented three questions for
  future consideration
• What percentage of school of public health
  faculty should have earned a Dr.P.H. degree?
• 2. If the current faculty of schools of public
  health do not have the Dr.P.H. degree, are they
  the appropriate faculty to offer Dr.P.H.
  education to others?
• 3. What is the objective of Dr.P.H. education?

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Group III What is the didactic course content
for a Dr.P.H.? 1. Are there educational
competencies unique to the Dr.P.H.? 2. What is
the balance between general and discipline
specific content? 3. Should there be leadership
and management content in all Dr.P.H. tracks? 4.
Are there other specific courses that should be
required? 5. What is the depth of content in
each core area? For example, how much
quantitative content? 6. Is there a difference
between masters level and Dr.P.H. course work?
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Group III Summary The curriculum should span
the five core areas of public health, require
work experience relevant to the degree, and
address learning methods and context.  Doctoral
competency requires the need to discuss
scholarship not practice.  The Ph.D. represents
discovery.  The Dr.P.H. should represent an
advanced competency in public health
differentiating it from the MPH.
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Areas of competency include -leadership,
-communications skills, -decision-making
skills, -critical thinking skills,
-problem-solving abilities -advanced
quantification, -advanced management and
finance, and -policy development and
evaluation.  The Dr.P.H. curriculum should use
problem-based learning, theory, methods, case
studies, and evaluation skills.
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The degree should include a case study based
interdisciplinary orientation in a seminar
course.  The group observed that university
infrastructure is not geared to the Dr.P.H.  and
recommended actions for career development and
advancement of Dr.P.H. faculty members in schools
of public health.  They also stated that there
is a need to look at problem-based learning in
other disciplines, assess the cost of doctoral
education, and a leadership/disciplinary skill
balance.
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Group IV  What are the field experience,
examination, and capstone/dissertation
requirements for the Dr.P.H.? 1. Should the
Dr.P.H. require a capstone/dissertation
requirement, or should it be more like clinical
professional degrees requiring practical
experience, or both? a. If a Capstone
project/dissertation, what should it look like?
How does it differ from a Ph.D. dissertation? b.
If practical experience, what should it look like
(activity, length)? c. If both, how do you
balance the activities? 2. Should there be
preliminary/qualifying and/or comprehensive
examinations?  If so, what should they look like?
3. Can prior work experience substitute for the
academic field experience(s)? Bonus question
Many health professions such as physical therapy
appear to be upgrading the entry-level credential
for practice from the masters level to the
doctoral degree.  Would it be appropriate to make
a doctoral degree the entry-level credential in
public health?
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Group IV Summary There should be a required
practicum that is flexible and not prescriptive. 
The practicum should be an opportunity to observe
the skills of a public health leader including
advocacy and leadership.  The practice activity
could include research.  Prior work experience
will not substitute for the required practicum.
A qualifying or comprehensive examination
should be required addressing core and specialty
area content.  The examination should be
scheduled before or during the practicum. 
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There should be a capstone requirement for the
Dr.P.H. however is should not be a Ph.D.
dissertation due to the difference in
curriculum.  The group recommended a portfolio of
work similar to the portfolio of work of a
graduate in architecture or art.  The portfolio
would address knowledge applicable to practice
and would be differentiated from the Ph.D.
Additional comments  A set of proposed
guidelines for Dr.P.H. education should be
developed to help SPH faculty understand the
Dr.P.H. Those in attendance believe that the
Dr.P.H. belongs in SPHs.  The Dr.P.H. should be
offered in SPHs that have a practice-based
orientation. An electronic bulletin board
should be established for further discussion of
the Dr.P.H.
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• Areas for Further Consideration
• Why do SPHs think there is market demand for
  Dr.P.H. graduates?
• Why do students, faculty, and employers view the
  Dr.P.H. as being of equal rigor to other doctoral
  degrees in public health?
• Why do Dr.P.H. applicants select the Dr.P.H. over
  other doctoral degrees?
• Does the same faculty teach in the Dr.P.H. and
  other doctoral degrees offered?
• If there is a separate Dr.P.H. faculty, are they
  typically on a traditional tenure track?
• Why have schools not offering the Dr.P.H. chosen
  to do so?
• If development of the Dr.P.H. degree under
  consideration, what are the reasons?

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• For schools offering the Dr.P.H. degree
• What are the reasons this degree was selected?
• Is the Dr.P.H. awarded as a degree in the
  Universitys Graduate School, as a professional
  degree such as Medicine, or in another format?
• If tuition or other benefits such as
  assistantships, research funding etc. are
  different from other doctoral degrees in your SPH
  or University? What are they, and what is the
  impact?
• Is the Dr.P.H. degree offered as a school wide
  curriculum?