Development of a Draft Set of MOH Competencies

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Development of a Draft Setof MOH Competencies

• Brent W. Moloughney MD, MSc, FRCPC
• Public Health Consultant
• December 6, 2007

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Session Overview

• Project background, purpose, and approach
• Draft roles and responsibilities
• Draft set of competencies
• Implications for recruitment and professional
  development
• Next steps

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Project Background

• Post-SARS, significant interest in public health
  workforce development
• Pan-Canadian Public Health Human Resource
  Framework (2005)
• Series of building blocks
• Competencies-based approach

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Definitions Concepts

• Competencies
• set of knowledge, skills and attitudes
  demonstrated by organizational or system members
  that are critical to the effective and efficient
  function of an organization or system
• Different types
• Core those common across disciplines
• Non-core/technical not common across disciplines
• Discipline-specific set of competencies
  possessed by a particular discipline group
  (combination of core and technical with expected
  breadth and depth)

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Why the Interest in Competencies?

• Identify the set of knowledge and skills required
  across an organization or program
• Provide a rational basis for curriculum
  development
• Provide a rational basis for assessing training
  needs of the current workforce
• Provide consistency in the development of job
  descriptions and performance assessment
• Assist describing the nature of public health

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Competency-Related Work To-Date

• Started with core competencies
• Several disciplines moving forward with defining
  their core competencies
• PHNs, PHIs, epis, health promoters (note MPHs in
  other countries)
• Likely see program/role competency sets next
• Leadership/management
• CD control
• Emergency preparedness, etc.

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Why MOH Competencies

• Current MOHs employed with wide range of
  backgrounds FRCPC, MPH, nil
• Significant number of vacancies
• Pragmatic questions in the field
• How CMOH/College assess MOH applicant without
  specialty training?
• Experienced GP wants to be MOH what training
  path should s/he follow?
• What competency areas typically need to be
  developed over time for new grads (FRCPC, MPH)?
• How do we approach CPD requirements for MOHs?

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Project Purpose and Scope

• Develop a draft set of competencies for MOHs that
  would be applicable to MOH positions across the
  country
• Note
• MOHs employed by govtal system and position
  recognized in legislation
• Exclude roles not uniform across jurisdictions
  (e.g. CEO)

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Project Structure

• PHAC providing financial support
• Ad hoc working group
• Chair Hilary Robinson (PHAC)
• Mix of MOHs from across country
• BWM project consultant

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Questions About Project Background?
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Process

• Two main options
• Start with RCPSC training requirements do line
  by line review. But,
• Community medicine training intended to be
  broader than just MOH career path
• Potential for watering down exercise
• On what basis make decisions?
• Identify common roles and responsibilities for
  MOHs and then identify related competencies

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Legislation
Compilation of MOH Roles
Position Descriptions
Create categories
List of Roles - - - - - - - - - - - - - - - -

• Existing
• Competency Sets
• Core
• MPH
• Specialist (non-CND)

Select/Match
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Roles and Responsibilities

• Legislation narrow and often dated
• Position descriptions retrieved from across
  country and much richer info source
• Roles responsibilities describe the position,
  competencies are the knowledge and skills to
  fulfil them
• Grouped common themes
• Added narrative description

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Competency Statements

• Started with core competencies
• Issues of breadth and depth
• Worked with MPH competencies (mainly Australian)
• Sought specific items from specialty-focussed
  areas ACPM, UK (multiple)
• While need to focus on individual statements, the
  whole set is important.

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Example

• To deal with a population-based health issue
• Assess and prioritize needs
• Identify and apply relevant evidence
• Make a decision identify a course of action
• Utilize appropriate communication
• Collaboration and perhaps advocacy
• Strategic/team leadership
• Project manage
• Perhaps identify relevant research questions
• Decision-making in a public health ethical
  framework

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Questions About Approach?
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Current Draft Set

• 12 current categories/domains (50 statements)
• Monitoring assessing health of the public
• Public health consultant
• Communication
• Advocacy for the publics health
• Collaboration
• Investigating and mitigating immediate risks to
  human health
• Policy, planning and program development
• Leadership
• Management
• Applied public health research
• Professional
• Educator

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Current Status

• Working group currently discussing 2nd draft of
  the statements
• Have not yet addressed number and order of
  domains

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Preliminary Analysis

• Comparison with RCPSC training requirements
• Impression that RCPCS often expecting greater
  breadth and depth
• MOH competencies appear to be expecting more
  highly developed K/S for identification of
  community health needs, leadership, and political
  context
• Application of statements?
• statements appear to be useful for intended uses
  for assessing candidates, identifying gaps in K/S
  and CPD

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Questions

• Recognizing that this is still a
  work-in-progress,
• Are the role/responsibility descriptions
  accurate?
• Do the competency statements appear to capture
  the key knowledge and skills required for a MOH?
• Does it look like they will be helpful in
  assessing candidates, reviewing training paths,
  CPD?

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Implications Next Steps

• Issues around preparation
• Unrealistic that MD without formal training will
  likely possess these competencies
• MPH alone unlikely to provide all of these
  competencies
• FRCPC is a strong foundation, but still need to
  develop additional competencies
• Given the above, entry-to-practice solo
  practitioner structures are a questionable model

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Next Future Steps

• Next
• Increase awareness among MOHs regarding this
  project
• Consultation process
• Future
• Analysis regarding implications
• Address variable MOH roles
• Region-wide system analysis
• CEO role

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Questions

• How best to get the word out that this work is
  happening?
• How best to conduct consultations across the
  country?
• Distribute by e-mail
• Web-based survey
• Focus groups
• Other